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军人酒精依赖患者绝对戒酒作为治疗结局的回顾性队列研究。

Absolute Abstinence as a Treatment Outcome in Servicemen with Alcohol Dependence: A Retrospective Cohort Study.

机构信息

Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India.

Department of Psychiatry, Command Hospital (Central Command), Lucknow, India.

出版信息

Subst Use Misuse. 2019;54(14):2304-2316. doi: 10.1080/10826084.2019.1646284. Epub 2019 Aug 6.

DOI:10.1080/10826084.2019.1646284
PMID:31386599
Abstract

: Within India's military medical framework, alcohol dependence syndrome (ADS) is deemed a treatable medical illness incompatible with military service, and complete abstinence is the only acceptable successful treatment outcome. : This study was designed to identify factors which were able to differentiate treatment outcomes of abstinence and relapse among ADS patients in a military framework. : Recognizing personal incentives to misrepresent alcohol consumption, abstinence, and relapse outcomes were established using official reports from a patient's parent unit, in combination with biochemical parameters and clinical examination. Patients serially admitted for ADS treatment or follow-up review were surveyed, and their socio-demographic and alcohol consumption profiles, coping styles, life events and specific relapse precipitants were recorded and compared as contributory variables in a cognitive-behavioral model of ADS. From this survey of 140 patients, membership to abstainer or relapser groups was then predicted using a discriminant analysis. : 34% of patients achieved early absolute abstinence. No baseline socio-demographic or drinking profile distinctions existed between abstainers and relapsers. Differences were forthcoming on coping styles, life-event, and relapse-precipitant exposure measures. Stepwise discriminant analysis produced a final equation comprising 10 independent variables (including two positive life event measures), which predicted an abstinence/relapse outcome with an 86% and 79% hit-rate (original and cross-validated). : Using prevailing cognitive-behavioral constructs, early absolute abstinence emerged as an actionable objective and an achievable goal without any contributory socio-demographic predilections. This preliminary evaluation suggests it is a tenable and realistic target of current ADS treatment programs.

摘要

在印度的军事医疗框架内,酒精依赖综合征(ADS)被视为一种可治疗的医学疾病,不符合服兵役条件,完全戒断是唯一可接受的成功治疗结果。

本研究旨在确定能够区分 ADS 患者在军事框架内戒断和复发治疗结果的因素。

鉴于个人有歪曲酒精摄入量、戒断和复发结果的动机,使用患者所在单位的正式报告,结合生化参数和临床检查,确定了这些因素。对连续因 ADS 接受治疗或随访审查的患者进行了调查,并记录和比较了他们的社会人口统计学和饮酒概况、应对方式、生活事件和特定的复发诱发因素,作为 ADS 的认知行为模型中的贡献变量。根据这项对 140 名患者的调查,然后使用判别分析预测其属于戒断组或复发组。

34%的患者早期实现了绝对戒断。戒断组和复发组之间在基线社会人口统计学或饮酒特征方面没有区别。在应对方式、生活事件和复发诱发因素方面存在差异。逐步判别分析产生了一个由 10 个独立变量组成的最终方程(包括两个积极的生活事件测量),该方程预测了戒断/复发结果,原始和交叉验证的命中率分别为 86%和 79%。

利用现有的认知行为结构,早期绝对戒断成为一个可行的目标,也是一个可以实现的目标,没有任何社会人口统计学倾向的影响。这初步评估表明,这是当前 ADS 治疗计划的一个可行和现实的目标。

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