Humphreys K, Moos R H, Cohen C
Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA 34025, USA.
J Stud Alcohol. 1997 May;58(3):231-8. doi: 10.15288/jsa.1997.58.231.
Long-term studies of the course of alcoholism suggest that a variety of factors other than professional treatment influence the process of recovery. This study evaluated the role of demographic factors, baseline alcohol-related problems and depression, professional treatment, Alcoholics Anonymous (AA) and other social and community resources in predicting remission and psychosocial outcome over 8 years.
A sample of 628 previously untreated alcoholic individuals was recruited at detoxification units and alcoholism information and referral services. Of these participants, 395 (68.2%) were followed 3 and 8 years later. Most (83.3%) were white (n = 329) and 50.1% (n = 198) were men. At each contact point, participants completed a self-administered inventory that assessed their current problems, treatment utilization, AA participation and quality of relationships.
Number of inpatient treatment days received in the 3 years after baseline were not independently related to 8-year remission or psychosocial outcomes. More outpatient treatment in the first 3 years increased the likelihood of 8-year remission, but was not related to psychosocial outcomes. The number of AA meetings attended in the first 3 years predicted remission, lower depression, and higher quality relationships with friends and spouse/partner at 8 years. Extended family quality at baseline also predicted remission and higher quality friendships and family relationships at 8 years.
Given that alcoholism is a chronic, context-dependent disorder, it is not surprising that short-term interventions have little long-term impact. Social and community resources that are readily available for long periods are more likely to have a lasting influence on the course of alcoholism.
对酗酒病程的长期研究表明，除专业治疗外，多种因素会影响康复进程。本研究评估了人口统计学因素、基线酒精相关问题与抑郁、专业治疗、戒酒互助会（AA）以及其他社会和社区资源在预测8年期间戒酒及心理社会结局方面的作用。
在戒毒所及酗酒信息与转诊服务机构招募了628名既往未接受过治疗的酗酒个体作为样本。其中395名参与者（68.2%）在3年和8年后接受了随访。大多数（83.3%）为白人（n = 329），50.1%（n = 198）为男性。在每个接触点，参与者完成一份自我管理问卷，评估其当前问题、治疗利用情况、参加戒酒互助会情况及人际关系质量。
基线后3年内接受住院治疗的天数与8年戒酒或心理社会结局无独立相关性。前3年更多的门诊治疗增加了8年戒酒的可能性，但与心理社会结局无关。前3年参加戒酒互助会会议的次数可预测8年时的戒酒情况、较低的抑郁水平以及与朋友和配偶/伴侣更高质量的关系。基线时大家庭关系质量也可预测8年时的戒酒情况以及更高质量的友谊和家庭关系。
鉴于酗酒是一种慢性的、依赖背景的疾病，短期干预几乎没有长期影响并不奇怪。长期可得的社会和社区资源更有可能对酗酒病程产生持久影响。
