Estimating the effect of help-seeking on achieving recovery from alcohol dependence
Estimating the effect of help-seeking on achieving recovery from alcohol dependence
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DOI：
10.1111/j.1360-0443.2006.01433.x
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发表时间：
2006-06-01
期刊：
影响因子：
6
通讯作者：
Chou, Patricia S.
中科院分区：
文献类型：
--
作者：
Dawson, Deborah A.;Grant, Bridget F.;Chou, Patricia S.
目的：研究求助对酒精依赖康复可能性的影响，特别是研究模型选择的影响，因素，缓和寻求帮助的效果和12步参与和正式治疗的效果之间的区别。方法这项分析是基于2001年第一波的数据-2002年全国酒精及相关疾病流行病学调查（NESARC），一项对18岁及以上美国成年人的全国代表性样本进行的横断面回顾性调查。分析样本包括4422个人与上年（PPY）发病的DSM-IV酒精dependence.Findings Logistic回归，比例风险和时间依赖的比例风险模型被用来估计的影响，寻求帮助的三个结果：（1）酒精依赖的任何恢复，要求完全缓解酒精滥用和依赖的所有症状，并排除酒精消费量超过低风险饮酒指南的无症状饮酒者;（2）非戒酒恢复（NR），代表低风险无症状饮酒者;和（3）禁欲恢复（AR），代表abstainers.Findings只有四分之一的个人与PPY发病酒精依赖曾经寻求帮助的酒精问题，包括3.1%的人参加了12步程序，5.4%的患者仅接受过正规治疗，17.0%的患者接受过12步治疗和正规治疗。根据最合适的模型，寻求帮助增加了任何恢复的可能性[风险率比（HRR）= 2.38]，NR（HRR = 1.50）和AR（HRR = 4.01）。寻求帮助对AR的影响在整个暴露期间没有显示出任何显着变化，但在其他因素中，严重程度有所改变。个人谁参加了12步程序，除了正式的治疗有几乎两倍的机会恢复和超过两倍的机会AR相比，那些谁收到正式treatmentals.Conclusions寻求帮助起着重要的作用，在实现戒酒恢复酒精依赖，12步参与发挥了重要作用。适当的模式选择对于评估求助的影响至关重要。
Aims To investigate the effect of help-seeking on the likelihood of recovery from Diagnostic and Statistical Manual version IV (DSM-IV) alcohol dependence, specifically examining the impact of model selection, factors that moderate the effect of help-seeking and distinctions between the effects of 12-Step participation and formal treatment.Methods This analysis is based on data from the Wave 1 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a cross-sectional, retrospective survey of a nationally representative sample of US adults 18 years of age and over. The analytical sample consisted of 4422 individuals with prior-to-past-year (PPY) onset of DSM-IV alcohol dependence.Findings Logistic regression, proportional hazards and time-dependent proportional hazards models were used to estimate the effects of help-seeking on three outcomes: (1) any recovery from alcohol dependence, which required full remission of all symptoms of alcohol abuse and dependence and excluded asymptomatic drinkers whose alcohol consumption exceeded low-risk drinking guidelines; (2) non-abstinent recovery (NR), representing low-risk asymptomatic drinkers; and (3) abstinent recovery (AR), representing abstainers.Findings Only one-quarter of individuals with PPY-onset alcohol dependence had ever sought help for alcohol problems, including 3.1% who had participated in 12-Step programs only, 5.4% who had received formal treatment only and 17.0% with both 12-Step and formal treatment. Based on the most appropriate model, help-seeking increased the likelihood of any recovery [hazard rate ratio (HRR) = 2.38], NR (HRR = 1.50) and AR (HRR = 4.01). The impact of help-seeking on AR did not show any significant variation across the exposure period but was modified by severity among other factors. Individuals who participated in 12-Step programs in addition to formal treatment had almost twice the chance of recovery and more than more than twice the chance of AR compared with those who received formal treatment alone.Conclusions Help-seeking plays a significant role in the achievement of abstinent recovery from alcohol dependence, with 12-Step participation playing a major role. Appropriate model selection is critical to assessing the impact of help-seeking.