Indexed on: 17 Jan '14Published on: 17 Jan '14Published in: Alcoholism: Clinical and Experimental Research
Alcohol use disorders (AUDs) and affective disorders commonly co-occur, and this co-occurrence is mutually detrimental. To date, few long-term outcome studies exist involving patients with these comorbid disorders. We wished to determine treatment outcomes 5 years after inpatient integrated treatment in patients with these co-occurring disorders, and identify prognostic factors associated with long-term outcome.Two hundred and five depressed and bipolar patients with AUD who completed an inpatient integrated treatment program for dual diagnosis were assessed at baseline, posttreatment discharge, and at 3 months, 6 months, 2 years, and 5 years after treatment.The retention rate at 3 months postdischarge was 95.6%, 75.6% at 6 months, 70.2% at 2 years, and 55.6% at 5 years. Depression, elation, anxiety, and craving scores all fell over the 5-year period, as did the drinking outcome measures in both the depressed and bipolar alcoholics. Each of the primary drinking outcome measures had independent prognostic factors: abstinence at 2 years predicted abstinence at 5 years; number of drinking days at 6 months and 2 years predicted number of drinking days at 5 years; number of drinks per drinking day at 6 months and 2 years predicted number of drinks per drinking day at 5 years. Moreover, the majority of nonabstinent light drinkers at 3 months, who had significantly reduced their mean weekly alcohol consumption since baseline, remained light drinkers at 5 years and very few went on to be heavy drinkers. Indeed, if they did alter category by 5 years, they tended to become abstinent.Dual diagnosis of AUD and depression or bipolar disorder may be treated successfully together with intensive intervention and follow-up, and various prognostic factors emerge. Early abstinence predicts later abstinence, and the vast majority of those who achieve light drinking early in recovery remain light drinkers or become abstinent at 5 years.