Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

Abstract

BackgroundRehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion.MethodsA total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity) at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncom-pleters for any reason.ResultsA total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be married but live separated.ConclusionRates of treatment noncompletion in inpatient and outpatient rehabilitation programs correspond to results from previous research. Noncompletion is a significant correlate of relapse 1 year after treatment, and noncompleters show an elevated level of psychopathology. These findings may help rehabilitation treatment facilities to tailor specific therapies for these individuals to reduce risk for treatment noncompletion.

Alkoholkonsumstörungen und Suizidalität: Ein narratives Review

“…Mehrere Studien deuten darauf hin, dass die positive Anamnese von Suizidversuchen bei Personen mit Alkoholkonsumstörungen auf ein erhöhtes Risiko für weitere Suizidalität hinweist. Darüber hinaus bedeuten Suizidversuche in der Vorgeschichte aber auch eine schlechtere Prognose und eine höhere Rückfallwahrschein lichkeit der Alkoholabhängigkeit [48]. Außerdem hängen sie mit einer signifikant höheren Rate komorbider psychischer Störungen zusammen [22,24], insbesondere affektiver Erkrankungen, Angst- [22], Persönlichkeits [49] und anderer Drogenkonsumstörungen [50].…”

Twelve-month Follow-up Results of Alcohol-Dependent Patients Followed by The Tidal Model

“…[22] Relapsı süre ve miktar belirtmeden alkol alımı olarak değerlendiren bir çalışmada yatarak tedavi sonrası relaps oranı %52.9, sürdürüm aşamasında olanların oranı %39.5 ve relaps sonrası bir aydır temiz olanların oranı ise %7.6 olarak belirtilmektedir. [23] Sürdürüm oranı için de literatürde farklı oranlar (%20-78) verilmektedir. [8,24,25] On iki aylık takip süresi içinde bireylerin alkol kullanımının depreşme oranı literatürle uyumlu olduğu söylenebilir.…”

Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up

“…Alcohol dependence is a major global public health problem which affects 5.1% of the global population and causes up to 3.3 million deaths per year, the majority of those being related to cardiovascular diseases [ 1 ]. Although integrative multimodal acute and rehabilitative treatment regimens have been widely established to reduce the disease burden related to alcohol dependence, malcompliance and low rates of adherence to treatment are frequently compromising success of these therapies [ 2 , 3 ]. Moreover, even after completion of rehabilitation relapse poses a major problem.…”