Assessment of psychosocial factors associated with relapse in patients with alcohol dependence: a retrospective observational study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20161554Keywords:
Alcohol, Psychosocial factors, Psychoactive effects, RelapseAbstract
Background: Alcohol in beverage form is among the most widely used psychoactive drugs in the world. Nonetheless, its complex pharmacologic actions, including panoply of psychoactive effects, have led societies throughout the world to surround alcoholic beverages with a variety of rules and regulations governing their use. Despite these efforts at control, excessive drinking, with its adverse effects are widespread.
Methods: It was a one year retrospective observational study. The sample consisted of fifty patients of alcohol dependence who following treatment for their condition had remained in a remitted state for at least four weeks, and had at least one relapse. The eligible patients fulfilling inclusion and exclusion criteria and giving written informed consent were enrolled into the study.
Results: Average time from treatment to lapse was 76.40±17.35 days, while time taken from treatment to relapse was 138.40±31.38 days. Average mean severity of alcohol dependence questionnaire score was 9.49±3.89, the total score of relapse precipitant inventory was 15.94±3.86, and the average value of coping behaviour inventory total score was 1.04±0.19. On the presumptive stressful life events scale the total stress score was 200.84±17.78. The self-efficacy scale (SES) of the patients, the average SES total scores was 60.10±8.77.
Conclusions: Clinical parameters like number of previous relapses and positive family history of substance use emerged as significant determinants of relapse related psychosocial factors and appeared to be of greater importance in determining relapse.
References
American Psychiatric Association: Diagnostic and statistical Manual of Mental Disorder, Fifth Edition, DSM-5TM. Washington, DC, American Psychiatric Association, 2013.
Ait-Daoud N, Malcolm RJJr, Johnson BA. An overview of medications for the treatment of alcohol withdrawal and alcohol dependence with an emphasis on the use of older and newer anticonvulsants. Addictive Behaviors. 2006;31:1628-49.
Deb PC, Jindal BR. Drinking in rural areas. Study in selected villages of Ludhiana, Punjab, India. Monograph, Punjab Agri. Univ. Ludhiana. (1975).
Anton RF, O'Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the Combine study: a randomized controlled trial. J Am Med Asso. 2006;295(17):2003-17.
World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines, Geneva: WHO. Mental and behavioural disorders due to psychoactive substance use.1992.
Grant BF. The impact of a family history of alcoholism on the relationship between age at onset of alcohol use and DSM-IV alcohol dependence: Results from the National longitudinal alcohol epidemiologic survey. Alcohol Health Res World. 1998;22:144-7.
Ministry of Health and Family Welfare. MOHFW: National Family Health Survey 3.Available at www. rchiips. org / NFHS/ index.html. Accessed 24 August 2015.
Sarkar AP, Sen S, Mondal S, Singh OP, Chakraborty A, Swaika B. A study on sociodemographic characteristics of alcoholics attending the de-addiction center at Burdwan Medical College and Hospital in West Bengal. Indian J Pub Health. 2013;57(1):33-5.
WHO India. Current patterns and trends of alcohol abuse. Available at http:// www.whoindiaorg / Linksfiles/ Mental Health and substance abuse alcohol atlas4 pdf 2011. Accessed 22 August 2015.
Obot SI, Room R. Alcohol, Gender and drinking problems: perspectives from low and middle income countries. department of mental health and substance abuse. Geneva: World Health Organization; 2005.
Mattoo SK, Chakrabarti S, Anjaiah M. Psychosocial factors associated with relapse in men with alcohol or opioid dependence. Indian J Med Res. 2009;130:702-8
Marlatt GA, Gordon JR. Relapse prevention. Maintenance strategies in addictive behavioural change. New York: Guilford Press;1980:152-60.
Litman GK, Eiser JR, Rawson JCB, Oppenheim AN. Differences in relapse precipitants and coping behaviour between alcohol relapsers and survivors. Behav Res Ther. 1979;17:89-94.
Mattoo SK, Basu D. Malhotra A, Malhotra R. Relapse precipitants, life events and dysfunctions in alcohol and opioid dependent men. Indian J Psychiatry. 2003;45:39-44.
Singh NH, Sharma SG, Pasweth AM. Psychiatric comorbidity among alcohol dependents. Indian J Psychiatry. 2005;47:222-4.
Mattoo SK, Malhotra R. Relapse precipitant inventory: hindi adaptation and factor structure. Indian J Clin Psychol. 2000;27:278-85.
Litman GK, Stapelton J, Oppenheim AN, Peleg M. An instrument for measuring coping behaviours in hospitalised alcoholics: implications for relapse prevention treatment. Br J Addict. 1983;78:269-79.
Mattoo SK, Malhotra R. Self-efficacy scale. Hindi translation and factor structure. Indian J Clin Psychol. 1998;25:154-8.
Singh G, Kaur D, Kaur H. Presumptive stressful life events scale for use in India. Indian J Psychiatry. 1984;26:107-14.
Singhal S, Nagalakshmi SV, Singhal S. Relapse in alcoholism: psychosocial study. Nimhans J. 1992:47-9.
Maisto SA, O’Farrell TJ, Connors GJ, Mckay JR, Pelcovits M. Alcoholics’ attributions of factors affecting their relapse to drinking and reasons for terminating relapse episodes. Addict Behav. 1988;13:79-82.
Burling TA, Reilly PM, Moltzen JO, Ziff DC. Self-efficacy and relapse among inpatients with drug and alcohol abuse. J Stud Alcohol. 1989;5:354-60.
Mckay JR, Maisto SA, O’Farrell TJ. End-of treatment self-efficacy, aftercare and drinking outcomes of alcoholic men. Alcohol Clin Exp Res. 1993;17:1076-83.
Marlatt GA. Taxonomy of high-risk situations for alcohol relapse: evolution and development of a cognitive-behavioural model. Addiction. 1996;91(1):37-50.
Finney JW, Moos RH, Mewborn CR. Post-treatment experiences and treatment outcome of alcoholic patients six months and two years after hospitalization. J Consult Clin Psychol. 1980;48:17-29.
