Shaw G K, Waller S, Latham C J, Dunn G, Thomson A D
Elmdene Research Unit, Bexley Hospital, Kent, UK.
Alcohol Alcohol. 1998 May-Jun;33(3):291-303. doi: 10.1093/oxfordjournals.alcalc.a008393.
This paper reports the detoxification experience and outcome at 6 months and 1 year following detoxification from alcohol in 160 patients admitted to a south-east London in-patient detoxification unit. Patients' socio-demographic characteristics are also described. The sample was predominantly middle-aged, mainly male, and highly dependent on alcohol. Subjects had been drinking heavily for many years and suffered physical and social complications in consequence. The rate of convulsions was 3.1% and of delirium tremens 1.25%. The details of the level of drug usage during detoxification and the assessment of severity of the withdrawal syndrome are also reported. The severity of the withdrawal syndrome and the incidence of significant complications of withdrawal were higher in those with a previous history of four or more episodes of detoxification, a previous history of withdrawal fits or evidence of high levels of tolerance and dependence assessed either by the Severity of Alcohol Dependence Questionnaire (SADQ) or by drinking on a typical heavy drinking day in excess of 24 U of alcohol. It is suggested that subjects with one or more of these attributes should be treated on an in-patient, rather than an out-patient, basis unless adequate support and monitoring systems are in place. Overall, patients made improvements on a wide range of social and psychological variables, but the 'abstinent' and 'controlled drinking' groups made significantly higher improvements on all variables in both follow-up periods. When patients improved their drinking status and reduced the levels of drink-related physical and social complications, in both time periods, their use of social and health resources decreased significantly. Living circumstances at intake were predictive of drinking status at both follow-up stages. The amount drunk on a heavy drinking day, at both follow-up stages, was predicted by severity of withdrawal, SADQ and living circumstances at intake in that order of importance.
本文报告了伦敦东南部一家住院戒酒治疗机构收治的160例患者戒酒6个月和1年后的解毒经历及结果。还描述了患者的社会人口学特征。样本主要为中年男性，对酒精高度依赖。受试者多年来大量饮酒，因此出现了身体和社会方面的并发症。惊厥发生率为3.1%，震颤谵妄发生率为1.25%。还报告了解毒期间药物使用水平的详细情况以及戒断综合征严重程度的评估。有过四次或更多次解毒经历、有过戒断发作史或通过酒精依赖严重程度问卷（SADQ）或在典型重度饮酒日饮酒超过24单位酒精评估显示有高度耐受性和依赖性证据的患者，戒断综合征的严重程度和戒断严重并发症的发生率更高。建议除非有足够的支持和监测系统，否则具有上述一种或多种特征的受试者应住院治疗，而非门诊治疗。总体而言，患者在广泛的社会和心理变量方面有所改善，但“戒酒”组和“控制饮酒”组在两个随访期的所有变量上改善更为显著。当患者改善饮酒状况并减少与饮酒相关的身体和社会并发症水平时，在两个时间段内，他们对社会和卫生资源的使用都显著减少。入院时的生活状况可预测两个随访阶段的饮酒状况。在两个随访阶段，重度饮酒日的饮酒量依次由戒断严重程度、SADQ和入院时的生活状况预测。
