[Long-term courses of alcohol dependence].

Abstract

Background: Descriptions of long-term histories of alcohol dependence provide insight into the etiology, prevention and care.

Objective: Report of empirical findings about the development into and remission from alcohol dependence.

Method: Narrative literature review, analysis of findings from cohort studies in the general population.

Results: Risk factors provide the opportunity to estimate increased probabilities of developing an alcohol dependence. Adolescents disclosed symptoms of alcohol dependence within 8 years after the first alcohol consumption. Alcohol dependence is related to a life expectancy 17.6 years fewer than in the general population. Data of a general population sample revealed a risk of early death 2.8 times higher than among people without mental disorders. The severity of alcohol dependence was shown to be a predictor of premature death. Nicotine dependence can add to the shortening of life in addition to alcohol dependence. Among the alcohol dependent residents in a general population sample, 90.2% did not have utilized detoxification treatment that included motivational treatment and 78.4% did not have utilized standard detoxification treatment in a psychiatric treatment facility. Remission without formal help has been proven. It is the main route of remission.

Conclusion: To reduce unfavorable courses of alcohol dependence, prevention and treatment should be focused more on the needs in the general population. In psychiatric and other medical routine care, screening and an appropriate brief intervention should be carried out.