Epidemiology, pathogenesis, and
long-termcourse of
chronic alcohol dependencelcoholism is a chronic and relapsing disorderthat imposes enormous costs on
society, is one of theleading causes of death in industrialized countries, and
isamong the
strongest cost drivers with respect to serviceuse.1-5 Thus, the development
of successful treatmentapproaches and their intensive analysis is of
major impor-tance
for public health.Alcohol dependence is one of themost frequent psychiatric disorders, with a
12-monthprevalence
of at least 3%, a lifetime prevalence of 8% to14%, and a male:female ratio of
2-5:1.6-11 Both, the
courseand the
treatment of alcoholism are complicated by ahigh rate of comorbid psychiatric
disorders, most impor-tantly personality disorders (approximately
30% to60%), 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 hACopyright � 2007 LLS SAS. All rights
reservedwww.dialogues-cns.orgOutpatient Long-term Intensive Therapy
forAlcoholics
(OLITA): a successful biopsychosocial approach to the treatment of alcoholismHenning Krampe, PhD; Sabina
Stawicki, PhD; Margret
R. Hoehe, MD, PhD;Hannelore
Ehrenreich, MD, DVMKeywords: 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-Instituteof Experimental Medicine, Goettingen, Germany (Henning Krampe,
SabinaStawicki,
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,
andincurable
disease with enormous societal costs. Thus, alco-holism therapy and research into its outcome
are of majorimportance 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 therapyof alcohol-dependent patients; and (iii)
discuss in detailprocess-outcome research on Outpatient
Long-termIntensive Therapy for Alcoholics (OLITA). This
successfulbiopsychosocial approach to the treatment of
alcoholismshows 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
treatmentprocesses
that have proven high predictive validity andgive concrete information about where to focus
the ther-apeutic
efforts. Thus, process-outcome research on OLITAcan serve for the development of new
therapeutic guide-lines on adapting individual relapse prevention
strategies.� 2007,
LLS SASDialogues
Clin Neurosci. 2007;9:399-412.
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