Masudomi Ichiro, Isse Kunihiro, Uchiyama Makoto, Watanabe Hirohumi
Section of Psychiatry and Behavioral Science, Tokyo Medical and Dental University, Tokyo, Japan.
Psychiatry Clin Neurosci. 2004 Oct;58(5):551-7. doi: 10.1111/j.1440-1819.2004.01299.x.
The present study aimed to determine whether alcoholics who attend self-help groups experience fewer deaths than those who do not. Subjects were patients from the Alcoholism Treatment Program (ATP) of Matsuzawa hospital. A cohort of alcoholic patients recruited into a prospective study was followed from April 1994 to March 1999. A total of 469 alcoholic patients met the International Classification of Diseases (10th edition) criteria for alcohol dependency. Of these, 94 patients refused to participate in the study, leaving a total of 375 participants. After discharge from the ATP and a complete explanation of the present study, subjects decided whether to attend a self-help group (SHG) or not. The SHG comprised 208 subjects, and the non-self-help group (NSHG) comprised 167 subjects. Outcomes were evaluated with regard to death during follow-up for a mean of 2.4 years. Death was ascertained through the records of the Setagaya Department of Health and Welfare center, Matsuzawa hospital and other hospitals, and through personal contact with informants, relatives, and significant others of subjects. Deaths were confirmed for 47 NSHG subjects and only five SHG subjects. NSHG displayed a significantly decreased cumulative survival compared with SHG (P < 0.0001). Cox proportion hazard analysis was used to examine variables that may help to predict mortality among alcoholics. Alcoholics who attended self-help groups differed from those who did not, with regard to mortality experience. Attending a self-help group represented the most important predictor of prognosis for alcoholics.
本研究旨在确定参加自助小组的酗酒者的死亡人数是否少于未参加者。研究对象为松泽医院酒精中毒治疗项目(ATP)的患者。对一组招募进前瞻性研究的酗酒患者从1994年4月至1999年3月进行随访。共有469名酗酒患者符合《国际疾病分类》(第10版)酒精依赖标准。其中,94名患者拒绝参与研究,最终共有375名参与者。从ATP出院并对本研究进行全面解释后,研究对象决定是否参加自助小组(SHG)。自助小组有208名研究对象,非自助小组(NSHG)有167名研究对象。对平均2.4年随访期内的死亡情况进行了评估。通过世田谷区卫生福利中心、松泽医院及其他医院的记录,以及与研究对象的举报人、亲属和重要他人进行个人联系来确定死亡情况。NSHG组有47名研究对象死亡,而SHG组仅有5名。与SHG组相比,NSHG组的累积生存率显著降低(P < 0.0001)。采用Cox比例风险分析来检验可能有助于预测酗酒者死亡率的变量。在死亡率方面,参加自助小组的酗酒者与未参加者不同。参加自助小组是酗酒者预后的最重要预测因素。