The long‐term course of alcoholism, 5, 10 and 16 years after treatment

Mann, Karl; Schäfer, Dorothee R.; Längle, Gerhard; Ackermann, Klaus; Croissant, Bernhard

doi:10.1111/j.1360-0443.2005.01065.x

Cited by 87 publications

(65 citation statements)

References 28 publications

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“…Because prior research indicates that individuals who are lost to follow-up are generally more likely to have relapsed than individuals with follow-up data (Bottlender and Soyka, 2005;Mann et al, 2004;Mann et al, 2005), we re-ran the primary multivariate regression analyses with all missing data counted as relapsed. Thus, this analysis now included 154 cases, 64 of whom were classified as non-relapsed and 90 of whom were now classified as relapsed.…”

Section: Supplementary Analysesmentioning

confidence: 99%

Impulsive suicide attempts predict post-treatment relapse in alcohol-dependent patients

Wojnar

Ilgen

Jakubczyk

et al. 2008

Drug and Alcohol Dependence

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Background-The present study was designed to examine the influence of suicidality on relapse in alcohol-dependent patients. Specifically, a lifetime suicide attempt at baseline was used to predict relapse in the year after treatment. Also, the unique contribution of impulsive suicide attempts was examined.Methods-A total of 154 patients with alcohol dependence, consecutively admitted to four addiction treatment facilities in Warsaw, Poland participated in the study. Of the 154 eligible patients, 118 (76.6%) completed a standardized follow-up assessment at 12 months.Results-Previous suicide attempts were common in adults treated for alcohol dependence with 43% patients in the present sample reporting an attempt at some point during their lifetime. Additionally, more than 62% of those with a lifetime suicide attempt reported making an impulsive attempt. Lifetime suicide attempts were not associated with post-treatment relapse (chisquare=2.37, df=1, p=0.124). However, impulsive suicide attempts strongly predicted relapse (OR=2.81, 95%C.I. = 1.13-6.95, p=0.026) and time to relapse (OR=2.10, 95% C.I. = 1.18-3.74, p=0.012) even after adjusting for other measures of baseline psychopathology, depression, impulsivity, hopelessness and alcohol use severity.Conclusions-This study is the first to document the relationship between pre-treatment impulsive suicide attempts and higher likelihood of post-treatment relapse in alcohol-dependent patents. Clinicians should routinely conduct an assessment for previous suicide attempts in patients with alcohol use disorders, and when impulsive suicidality is reported, they should recognize the increased risk for relapse and formulate their patients' treatment plans accordingly with the goals of reducing both alcoholic relapse and suicide rates.

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Section: Supplementary Analysesmentioning

confidence: 99%

Impulsive suicide attempts predict post-treatment relapse in alcohol-dependent patients

Wojnar

Ilgen

Jakubczyk

et al. 2008

Drug and Alcohol Dependence

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“…A pesar de su plena justificación clínica y científica, los estudios longitudinales a largo plazo de muestras clínicas son escasos, y lo son aún más si entendemos por largo plazo el seguimiento de los pacientes durante periodos mayores a 15 años (Mann, Shäfer, Längle, Ackermann y Croissant, 2005). Por esta razón, durante décadas se ha señalado un total desequilibrio entre la abundancia de resultados de tratamiento a corto plazo y la casi virtual ausencia de resultados a largo plazo (Edwards, 1989;Mann et al 2005).…”

Section: Introductionunclassified

“…Por esta razón, durante décadas se ha señalado un total desequilibrio entre la abundancia de resultados de tratamiento a corto plazo y la casi virtual ausencia de resultados a largo plazo (Edwards, 1989;Mann et al 2005). Esta tendencia no sólo causa desconocimiento respecto al curso del alcoholismo tratado, sino que además está relacionada con la falta de acuerdo respecto a la metodología de los estudios longitudinales en alcoholismo.…”

Section: Introductionunclassified

Investigación longitudinal del alcoholismo tratado: Una revisión sistemática de los seguimientos a largo plazo

