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The course of psychiatric comorbidity in chronic alcoholics and its impact on abstinence during 4-year follow-up of integrated outpatient treatment
This prospective treatment study examines (1) the course of comorbid Axis I disorders in 89 severely affected chronic alcoholics over 2 years in the Outpatient Long-term Intensive Therapy for Alcoholics (OLITA 1, 2, 3), and (2) the effect of comorbid Axis I and II disorders on subsequent drinking outcome over a 4-year follow-up.
Axis I disorders remit from t1 (59.0% ill), t2 (38.5%), t3 (28.2%) to t4 (12.8%). During the 4-year follow-up, the cumulative probability of not having relapsed amounts to .59. Two predictors have a strong negative impact on abstinence probability: previous inpatient detoxifications and personality disorders.
The present study demonstrates a striking remission of comorbid Axis I disorders during comprehensive long-term outpatient alcoholism treatment. The presence of an Axis II rather than an Axis I disorder on admission strongly predicts drinking outcome over a 4-year follow-up.
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2. Krampe, H. et al. Psychotherapeut 46 (2001) 232–242
3. Wagner, T. et al. (in press)