Therapy and course of alcohol dependence. Effects on the patient and family

: 100 male and female patients, aged 20 to 60 years with the diagnosis alcohol-addiction (ICD 9 No 303.0) took part in a longitudinal treatment evaluation study. Consecutive admissions from May '83 until July '85 were assessed. All patients participated in a 6-week inpatient group therapy and a 6-week outpatient treatment for alcohol-dependent patients at the Psychiatric University Hospital in Munich. Assessments were performed at the following times: 1. on admission, 2. at the end of inpatient therapy, 3. at the end of outpatient therapy, 4. at a 6-month follow-up and 5. at an 18-month follow-up. The major goals of the study were as follows: 1. Descriptive analysis of the course of illness from admission to the 18-month follow-up; 2. Analysis of the influence of the social setting at home (relationship, attitude of the family towards the patient) (Kreisman's Patient Rejection Scale) and expression of emotions in the family according to the "Camberwell Family Interview" (CFI); 3. Evaluation of the effect of the additional treatment component (A) "Systematic involvement of the significant other" as compared to an alternative component (B) "Systematic encouragement of the patient in self-help initiatives"; 4. Identification of risk factors for relapse and predictors of good prognosis that can be used to improve the therapeutic concept. The sample consisted of 42% women and 58% men, with a mean age of 37.9 years. Only patients who had a spouse or another close relative were accepted for participation in the study. At the beginning of the study 48% of the patients were married, 18% divorced, 27% unmarried and 6% lived separately or were widowed. 95 of the 100 patients could be reassessed at discharge from inpatient therapy, 92 at the end of 6-week outpatient treatment phase, 91 at the 6-month follow-up and 90 at the 18-month follow-up. The additional treatment components (A versus B) showed no major differences in effect. Significant changes in the patients attitude, behaviour and psychopathology were observed for patients receiving either one of the additional treatment components (A or B). The lack of differing effects from the additional treatment components is plausible, because the main part of the therapy (without the additional therapy component) was the same in both groups; this basic therapy took up most treatment time and by itself brought about major changes in personality scales, psychopathology and partnership interactions.(ABSTRACT TRUNCATED AT 400 WORDS)