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Personality disorders predict relapse in alcoholic patients
R Verheul1, W van den Brink, C Hartgers
1Amsterdam Institute for Addiction Research, The Netherlands.
Addictive Behaviors
|November 5, 1998
Summary
Alcoholism treatment outcomes are negatively impacted by Axis II comorbidity, especially in outpatients with low motivation. Poor working alliance may also contribute to relapse in these patients.
Area of Science:
- Psychiatry
- Clinical Psychology
- Addiction Medicine
Background:
- Comorbidity of personality disorders (Axis II) is common in alcoholism.
- Understanding factors influencing relapse after treatment is crucial for improving patient outcomes.
Purpose of the Study:
- To examine the association between DSM-III-R Axis II comorbidity and relapse in alcoholics post-treatment.
- To investigate the mediating roles of motivation for change, time in program, and working alliance.
Main Methods:
- Prospective study design.
- Sample of 105 outpatients and 82 inpatients with alcoholism.
- Assessment of DSM-III-R Axis II comorbidity, motivation for change, time in program, working alliance, and relapse.
Main Results:
- Axis II comorbidity significantly predicts relapse in alcoholics.
- The association between Axis II comorbidity and relapse is strongest in outpatients with low motivation and/or short treatment duration.
- Motivation for change and time in program did not mediate the Axis II-relapse association.
- Poor working alliance was linked to personality pathology in inpatients and may mediate relapse in outpatients.
Conclusions:
- Axis II comorbidity is a significant risk factor for relapse in alcohol use disorder.
- Patient motivation and treatment duration are critical moderators, particularly for outpatient treatment.
- Working alliance may play a role in the relationship between personality pathology and treatment outcomes in alcoholism.