2010

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Aims:To analyze the methodological design of long-term longitudinal studies of alcoholics who have undergone treatment. Methods: Systematic review of prospective longitudinal studies of treated alcoholics with follow-up periods of at least 8 years, and published in English, during the period 1983-2009. The review includes 9 studies which analyzed: follow-up evaluations, information sources, the period of reference in the final assessment, the measurement of alcohol use, the operationalization of drinking patterns, and data analysis. Results: 2434 patients (ranging between 57 and 850 per study) were studied on average for a period of 15.3 (D.T. = 3.2) years (range 8-20 years). Studies differ in the number of intermediate evaluations (0, 1, 3, 4) and the length of the period considered for the final evaluation (the whole period, the last 3 years, the last year, last 6 months, last month or present situation). Drinking patterns tend to be used as the main outcome variable, but they are operationalized in non-equivalent forms and the analysis is performed using classical cross-sectional statistical techniques. Alcoholism evolution is studied by analyzing the evolution of drinking patterns and patients' life situation during the period under study. Conclusions:The scarce amount of data available on the evolution of treated alcoholism cannot be compared across studies due to considerable methodological differences. There is a need to promote common methodological criteria in relation to follow-up strategies. New statistical methods that permit longitudinal analysis for non-balanced and correlated data should also be incorporated. Key words: alcoholism, longitudinal studies, methodology RESUMEN ABSTRACTObjetivo: Analizar el diseño metodológico de los estudios longitudinales a largo plazo en el campo del alcoholismo tratado. Método: Revisión sistemática de los estudios longitudinales prospectivos de pacientes alcohólicos con seguimiento de al menos 8 años y publicados en inglés entre 1983-2009. La revisión incluye 9 estudios en los que se analizan: Las evaluaciones de seguimiento, las fuentes de información, el periodo de referencia en la evaluación final, la medición del consumo de alcohol, la categorización del patrón de consumo y el análisis de los datos. Resultados: 2.434 pacientes (rango 57 -850 por estudio) tratados por alcoholismo fueron seguidos en promedio 15.3 (D.T. =. 3.2) años (rango 8 -20 años). Los estudios se diferencian en el número de evaluaciones intermedias (0, 1, 3 y 4) y en el periodo de referencia usado en la evaluación final (todo el seguimiento, últimos 3 años, último año, últimos 6 meses, último mes y actual). Los patrones de consumo (principal resultado de tratamiento) se definen de manera no equivalente y los datos se analizan principalmente de manera transversal usando técnicas estadísticas clásicas. La evolución del alcoholismo se estudia analizando la trayectoria de los patrones de consumo y del estado vital de los pacientes durante los seguimientos. Conclusiones: Los escasos datos disponi...

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“…Among age-matched populations high mortality rates of 1.6 to 4.7 greater have been reported among individuals as compared to those without the disorders [115]. Post-treatment deaths are associated with post-treatment relapse [116] and are products of poisoning and overdose, cancer, liver disease, suicide, cardiovascular disease, AIDS, or homicide [20].…”

Section: Positive Outcomesmentioning

confidence: 99%

Review on Treatment of Substance Use Disorders

Njoroge¹

2017

J Addict Res Ther

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Services for mental and substance use disorders have typically been neglected, and in many countries segregated from mainstream health care with resources allocated not commensurate with the burden. The attention given to mental and substance use disorders cannot be compared to other diseases such as HIV/AIDS, Malaria, Cancer, and Diabetes among others. Mental and substance use disorders account to about 7.4% of disease burden worldwide. These disorders are responsible for more of the global burden than HIV/AIDS and tuberculosis, diabetes, or transport injuries.The increasing number of cases of SUDs globally presents a public health challenge that requires effective evidence based interventions. One of the major challenges is inadequate treatment for SUDs which mostly plague developing countries. It may be difficult to measure the efficacy of treatment as a result of unique patient characteristics that contribute to person's treatment experience. Care factors such as duration of treatment and length of stay have been studied as having influence on the outcome of treatment. Others include patient and environmental factors.Globally, poor treatment outcomes mostly reported include dropout rates as high as 90%; relapse rates as high as 91% and high after treatment mortality rates. Research findings have identified many evidence-based treatment strategies for managing substance use disorders, nevertheless there is a gap that continues to exist, that of a lack of success of effective interventions to be spread and implemented so as to improve the lives of those affected. Other studies have also reported these differences in the outcomes and effectiveness of treatment of substance use disorders.There is need for enhanced interventional research that aims at providing an overview of conceptual issues relating to factors that influence treatment outcomes and identifying gaps and directions for improving treatment and treatment outcomes. The fundamental objective of enhanced research in substance use treatment is to reduce the increasing prevalence rates of substance use disorders.

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The long‐term course of alcoholism, 5, 10 and 16 years after treatment

Cited by 87 publications

References 28 publications

Impulsive suicide attempts predict post-treatment relapse in alcohol-dependent patients

Impulsive suicide attempts predict post-treatment relapse in alcohol-dependent patients

Investigación longitudinal del alcoholismo tratado: Una revisión sistemática de los seguimientos a largo plazo

Review on Treatment of Substance Use Disorders

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