European Addiction Research · 2005 · 71 citations · 19 references
NursingPsychiatryPsychotherapyRehabilitationSubstance Use DisordersAlcohol DependencePsychosocial InterventionsAlcohol Dependence TreatmentAlcohol Use Disorder TreatmentsIntensive Outpatient TreatmentOutpatient Alcohol Withdrawal ManagementPre-treatmentSubstance Abuse TreatmentTreatment Strategies
Alcohol treatment has traditionally been inpatient, proven effective, but rising costs and emerging evidence suggest outpatient programs may be comparably effective for certain subgroups. This study assessed the efficacy of a highly structured outpatient rehabilitation program in 103 alcohol‑dependent patients. At six months, 64% were abstinent, with completion rates of 72% and 95% follow‑up; higher dependence severity, more prior treatments, greater craving, depression, and anxiety predicted non‑abstinence.
Treatment of alcohol-dependent patients was primarily focused on inpatient settings in the past decades. The efficacy of these treatment programs has been evaluated in several studies and proven to be sufficient. However, with regard to the increasing costs in public healthcare systems, questions about alternative treatment strategies have been raised. Meanwhile, there is growing evidence that outpatient treatment might be comparably effective as inpatient treatment, at least for subgroups of alcohol dependents. On that background, the present study aimed to evaluate the efficacy of a high-structured outpatient treatment program in 103 alcohol-dependent patients. 74 patients (72%) terminated the outpatient treatment regularly. At 6 months’ follow-up, 95% patients were successfully located and personally re-interviewed. Analyses revealed that 65 patients (64%) were abstinent at the 6-month follow-up evaluation and 37 patients (36%) were judged to be non-abstinent. Pre-treatment variables which were found to have a negative impact (non-abstinence) on the 6-month outcome after treatment were a higher severity of alcohol dependence measured by a longer duration of alcohol dependence, a higher number of prior treatments and a stronger alcohol craving (measured by the Obsessive Compulsive Drinking Scale).Further patients with a higher degree of psychopathology measured by the Beck Depression Inventory (depression) and State-Trait Anxiety Inventory (anxiety) relapsed more often. In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program.
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