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Remission from alcohol dependence without help: how restrictive should our definition of treatment be?
Gallus Bischof1, Hans-Jürgen Rumpf, Ulfert Hapke
1Department of Psychiatry and Psychotherapy, Medical University of Lübeck, Germany. bischof.g@psychiatry.mu-luebeck.de
Objective:
Studies on untreated remissions from addictive behaviors have utilized very different definitions of treatment, ranging from regular self-help group participation to almost no help at all. The purpose of this article is to examine the impact of different treatment definitions on triggering and maintenance mechanisms of recovery.
Method:
Sample 1 consists of 103 remitted alcohol dependent subjects (30% female) who never received any kind of treatment or counseling for alcohol problems. Sample 2 consists of 75 remitted alcohol dependent subjects (20% female) who received minor help, defined as contact with alcohol treatment not exceeding nine self-help group sessions or three counseling sessions by a specialty provider. Sample 3 consists of 50 remitted alcohol dependent subjects (24% female) who regularly participated in self-help group meetings. All participants were media recruited. Groups were compared on grounds of a comprehensive, standardized interview, including the assessment of sociodemographic and substance related variables as well as triggering and maintenance factors of remission.
Results:
On most triggering and maintenance factors of the remission, remitters from alcohol dependence who received minor help are comparable with remitters who received no help, and both groups differ significantly from regular self-help group participants.
Conclusions:
Inconsistencies in studies on recovery from alcohol dependence without treatment cannot be accounted for by varying definitions of treatment, as the inclusion of subjects who received some minor help does not lead to a bias in most variables associated with remission.