Wölwer W, Burtscheidt W, Redner C, Schwarz R, Gaebel W
Department of Psychiatry, Heinrich Heine University, Duesseldorf, Germany.
Acta Psychiatr Scand. 2001 Jan;103(1):30-7. doi: 10.1034/j.1600-0447.2001.00149.x.
We investigated whether alcoholic patients with comorbid personality disorders and those with cognitive impairments would benefit in a different way from different behaviour therapy strategies.
After detoxification, 120 alcoholics were assigned randomly to one of three out-patient treatment programmes comprising 'coping skills training', 'cognitive behaviour therapy' or unspecific supportive control therapy. Personality disorders and cognitive impairments were assessed at the beginning of the 6-month treatment period.
The impact of concomitant personality disorders or cognitive impairments was generally only moderate and mainly independent from treatment condition. However, alcoholic patients relapsing within 6 months after detoxification showed a higher rate of personality disorders (especially antisocial and borderline) and slightly more cognitive deficits (especially in verbal memory and visuomotor functions) than abstainers even before therapy.
The high amount of early relapses and drop-outs probably hindered larger differentiated treatment effects. Hypotheses will be retested in treatment completers using forthcoming follow-up data.
我们研究了伴有共病性人格障碍的酗酒患者以及有认知障碍的酗酒患者是否会从不同的行为治疗策略中获得不同程度的益处。
在戒酒之后，120名酗酒者被随机分配到三个门诊治疗项目之一，这些项目包括“应对技能训练”、“认知行为疗法”或非特异性支持性对照疗法。在为期6个月的治疗期开始时，对人格障碍和认知障碍进行评估。
共病性人格障碍或认知障碍的影响通常仅为中等程度，且主要独立于治疗条件。然而，即使在治疗前，解毒后6个月内复发的酗酒患者比戒酒者表现出更高的人格障碍发生率（尤其是反社会型和边缘型）以及稍多的认知缺陷（尤其是在言语记忆和视觉运动功能方面）。
大量的早期复发和退出可能阻碍了更大的差异化治疗效果。将使用即将到来的随访数据在完成治疗者中重新检验这些假设。
