Ink O, Dejonghe J P, Hagege H, Sibony-Tua L, Goubet M, Guilliet A, Pelletier G, Balette M, Feline A, Etienne J P
Service des Maladies du Foie et de l'Appareil Digestif, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Gastroenterol Clin Biol. 1991;15(8-9):620-8.
The long term results of psychologically oriented treatment for alcoholism were evaluated in 147 patients hospitalized in a liver unit and followed for 1-5 years. Twenty-three percent of the patients were hospitalized for treatment of alcoholism, while 61 percent were hospitalized for alcohol-related disease. The main patient characteristics were: males: 71 percent; age: 48 +/- 10 years (mean +/- SD); alcoholic cirrhosis: 48 percent; initial request for help in abstinence: 9 percent; and unemployment: 35 percent. During the hospitalization (16 +/- 10 days), each patient had 1 to 4 psychotherapeutic interviews. Seventy-four percent of patients responded to follow-up after discharge and contact was maintained in 23 percent of patients 2 years thereafter. The only two independent prognostic variables for long-term follow up were the need for medical supervision (P less than 0.001) and employment (P less than 0.005) (Cox model). Only 10 percent of the patients attended a post-hospitalisation psychotherapeutic program. Among the 108 patients who were followed, 35 percent were totally abstinent immediately after discharge and 17 percent did not relapse during the 2 following years. Relapse was unpredictable according to any of the initial variables. Half of the patients who were abstinent immediately after discharge remained totally so at long-term follow-up. Total abstinence was obtained for 39 percent of patients during a mean period of 27 +/- 34 months. Medical, social, or psychological improvement was observed more often in abstainers (61 percent) than in non abstainers (11 percent, P less than 0.001). We conclude that: a) long-term follow-up and abstinence were infrequently obtained in unselected alcoholic patients hospitalized in a liver unit; b) no initial criteria could predict the alcoholic relapse or select patients for alcoholism treatment; c) long-term results seemed more favorable when the patients where totally abstinent immediately after discharge.
