Impact of craving on alcohol relapse during, and 12 months following, outpatient treatment
Impact of craving on alcohol relapse during, and 12 months following, outpatient treatment
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DOI：
10.1093/alcalc/agh073
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发表时间：
2004-07-01
影响因子：
2.8
通讯作者：
Soyka, M
中科院分区：
文献类型：
--
作者：
Bottlender, M;Soyka, M
目的：本研究通过强迫渴求量表（OCDS） （Anton et al., 1995）调查戒断性酒精依赖患者的渴求与在强化门诊治疗计划期间和完成后的复发之间的关系。方法：在一项前瞻性研究中，参与者在门诊治疗项目开始、结束和项目结束后12个月接受采访。对渴望的测量采用Anton et al.（1995）和Kranzler et al.（1999）的三因素模型。强迫症在治疗开始时（当所有患者都戒断时）进行治疗，在治疗结束时对那些戒断并完成方案的患者进行治疗。结果：103例酒精依赖患者中，74例完成了治疗方案，在12个月的随访中，97%的患者重新接受了个人访谈。32例（31%）患者在治疗期间复发。与戒断患者相比，他们在强迫症总得分上的渴望程度明显更高，在“强迫”和“饮酒控制及后果”亚量表上的得分也明显更高。在74名完成该计划的患者中，16%的患者在接下来的12个月内出现了严重复发。重度复发由OCDS总分和“强迫症”分量表预测。结论：OCDS总分可预测门诊患者的复发。应加强对高渴望患者的治疗和术后护理。在我们的研究设计中，Kranzler et al.（1999）的三因素模型的子量表与强迫症总分相比只提供了很少的信息增益。
Aims: This study investigated the relationship between craving in abstinent alcohol-dependent patients measured by the Obsessive Compulsive Craving Scale (OCDS) (Anton et al., 1995) and relapse during and after completion of an intensive outpatient treatment programme. Methods: In a prospective study, participants were interviewed at entry to, and end of, an outpatient treatment programme, and 12 months after the end of the programme. To measuring craving the OCDS total score by Anton et al. (1995) and the three-factor model by Kranzler et al. (1999) were used. OCDS was administered at the beginning of treatment (when all patients were abstinent), and at the end of treatment in those who were abstinent and had completed the programme. Results: Of 103 alcohol-dependent patients, 74 completed the treatment programme and at follow-up after 12 months 97% of these patients were personally re-interviewed. Thirty-two patients (31%) relapsed during the treatment phase. They had significantly higher craving measured by the total OCDS score and a significantly higher score on the subscales 'obsessions' and 'drinking control and consequences' compared to abstinent patients. Of the 74 patients who completed the programme 16% had a major relapse in the next 12 months. Major relapse was predicted by the total OCDS score and the subscale 'obsessions'. Conclusions: OCDS total score predicts relapse in outpatient treatment. Treatment and aftercare of patients with high craving should be intensified. In our study design, the subscales of the three-factor model by Kranzler et al. (1999) provided only little information gain compared to the OCDS total score.