Psychological changes in alcohol-dependent patients during a residential rehabilitation program

Abstract

BackgroundAlcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive–affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse.Materials and methodsThe sample included 560 subjects (mean age 46.91±10.2 years) who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment – Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome evaluation of the residential intervention. Moreover, differences in the psychological functioning between patients with different characteristics were investigated.ResultsThe score measured by the Cognitive Behavioral Assessment – Outcome Evaluation showed significant improvements in all the psychological characteristics assessed, and the profile at discharge was within the normal scores. Some significant differences were found in relation to specific characteristics of the sample, such as age, sex, level of education, type of intervention, and polysubstance use.ConclusionThis study shows the changes in psychological profile in subjects undergoing residential rehabilitation from alcohol and how this profile may permit identification of subjects requiring more psychosocial support after discharge.

Motivation to change and posttreatment temptation to drink: a multicenter study among alcohol-dependent patients

“…Indeed, polysubstance abusers run the risk of developing an addiction to multiple substances and have an increased risk of developing serious physical and mental diseases. This is in line with a previous study among patients in a residential rehabilitation program, which showed that the polyabuser group scored higher in depression, anxiety, and psychological distress compared to the pure alcoholics group 6. Furthermore, a recent meta-analytic review of psychosocial interventions for substance use disorders found that treatments targeting polysubstance use were less effective and had the lowest percentage of posttreatment abstinence compared to other interventions for substance dependence 44.…”

“…These findings confirm previous research which showed a decrease in psychological distress during the early alcohol detoxification period 6,11,35,36. It is well known that addiction is associated with negative affectivity (eg, anxiety and depression) and that alcohol use in many cases can be considered as an avoidance coping strategy to escape from negative internal states and to reduce self-focused attention 10,24,37.…”

“…The treatment of alcohol addiction currently involves a wide variety of effective treatment options which can be performed either in an inpatient or outpatient setting, including medications (eg, disulfiram), cognitive behavioral therapy (CBT), motivational enhancement therapy, 12-step facilitation therapy, contingency management, relapse prevention therapy, and family therapy 6–8. During the last 20 years, there has been a growth in the number of short-term residential treatment facilities characterized by highly structured and short-duration treatments involving group therapy, individual therapy, and alcoholism educational programs designed to address the specific behavior of drinking 6,9.…”

Cognitive and metacognitive factors among alcohol-dependent patients during a residential rehabilitation program: a pilot study

“…4 The wide variety of current treatment options includes drugs (eg, disulfiram), cognitive behavioral therapy (CBT), motivational reinforcement techniques, 12-step facilitation therapy, coping skills’ management, relapse prevention therapy, and family therapy. 5 The inpatient rehabilitation 28-day program 6 used in this study was inspired by the American Minnesota Model, 7 Croatian psychiatry studies, 8 and German and Austrian “psychosomatic clinics”. 9 It consisted of a series of highly structured interventions involving group psychotherapy, individual therapy (CBT), alcohol-related risk education sessions, and group activities and group meetings with family members to manage the patient’s medical and psychological problems.…”

“…Previous studies have shown an overall reduction in anxious–depressive symptoms and a psychological improvement among alcoholics during the first weeks after detoxification. 6 , 10 , 11 However, some authors have found that the period after detoxification is at great risk of depressive symptoms and relapses and research is needed to examine factors associated with the maintenance of change and abstinence. 10 …”