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Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: Impact of alcohol deterrents on outcome

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Krampe,  Henning
Clinical neuroscience, Max Planck Institute of Experimental Medicine, Max Planck Society;

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Stawicki,  Sabina
Clinical neuroscience, Max Planck Institute of Experimental Medicine, Max Planck Society;

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Wagner,  Thilo
Clinical neuroscience, Max Planck Institute of Experimental Medicine, Max Planck Society;

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Bartels,  Claudia
Clinical neuroscience, Max Planck Institute of Experimental Medicine, Max Planck Society;

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Aust,  Carlotta
Clinical neuroscience, Max Planck Institute of Experimental Medicine, Max Planck Society;

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Ehrenreich,  Hannelore
Clinical neuroscience, Max Planck Institute of Experimental Medicine, Max Planck Society;

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Citation

Krampe, H., Stawicki, S., Wagner, T., Bartels, C., Aust, C., Rüther, E., et al. (2006). Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: Impact of alcohol deterrents on outcome. Alcoholism-Clinical and Experimental Research, 30(1), 86-95. doi:10.1111/j.1530-0277.2006.00013.x.


Cite as: http://hdl.handle.net/11858/00-001M-0000-002A-1FAC-4
Abstract
Objective: (1) To perform a 9-year study of abstinence, lapse, and relapse in 180 chronic alcoholic patients, participants of the Outpatient Longterm Intensive Therapy for Alcoholics (OLITA); (2) To investigate the role of supervised alcohol deterrents (AD) in relapse prevention and as an adjunct for maintenance of long-term abstinence. Method: This prospective open treatment study evaluates the long-term course of drinking outcomes and AD use of 180 chronic alcoholics consecutively admitted from 1993 to 2002. Subsamples are compared for (1) sham-AD versus verum-AD (disulfiram/calcium carbimide), (2) coped lapses versus finally detrimental lapses versus malignant relapses, and (3) AD use for 13 to 20 versus > 20 months. Results: In this 9-year study, the cumulative probability of not having relapsed was 0.52, and that of not having consumed any alcohol was 0.26. Despite long-term use, disulfiram/calcium carbimide was well tolerated. Patients on sham-AD (due to contraindications to verum-AD) showed higher cumulative abstinence probability than patients on verum (S = 0.86 vs. S = 0.49, p = 0.03). Detrimental lapses and malignant relapses occurred earlier than successfully coped lapses (p < 0.001); patients with detrimental lapse and with malignant relapse had rewer days of AD intake and less subsequent days without AD than patients with coped lapse (p < 0.001). The cumulative abstinence probability was S = 0.75 for patients with long-term intake compared with S = 0.50 for patients who stopped AD between months 13 and 20 (p < 0.001). Conclusions: An abstinence rate of > 50% in this 9-year study strongly supports the concept of comprehensive, long-term outpatient treatment of alcoholics. Supervised, guided intake of AD, also over extended periods, can be used as a predominantly psychologically acting ingredient of successful alcoholism therapy.