Vol 9, No 4 - Addictive Substances
Past issues Contributors How to publish Contributions and comments Home
Epidemiology, pathogenesis, and long-term course of chronic alcohol dependence lcoholism is a chronic and relapsing disorder that imposes enormous costs on society, is one of the leading causes of death in industrialized countries, and is among the strongest cost drivers with respect to service use.1-5 Thus, the  development  of  successful  treatment approaches and their intensive analysis is of major impor- tance for public health.Alcohol dependence is one of the most frequent psychiatric disorders, with a 12-month prevalence of at least 3%, a lifetime prevalence of 8% to 14%, and a male:female ratio of 2-5:1.6-11 Both, the course and the treatment of alcoholism are complicated by a high rate of comorbid psychiatric disorders, most impor- tantly  personality  disorders  (approximately  30%  to 60%), anxiety  (20%  to  30%), and  mood  disorders (20%).9,12-15 The alcohol-associated burden of disease isC l i n i c a l  r e s e a r c h A Copyright © 2007 LLS SAS.  All rights reserved www.dialogues-cns.org Outpatient Long-term Intensive Therapy for Alcoholics (OLITA): a successful biopsychosocial approach to the treatment of alcoholism Henning Krampe, PhD; Sabina Stawicki, PhD; Margret R. Hoehe, MD, PhD; Hannelore Ehrenreich, MD, DVM Keywords: alcohol;  alcoholism  therapy;  addiction;  chronic  psychiatric  disease; integrated long-term treatment; therapeutic alliance; therapy process and out- come Author affiliations: Division of Clinical Neuroscience, Max-Planck-Institute of Experimental Medicine, Goettingen, Germany (Henning Krampe, Sabina Stawicki, Hannelore Ehrenreich); Genetic Variation Program, Max-Planck- Institute for Molecular Genetics, Berlin, Germany (Margret R. Hoehe) Address  for  correspondence: Hannelore  Ehrenreich,  MD,  DVM,  Max-Planck- Institute of Experimental Medicine, Division of Clinical Neuroscience, Hermann- Rein-Str.3, 37075 Goettingen, Germany (e-mail: ehrenreich@em.mpg.de) Alcohol dependence is a frequent, chronic, relapsing, and incurable disease with enormous societal costs. Thus, alco- holism therapy and research into its outcome are of major importance for public health. The present article will: (i) give a brief overview of the epidemiology, pathogenesis, and treatment outcomes of alcohol dependence; (ii) intro- duce the basic principles of outpatient long-term therapy of alcohol-dependent patients; and (iii) discuss in detail process-outcome  research  on  Outpatient  Long-term Intensive Therapy for Alcoholics (OLITA). This successful biopsychosocial approach to the treatment of alcoholism shows a 9-year abstinence rate of over 50%, a re-employ- ment rate of 60%, and a dramatic recovery from comor- bid depression, anxiety disorders, and physical sequelae. The outcome data are empirically based on treatment processes that have proven high predictive validity and give concrete information about where to focus the ther- apeutic efforts. Thus, process-outcome research on OLITA can serve for the development of new therapeutic guide- lines on adapting individual relapse prevention strategies. © 2007, LLS SAS Dialogues Clin Neurosci. 2007;9:399-412.