Factors Related With Relapse in Male Alcohol Dependents: 12 Months Follow-up Study

Researches ÖZET Erkek alkol bağımlılarında depreşme ile ilişkili etkenler: 12 aylık takip çalışması Amaç: Bu çalışmanın amacı, erkek alkol bağımlılarında yatarak tedavinin ardından, 12 aylık takipte alkol kullanı-mının depreşmesiyle ilişkili klinik değişkenlerin saptanmasıdır. Yöntem: Çalışmaya, ardışık olarak hastaneye yatırılmış 156 erkek alkol bağımlısı hasta katılmıştır. Yatarak tedaviden 12 ay sonra, bu hastalardan 102'sinin değerlendirilmesi mümkün olmuştur. Hastalar, başlangıçta, Belirti Tarama Listesi (SCL-90) ve Michigan Alkolizm Tarama Testi (MATT), 12 ay sonra ise PENN Alkol Aşerme Ölçeği (PAAÖ) ile değerlendirilmiştir. Bulgular: Yatarak tedavi görmüş 102 alkol bağımlısı hastanın %61.8'i (n=63) alkol kullanımı depreşmiş olarak değerlendirilmiştir. Sosyodemografik değişkenler gruplar arasında fark göstermemiştir. MATT ve SCL-90 genel şiddet puanı gruplar arasında fark göstermemiş iken, aşerme puanı depreşen grupta yüksek bulunmuştur. Depreşen gruptakilerin 12 aylık takip süresince daha az poliklinik kontrolüne geldikleri, Ayaktan Tedavi Programı'na (ATP) daha az katıldıkları, kendilerini korumak amaçlı daha az sosyal çevre değişikliği yaptıkları ve aşerme için daha az ilaç kullandıkları bulunmuştur. Aşerme şiddeti ve takipte ATP'ye katılmama, alkol bağım-lılarında depreşmeyi belirlemiştir. Sonuç: Aşerme şiddeti ve ATP'ye katılmama depreşme ile ilişkili temel etkenlerdir. Aşerme giderici ilaç kullanımı ile birlikte ATP'ye düzenli katılımın sağlanması, hastaların alkol aşermesini tanımalarına ve onunla başet-melerine yardımcı olabilir. Anahtar kelimeler: Alkol bağımlılığı, aşerme, depreşme, terapi ABSTRACT Factors related with relapse in male alcohol dependents: 12 months follow-up study Objective: Aim of this study was to evaluate clinical variables related with relapse to alcohol abuse during 12 months follow-up after inpatient treatment in male alcohol dependents. Method: Participants were 156 consecutively admitted male alcohol dependents. Among these patients, 102 were available at the evaluation that took place one year after the inpatient treatment. Patients were investigated with the Symptom Check List (SCL-90) and Michigan Alcoholism Screening Test (MAST) at baseline and with the PENN Alcohol Craving Scale (PACS) one year later, at follow-up. Results: Among 102 alcohol dependent inpatients, 61.8% (n=63) were considered as relapsed to alcohol abuse. Sociodemographic variables did not differ between groups. Mean scores of MAST and global severity index of SCL-90 did not differ significantly between groups, whereas craving score was higher in the relapsed group. Also the relapsed group had less polyclinic control, less attendance to the Outpatient Treatment Program (OTP), less changes in social environment for self protection and less use of anticraving medications during one year follow-up. Severity of craving and not attending OTP during follow-up period predicted relapse in alcohol dependents. Conclusions: Severity of craving and not attending OTP seems to be the main factors related with relapse. Together with using anti-craving medications, regular attendance to OTP may help patients to recognize and manage with alcohol craving

Lifetime PTSD and quality of life among alcohol-dependent men: Impact of childhood emotional abuse and dissociation

The aim of this study was to investigate the impact of lifetime posttraumatic stress disorder (PTSD), dissociation and a history of childhood trauma on quality of life (QoL) among men with alcohol dependency. A consecutive series of alcohol-dependent men (N=156) admitted to an inpatient treatment unit were screened using the Michigan Alcoholism Screening Test, the Clinician Administered PTSD Scale, the Dissociative Experiences Scale, and the Childhood Trauma Questionnaire. QoL was assessed using the Medical Outcomes Study Short-Form 36-item health survey. Fifty (32.1%) patients had lifetime diagnosis of PTSD. Besides problems related to severity of alcohol use, the lifetime PTSD group was impaired on several physical and mental components of QoL. While the lifetime PTSD group and remaining patients did not differ on reports of childhood trauma and dissociation, in lifetime PTSD group, dissociative patients had higher scores of childhood emotional abuse than those of the non-dissociative patients. In multivariate covariance analysis, both dissociation and lifetime PTSD predicted impairment in physical functioning, general health, vitality, and mental health components of QoL Among alcohol-dependent men with lifetime PTSD. a history of childhood emotional abuse contributes to impairment of QoL through its relationship with dissociation. (C) 2010 Elsevier Ireland Ltd. All rights reserved

Childhood Trauma and Psychopathology among Alcohol-Dependent Men: No Interaction with Temperament and Character

Objective: The aim of this study was to evaluate possible interactions between childhood trauma, temperament, character, and psychopathology among alcohol-dependent men. Methods: Participants were 156 alcohol-dependent men consecutively admitted to a dependency treatment unit. The Childhood Abuse and Neglect Questionnaire, the Temperament and Character Inventory, and the Symptom Checklist-Revised were administered to all participants. Results: Childhood abuse and neglect did not have any effect on temperament and character scores in multivariate analysis. Whereas childhood abuse had a significant main effect on all types of clinical psychopathology except depression and psychoticism scores, childhood neglect only had a significant main effect on depression scores. There was no interaction between childhood abuse and neglect on these analyses. Conclusions: Among alcohol-dependent men, childhood abuse and neglect contribute to general psychopathology through distinct clinical consequences, independently of temperamental and characterological features. Copyright (C) 2010 S. Karger AG, Base