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Post discharge dropout of alcoholics - a naturalistic study in a general hospital setting
S Sengupta1, N Kar, P S Sharma
1Somenath Sen Gupta, M.D., Associate Professor in Psychiatry I.H.B.A.S., Po.Box.9520, Dilshad Garden Delhi-110095.
Insights
Patients with alcohol dependence syndrome who dropped out after hospital discharge were younger, less educated, and had earlier problem drinking onset. This highlights post-discharge attrition as a significant social and clinical challenge in alcoholism treatment.
Area of Science:
- Addiction Medicine
- Psychiatry
- Public Health
Background:
- Alcohol dependence syndrome is a chronic relapsing condition requiring ongoing management.
- Post-discharge follow-up is crucial for sustained recovery in patients with alcohol dependence.
- High attrition rates in treatment programs pose a challenge to effective alcoholism management.
Purpose of the Study:
- To identify sociodemographic and clinical characteristics differentiating patients with alcohol dependence who complete follow-up from those who drop out.
- To understand factors contributing to post-discharge attrition in alcoholism treatment.
Main Methods:
- A naturalistic longitudinal study followed 133 inpatients with alcohol dependence syndrome for one year post-discharge.
- Patients were categorized into regular follow-up (Group 1) and no return/dropout (Group 2) groups.
- Sociodemographic and clinical variables were compared between the two groups.
Main Results:
- Patients who dropped out (Group 2) were significantly younger than those who attended follow-up (Group 1).
- Dropouts had lower education levels, were less frequently married, and reported earlier onset of problem drinking.
- Poor social support and higher rates of mental health problems were also associated with dropout.
Conclusions:
- Post-discharge attrition among individuals with alcohol dependence is influenced by a combination of social and clinical factors.
- Identifying at-risk individuals early can inform targeted interventions to improve treatment adherence.
- Addressing social support and co-occurring mental health issues is vital for reducing dropout rates in alcoholism treatment.
Abstract:
In a naturalistic longitudinal design 133 consecutive inpatients with alcohol dependence syndrome were followed up for one year following discharge from the hospital. 59 patients (group 1) paid follow up visit at regular intervals whereas 28 subjects (group 2)never returned despite three consecutive postal intimations. Rest of the patient were irregular in follow up. The individuals in group 1 were compared with those in group 2 on various sociodemographic and clinical variables with the aim of delineating the characteristics that could define the alcoholics who dropped out following discharge. It was found that such patient were relatively younger with lower level of education, less frequently married, had earlier onset of problem drinking with poor social support and higher rates of mental problems. It was concluded that post discharge attrition of alcoholics could be a social as well as a clinical problem in any setting rendering long treatment for alcoholism.
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