[Efficiency of outpatient and inpatient alcohol treatment - predictors of outcome]. / Effizienz der ambulanten und stationären Alkoholentwöhnung - Prädiktoren des Behandlungserfolgs.

AIM: To study the prediction potential of demographic and psychopathological variables in the patient allocation context. METHOD: This was a follow-up study of alcohol-dependent patients (n = 242) who were treated in an outpatient (n = 75), inpatient short-term (n = 88), or inpatient long-term (n = 79) setting between 2003 and 2004. Demographic and psychopathological variables were measured by psychiatric basic documentation and the European Addiction Severity Index (EuropASI) . Abstinence two years after discharge from treatment was the primary outcome criterion. RESULTS: Significant predictors of outcome were a higher secondary school qualification, a finished professional training, later onset of alcohol dependence, less number of treatments for physical illness as well as no history of suicide attempts. Both satisfaction with the family background and being employed were predictors with allocation potential.

[Is the European Addiction Severity Index a useful tool in the diagnostic routines of alcohol dependence?]. / Ist der European Addiction Severity Index ein sinnvolles Diagnoseinstrument bei Alkoholabhängigkeit?

AIM: To study the validity of the EuropASI in the patient allocation context and to measure the alcohol severity changes with treatment. METHOD: The examination based on three groups of alcohol-dependent patients (n = 242): outpatients (n = 75), inpatients in a short-term treatment (n = 88), and inpatients in a long-term treatment (n = 79). Treatments took place in two clinics. The European Addiction Severity Index (EuropASI)-Composite Scores were calculated for severity assessment of alcohol dependence. These scores are qualified for change measurement and scientific utilization. Assessments took place on admission and at discharge from the treatment unit. Analyses included the outset values comparison and the examination of both time as well as group effects. RESULTS: Mean age of patients was 45.3 years (SD = 8.6) and 26,4 % of the participants were females (n = 64). The three groups differed significantly in their completion of professional training, employment status, marital status, onset of alcohol dependence, daily alcohol intake in the past half year, previous detoxifications, previous rehabilitations, and at least one attempted suicide. Adjusted for these variables, the 3 groups differed in the alcohol domain at t0, and t0-t1-improvements resulted for the whole sample in the alcohol domain and the domain 'employment satisfaction'. DISCUSSION: The severity ratings by means of EuropASI-Composite Scores illustrated the assumption that the severity level gives information about the treatment needs: the more severe disorder the larger the treatment needs. Furthermore, a t0-t1-decrease of the Composite Scores was shown for the whole sample in the domains 'alcohol use' and 'employment satisfaction'. This points to a reduction of the addiction severity level due to treatment. In spite of some limitations regarding the Composite Scores, the EuropASI seems to be useful for patient allocation.

[New possibilities in treatment and rehabilitation of alcohol-dependent patients--a catamnestic study on the efficiency of outpatient treatment programmes demonstrated by a model procedure]. / Prospektive Untersuchung zur Effizienz der ambulanten Entwöhnungstherapie bei alkoholabhängigen Patienten. Ergebnisse zur Haltequote und Katamnese.

First results of a clinical and catamnestic investigation are reported for the efficiency of a highly structured outpatient therapy with alcohol-dependents. One hundred and two patients were included in the study. Of the patients,60% were male and 40% female. The average age was 45 years (+/-8). The average duration of alcohol dependence amounted to 15 years (+/-9), and the last average quantity of pure alcohol drunk was 193 g. Twenty-seven per cent of the patients had completed inpatient therapies in the past. Treatment retention amounted to n=74 (72.5%), and 18 of the 25 dropped out because of alcohol relapse. On average, relapsed dropouts indicated a longer abuse of alcohol and significantly more pretreatments than completers, and they also reported significantly stronger craving for alcohol (measured with the OCDS). Furthermore, they also achieved significantly higher total scores in the BDI (depression) and STAI (anxiety) scales at the beginning of therapy. At 6/12-month follow-ups, 90%-95% of the patients were successfully located and interviewed. Analyses revealed that 64% of the patients were still abstinent at 6-month follow-up evaluation, and 56% had remained abstinent until 12-month follow-up. Therapeutic implications of these satisfying therapy results are discussed, and the current knowledge on the efficiency of outpatient therapies is presented.

[Combined outpatient alcoholism therapy and occupational rehabilitation on welfare recipients--results of a pilot study]. / Kombinierte ambulante Alkoholismustherapie und berufliche Rehabilitation bei Sozialhilfeempfängern--Ergebnisse eines Modellprojekts.

This study tested the feasibility of outpatient abstinence treatment among alcohol dependent subjects on welfare. Patients had a long history of alcohol dependence and prolonged unemployment. Over a period of six months a total of 250 patients were approached by the social welfare office and asked to participate in the program. The program involved detoxification and a three month combined alcohol treatment and personal job training. Of the 250 persons approached 96 patients (about 40 %) appeared for the initial examination, 19 patients (13 %) finished detoxification and a total of 5 patients completed the program. The majority of a group of patients considered to be highly therapy resistant did not complete the program. Still it was important to demonstrate that a subgroup of patients did successfully complete this program. We consider this pilot project a successful starting point for further development of treatment approaches targeted more specifically at this group of patients.