[Treatment of alcoholism. Study of the efficacy of 4 therapeutic orientations].

The present survey studies, in a group of 145 alcoholics from the National Institute on Alcoholism in Costa Rica, the effectiveness of four therapeutic orientations in alcoholism: behavioral, psychosocial, occupational and multiple. The survey was carried out in a harmless population of alcoholics, and it aims to work out and to test treatment designs suitable to the uncovered level or prevention respecting to alcoholism, the secondary one. Each one of the groups receiving the diverse treatments stayed as in-patient under similar conditions. The treatment had a two-week duration; once finished, the patient was discharged and continued with a one-year follow-up. The outcomes are the following: 1. Treatment. The occupational and behavior-oriented treatments present a five months abstinence period as an estimate average effectiveness. The psychosocial-oriented treatments reach a seven months abstinence period. Its major effectiveness is due to the specific action this orientation develops on the patients having the worst prognosis. The integration, in a treatment, of orientations corresponding to different theoretical frames can determine reciprocal inhibition phenomena among orientations and lower the general effectiveness level. 2. Diagnosis. The personalities defined as depressive and paranoiac according to their prevailing basic anxiety, and the presence or absence of a conjugal tie holds an estimate link with the abstinence the patient showed when he was discharged from treatment. The prognosis value of this characteristic disappears when it is then direct object of a therapeutic orientation (psychosocial) given that this characteristics are sensitive to changes by action in a specific treatment.