Psychological severity and response to alcoholism rehabilitation

This study examines the problem of effective treatment for alcoholic patients with concurrent psychopathology. The subjects were 131 male veterans admitted to the Coatesville Veterans Administration Medical Center. They remained in an alcohol rehabilitation program at least five days following detoxification and were successfully followed up six months after admission. Subjects were divided into LOW, MID, and HIGH groups based on their psychological severity score. The Addiction Severity Index (ASI) was then used to assess problem severity in six areas (medical, legal, family, substance abuse, employment and psychological) at admission and 6-month follow-up. All groups showed significant improvement in several areas, especially alcohol use. However, between-groups analyeses of the outcome measures (adjusted for pre-treatment differences) showed significantly poorer status in the HIGH group on 10 of 17 criteria. The authors conclude that a general assessment of psychological status at admission can effectively predict response to alcoholism rehabilitation. Finally, the authors suggest that, despite the relatively poor results of alcohol rehabilitation for the HIGH patients, this type of treatment may provide a necessary and beneficial basis for subsequent treatment in a conventional psychiatric setting.