A prospective study of successful long-term adjustment in alcohol dependence: social drinking versus abstinence.

A series of 1312 alcoholics admitted to the Department of Psychiatry, University Hospital, Lund, Sweden, from 1949 through 1969 was followed up by record data up to 31 December 1980. The conditions of the patients were evaluated with a multidimensional diagnostic rating schedule when first admitted. Two decades after their first admission, 70 male alcoholics with a good social adjustment were chosen for personal examination and of these 60 (86%) were interviewed. Social drinking was twice as common as abstinence among the former alcohol-dependent subjects. Abstainers had a higher frequency of initial ratings indicating lack of internal control of behavior and were less often socially stable when first admitted as compared with the social drinkers. Early improvement was related to initial abstinence; the subjects who improved later in life more often reported a gradual change from alcohol abuse to social drinking.