Department of Psychiatry, Washington University School of Medicine, 40 North Kingshighway, Suite 4, St. Louis, Missouri 63108, USA.
J Stud Alcohol Drugs. 2010 Jul;71(4):581-7. doi: 10.15288/jsad.2010.71.581.
The aims of this study were to test if outcomes would be different when family members of alcohol-dependent individuals were included in intervention and to examine the factors associated with relapse during a 6-month follow-up period.
Ninety male participants admitted for 3 weeks at an inpatient facility in India were randomly assigned to individual relapse prevention (IRP), dyadic relapse prevention (DRP), and treatment as usual (TAU), with 30 participants in each group. In IRP, intervention was administered to the individual participant. In DRP, both the participant and a family member were included in intervention. In all three conditions, family members stayed in the facility with participants. Participants were followed up for 6 months after discharge from the treatment center.
DRP consistently performed better than TAU on all of the outcomes (reduction in quantity of alcohol, drinking days, and number of days with dysfunction in family, occupational, and financial dimensions). DRP participants also reported a significant reduction in the quantity of alcohol, drinking days, and family problems, compared with IRP. Results of Cox regression showed that being in IRP/TAU groups, early-onset dependence (<25 years), and paternal history of alcohol dependence were associated with relapse after adjusting for baseline alcohol use and other covariates.
Findings provide evidence for the effectiveness of Western-based family-oriented intervention for alcohol-dependent patients in India; also, findings might help to alert treatment providers that some subsets of alcohol users might need more tailored interventions and rigorous monitoring during follow-up.
本研究旨在检验当酗酒者的家庭成员被纳入干预时,结果是否会有所不同,并探讨在 6 个月随访期间与复发相关的因素。
90 名男性参与者在印度的一家住院机构接受了 3 周的治疗,他们被随机分配到个体预防复发(IRP)、双体预防复发(DRP)和常规治疗(TAU)组,每组 30 人。在 IRP 中,对个体参与者进行干预。在 DRP 中,参与者和家庭成员都被纳入干预。在所有三种情况下,家庭成员都与参与者一起留在机构中。参与者在治疗中心出院后接受了 6 个月的随访。
DRP 在所有结果上的表现均优于 TAU(酒精量、饮酒天数和家庭、职业和财务方面功能障碍天数的减少)。与 IRP 相比,DRP 参与者也报告酒精量、饮酒天数和家庭问题显著减少。Cox 回归结果表明,在调整了基线酒精使用和其他协变量后,IRP/TAU 组、早发性依赖(<25 岁)和父亲酗酒史与复发相关。
这些发现为印度基于西方的面向家庭的酗酒者干预措施的有效性提供了证据;此外,这些发现可能有助于提醒治疗提供者,一些亚组的酒精使用者可能需要更定制的干预措施和在随访期间更严格的监测。