[Short-term and long-term prognosis of alcohol dependence: a follow-up study of Danshu-Kai (Alcohol Abstinence Club) members].

595 alcohol dependent cases had been enrolled in the Mie Danshu-Shinsei-Kai (The Alcohol Abstinence Club in Mie) since its establishment in Jan. 1972 by Oct. 1984 when this study started. 163 cases of them, who had been practising abstinence at least for 6 months when the first observation was made in Oct. 1984, were selected for the follow-up study. Relapses in these cases were checked twice, 2.5 years later in 1987 and 5 years later in 1989. The results obtained were summarized as follows: It was observed that 64% of those who had practised abstinence for 2 years sustained abstinence successfully at least for the next 5 years, and 74% of those who had kept non-drinking for 3 years continued abstinence for the next 5 years. Those who had practised abstinence for shorter than 2 years just before the first observation showed that the closer the term of abstinence approached to 2 years, the more sharply the following 5 year abstinence rate increased. It was noticed among those who had kept abstinence for longer than 3 years that the longer the abstinence period became, the more slowly the next 5 year abstinence rate increased, eventually reaching to as high as 81%. A turning point from sharp increase to slow increase was found in between 2 and 3 years of abstinence. From the observation mentioned above, the period of abstinence can be classified into three categories in view of prognosis: shorter than 2 years, 2 to 3 years, and longer than 3 years, which stand for "unstable," "intermediate," and "stable" period respectively. The intermediate period is considered to be critically important in terms of prognosis and treatment of alcohol dependence. It would be reasonable therefore to prospect prognosis in the short term or in the long term basis according to the period of abstinence. The object and contents of treatment might become different before and after the intermediate period. The major factors which affect the prognosis can be classified into 5 categories; 1) the degree of insight into his or her drinking, 2) biological condition, 3) financial problems like "debt," 4) tendency toward multiple addiction, and 5) problems of "co-dependency." It was noticed that although all of these factors remained unresolved in most cases of unstable period, factors 1), 2) and 3) were mostly successfully resolved in a stable period. Factors 4) and 5) are found in not rarely even in a stable period.(ABSTRACT TRUNCATED AT 400 WORDS)