Substantial decrease of psychiatric comorbidity in chronic alcoholics upon integrated outpatient treatment - Results of a prospective study. It is far from clear how comorbidity changes during alcoholism treatment. This study investigates: (1) the course of comorbid Axis I disorders in chronic alcoholics over 2 years of controlled abstinence in the outpatient long-term intensive therapy for alcoholics (OLITA) and (2) the effect of comorbid Axis I and II disorders in this group of patients on subsequent drinking outcome over a four-year follow-up. This prospective treatment study evaluates psychiatric variables of 89 severely affected chronic alcohol dependent patients on admission (t₁), month 6(t ₂), 12 (t₃) and 24 (t₄). Drinking outcomes have been analyzed from 1998 to 2002. On admission, 61.8\% of the patients met criteria for a comorbid Axis I disorder, 63.2\% for a comorbid personality disorder. Axis I disorders remit from t₁ (59.0\% ill), t₂ (38.5\%), t₃ (28.2\%) to t₄ (12.8\%) (p < 0.0001). Anxiety disorders remit more slowly from t, (43.6\%) to t₃ (20.5\%, p=0.0086), whereas mood disorders remit early between t₁ (23.1\%) and t₂ (5.1\%, p=0.0387) with a slight transient increase at t₃ (10.3\%). During the four-year follow-up, the cumulative probability of not having relapsed amounts to 0.59. Two predictors have a strong negative impact on abstinence probability: number of inpatient detoxifications (p=0.0013) and personality disorders (p=0.0106). The present study demonstrates a striking remission of comorbid Axis I disorders upon abstinence during comprehensive long-term outpatient alcoholism treatment. The presence of an Axis II rather than an Axis I disorder on admission strongly predicts drinking outcome over a four-year follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved) https://www.psych.uni-goettingen.de/de/clinical/publications/publications-folder/wagneretal2004 https://www.psych.uni-goettingen.de/@@site-logo/university-of-goettingen-logo.svg

Thilo Wagner, Henning Krampe, Sabina Stawicki, Jennifer Reinhold, Henriette Jahn, Kristin Mahlke, Ulrike Barth, Sonja Sieg, Oliver Maul, Claudia Galwas, Carlotta Aust, Birgit Kröner-Herwig, Edgar Brunner, Wolfgang Poser, Fritz Henn, Eckart Rüther and Hannelore Ehrenreich

Substantial decrease of psychiatric comorbidity in chronic alcoholics upon integrated outpatient treatment - Results of a prospective study.

Journal of Psychiatric Research

Abstract

It is far from clear how comorbidity changes during alcoholism treatment. This study investigates: (1) the course of comorbid Axis I disorders in chronic alcoholics over 2 years of controlled abstinence in the outpatient long-term intensive therapy for alcoholics (OLITA) and (2) the effect of comorbid Axis I and II disorders in this group of patients on subsequent drinking outcome over a four-year follow-up. This prospective treatment study evaluates psychiatric variables of 89 severely affected chronic alcohol dependent patients on admission (t₁), month 6(t ₂), 12 (t₃) and 24 (t₄). Drinking outcomes have been analyzed from 1998 to 2002. On admission, 61.8\% of the patients met criteria for a comorbid Axis I disorder, 63.2\% for a comorbid personality disorder. Axis I disorders remit from t₁ (59.0\% ill), t₂ (38.5\%), t₃ (28.2\%) to t₄ (12.8\%) (p < 0.0001). Anxiety disorders remit more slowly from t, (43.6\%) to t₃ (20.5\%, p=0.0086), whereas mood disorders remit early between t₁ (23.1\%) and t₂ (5.1\%, p=0.0387) with a slight transient increase at t₃ (10.3\%). During the four-year follow-up, the cumulative probability of not having relapsed amounts to 0.59. Two predictors have a strong negative impact on abstinence probability: number of inpatient detoxifications (p=0.0013) and personality disorders (p=0.0106). The present study demonstrates a striking remission of comorbid Axis I disorders upon abstinence during comprehensive long-term outpatient alcoholism treatment. The presence of an Axis II rather than an Axis I disorder on admission strongly predicts drinking outcome over a four-year follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Note

Accession Number: 2004-20030-009. PMID: 15458858 Partial author list: First Author & Affiliation: Wagner, Thilo; Department of Psychiatry and Psychotherapy, Georg-August-University, Göttingen, Germany. Release Date: 20041129. Correction Date: 20120910. Publication Type: Journal (0100), Peer Reviewed Journal (0110). Format Covered: Print. Document Type: Journal Article. Language: English. Major Descriptor: Alcohol Rehabilitation; Alcoholism; Comorbidity; Mental Disorders; Outpatient Treatment. Classification: Drug & Alcohol Rehabilitation (3383); Substance Abuse & Addiction (3233). Population: Human (10); Male (30); Female (40). Location: Germany. Age Group: Adulthood (18 yrs & older) (300). Tests & Measures: Global Symptom Index; Anxiety Disorders Interview Schedule; International Diagnostic Checklists for Personality Disorders; Structured Clinical Interview for DSM-IV. Methodology: Empirical Study; Longitudinal Study; Prospective Study; Quantitative Study. References Available: Y. Page Count: 17. Issue Publication Date: Nov-Dec, 2004.