Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Alcohol Clin Exp Res. 2017 Oct;41(10):1760-1767. doi: 10.1111/acer.13468. Epub 2017 Sep 20.
Relapse after detoxification treatment is a common problem in alcohol dependence. However, its prediction still lacks reliability. We here investigated whether the easily accessible clinical Cloninger and Lesch classifications predict alcohol-related hospital readmission following inpatient withdrawal treatment.
In this bicentric prospective clinical study, 67 female and 84 male alcohol-dependent inpatients were characterized according to the Cloninger items and the Lesch typology. The patients' records were followed for 24 months. Because of the well-established sex differences in alcohol dependence, we studied females and males separately.
Overall, 54% of the female patients and 67% of the male patients sustained at least 1 alcohol-related hospital readmission during the follow-up. Readmission was related to a higher Cloninger type 2 score than nonreadmission (females, p = 0.007, males p = 0.044). In females, the Cloninger type 2 score correlated with the number of readmissions (ρ = 0.384, p = 0.001) and the days to first readmission (ρ = -0.333, p = 0.006). The effects were stronger in patients with age at onset of alcohol dependence over 25 years. We found gender dimorphisms concerning the Cloninger items. In female patients, the 4 Lesch subtypes differed in their risk (p = 0.010), the number (p = 0.040), and the days to first readmission (p = 0.031). Lesch type 1 was associated with an increased risk (OR = 4.83, p = 0.041) and Lesch type 2 with a reduced risk (OR = 0.07, p = 0.004). In addition, the number of previous inpatient alcohol withdrawals predicted the patients' outcomes (p < 0.05).
The Cloninger type 2 score and the Lesch typology are promising tools for the prediction of alcohol-related readmissions. Our findings provide the basis to optimize relapse prevention in alcohol dependence.
脱毒治疗后的复发是酒精依赖的一个常见问题。然而，其预测仍然缺乏可靠性。我们在这里研究了是否容易获得的临床 Cloninger 和 Lesch 分类可以预测住院戒酒治疗后的与酒精相关的住院再入院。
在这项双中心前瞻性临床研究中，根据 Cloninger 项目和 Lesch 分型对 67 名女性和 84 名男性酒精依赖住院患者进行了特征描述。对患者的记录进行了 24 个月的随访。由于在酒精依赖方面存在明显的性别差异，我们分别研究了女性和男性。
总体而言，54%的女性患者和 67%的男性患者在随访期间至少有 1 次与酒精相关的住院再入院。再入院与较高的 Cloninger 类型 2 评分相关，而非再入院（女性，p=0.007，男性，p=0.044）。在女性中，Cloninger 类型 2 评分与再入院次数（ρ=0.384，p=0.001）和首次再入院天数（ρ=-0.333，p=0.006）相关。在发病年龄超过 25 岁的患者中，这些影响更为明显。我们发现了与 Cloninger 项目有关的性别二态性。在女性患者中，4 种 Lesch 亚型在风险（p=0.010）、数量（p=0.040）和首次再入院天数（p=0.031）方面存在差异。Lesch 类型 1 与风险增加相关（OR=4.83，p=0.041），Lesch 类型 2 与风险降低相关（OR=0.07，p=0.004）。此外，以前的住院酒精戒断次数预测了患者的结局（p<0.05）。
Cloninger 类型 2 评分和 Lesch 分型是预测与酒精相关再入院的有前途的工具。我们的发现为优化酒精依赖的复发预防提供了依据。
