Efficacy of an intensive outpatient rehabilitation program in alcoholism: Predictors of outcome 6 months after treatment
Efficacy of an intensive outpatient rehabilitation program in alcoholism: Predictors of outcome 6 months after treatment
复制标题
DOI：
10.1159/000085548
复制
发表时间：
2005-01-01
影响因子：
3.9
通讯作者：
Soyka, M
中科院分区：
文献类型：
--
作者：
Bottlender, M;Soyka, M
在过去的几十年里，酒精依赖患者的治疗主要集中在住院治疗。这些治疗方案的疗效已在多项研究中进行了评估，并被证明是足够的。然而，由于公共卫生系统的费用不断增加，人们对替代治疗策略提出了质疑。与此同时，越来越多的证据表明，门诊治疗可能比住院治疗更有效，至少对酒精依赖者来说是这样。在此背景下，本研究旨在评估103例酒精依赖患者的高结构门诊治疗方案的疗效。74例患者（72%）定期终止门诊治疗。在6个月的随访中，95%的患者被成功定位并亲自再次访问。分析显示，65例患者（64%）在6个月随访评价时禁欲，37例患者（36%）被判定为非禁欲。被发现对治疗后6个月结果有负面影响（非禁欲）的治疗前变量是酒精依赖的严重程度较高（通过酒精依赖的持续时间较长来测量）、既往治疗次数较多和酒精渴望较强（通过强迫性饮酒量表测量）。此外，贝克抑郁量表（抑郁）和状态-特质焦虑量表（焦虑）测量的精神病理学程度较高的患者复发更频繁。总之，本研究的结果表明，社会稳定的酒精依赖患者和抑郁，焦虑和渴望程度较低的患者在一个密集的门诊康复计划的有利结果。
Treatment of alcohol-dependent patients was primarily focused on inpatient settings in the past decades. The efficacy of these treatment programs has been evaluated in several studies and proven to be sufficient. However, with regard to the increasing costs in public healthcare systems, questions about alternative treatment strategies have been raised. Meanwhile, there is growing evidence that outpatient treatment might be comparably effective as inpatient treatment, at least for subgroups of alcohol dependents. On that background, the present study aimed to evaluate the efficacy of a high-structured outpatient treatment program in 103 alcohol-dependent patients. 74 patients (72%) terminated the outpatient treatment regularly. At 6 months' follow-up, 95% patients were successfully located and personally re-interviewed. Analyses revealed that 65 patients (64%) were abstinent at the 6-month follow-up evaluation and 37 patients ( 36%) were judged to be non-abstinent. Pretreatment variables which were found to have a negative impact (non-abstinence) on the 6-month outcome after treatment were a higher severity of alcohol dependence measured by a longer duration of alcohol dependence, a higher number of prior treatments and a stronger alcohol craving (measured by the Obsessive Compulsive Drinking Scale). Further patients with a higher degree of psychopathology measured by the Beck Depression Inventory (depression) and State-Trait Anxiety Inventory (anxiety) relapsed more often. In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program.