Maisto Stephen A, Witkiewitz Katie, Moskal Dezarie, Wilson Adam D
Department of Psychology, Syracuse University, Syracuse, New York.
Department of Psychology, University of New Mexico, Albuquerque, New Mexico.
J Stud Alcohol Drugs. 2016 Nov;77(6):849-858. doi: 10.15288/jsad.2016.77.849.
Alcohol use disorder (AUD) relapse is a construct that has been of major clinical and research interest but has been inconsistently defined. The purpose of this study was to review the definitions of AUD relapse that have been used in clinical research as a basis for drawing conclusions about its heuristic value.
A systematic review of the literature was conducted on empirical studies that (a) were published in peer-reviewed journals, (b) were published between 2010 and 2015, (c) were written in English, and (d) provided a definition of alcohol relapse (or lapse) that was used in the study.
The review yielded 139 individual studies that met inclusion criteria. The studies showed wide variability in how relapse was defined and interpreted in the literature, and there was little direct empirical or theoretical rationale provided for the definitions of relapse that were chosen. Furthermore, the concept of AUD relapse as a discrete state is not consistent with the empirical literature on the clinical course of alcohol consumption.
We conclude that the heuristic value of AUD relapse as currently studied is low. An alternative approach that embeds the construct in theory and data on the clinical course of alcohol consumption and aligns with current trends in healthcare would seem to have a better chance of improving AUD clinical decision-making and knowledge about AUD in general.
酒精使用障碍（AUD）复发是一个在临床和研究中备受关注的概念，但定义并不一致。本研究旨在回顾临床研究中使用的AUD复发定义，以此为基础对其启发价值得出结论。
对实证研究进行系统文献回顾，这些研究需满足以下条件：（a）发表于同行评审期刊；（b）发表时间在2010年至2015年之间；（c）英文撰写；（d）提供研究中使用的酒精复发（或失误）定义。
该回顾产生了139项符合纳入标准的个体研究。研究表明，文献中对复发的定义和解释差异很大，且所选复发定义几乎没有直接的实证或理论依据。此外，AUD复发作为一种离散状态的概念与酒精消费临床过程的实证文献不一致。
我们得出结论，目前所研究的AUD复发的启发价值较低。一种将该概念纳入酒精消费临床过程的理论和数据中，并与当前医疗保健趋势相一致的替代方法，似乎更有机会改善AUD的临床决策以及对AUD的总体认识。
