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Clinical factors associated with relapse in male alcohol dependents during six-month follow-up

Cüneyt Evren, Rabia Cetin, Mine Durkaya, Ercan Dalbudak.

Abstract
Objective: Aim of this study was to evaluate the clinical factors associated with relapse to alcohol use during six-month after inpatient treatment in male alcohol dependents.

Method: Participants were 156 consecutively admitted male alcohol dependents. Among these patients 107 were available to examine 6 months after inpatient treatment. Patients were administered the Symptom Checklist-Revised-90 (SCL-90-R), and Michigan Alcoholism Screening Test (MAST) at baseline and the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), AMATEM Motivation for Treatment Scale (AMTS), and the PENN Alcohol Craving Scale (PACS) six-month later at follow-up.

Results: Among 107 alcohol dependent inpatients 53.3% (n=57) were considered as relapsed to alcohol use. Current age, age at regular alcohol use, duration of education, and marital and employment status did not differ between groups. Mean scores of MAST, awareness of problems of AMTS and GSI also did not differ significantly between groups, whereas depression, anxiety and craving scores were higher and ?treatment motivation and readinees to change? subscale of AMTS was lower in relapsed group. Relapsed group had less outpatient clinic control, attendance to outpatient treatment program, change in social milieu to protect themselves and use of medicine for craving but experienced more life stressors during six- month follow-up. Severity of craving (particularly 5th item), not changing social milieu and life stressors experienced during six-month follow-up predicted relapse in alcohol dependents after inpatient treatment.

Conclusions: Craving seems to be the main factor associated with relapse. Also factors that increase craving (i.e., not changing risky environment, experiencing life stressor during remission and higher negative affect) may put sober alcohol dependents at risk of relapse. Adjunct anti-craving medications, regular attendance to the outpatient treatment may motivate patients for life changes and teach them how to cope with life-stressors.

Key words: Alcohol dependence, craving, relapse, therapy



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