A 5-Year Follow-Up of Depressed and Bipolar Patients with Alcohol Use Disorder in an Irish Population

作者：Farren Conor K^*; Murphy Philip; McElroy Sharon

来源：Alcoholism: Clinical and Experimental Research , 2014, 38(4): 1049-1058.

DOI：10.1111/acer.12330

• Alcohol Use Disorder
• Depression
• Bipolar Disorder
• Treatment

BackgroundAlcohol 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 5years after inpatient integrated treatment in patients with these co-occurring disorders, and identify prognostic factors associated with long-term outcome. %26lt;br%26gt;MethodsTwo 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 3months, 6months, 2years, and 5years after treatment. %26lt;br%26gt;ResultsThe retention rate at 3months postdischarge was 95.6%, 75.6% at 6months, 70.2% at 2years, and 55.6% at 5years. 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 3months, who had significantly reduced their mean weekly alcohol consumption since baseline, remained light drinkers at 5years and very few went on to be heavy drinkers. Indeed, if they did alter category by 5years, they tended to become abstinent. %26lt;br%26gt;ConclusionsDual 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 5years.

• 出版日期2014-4