Clinical, Cognitive, and Motivational Correlates of Short-term Outcomes in Alcohol Dependence: A Prospective Observational Study.

Abstract

Background: Alcohol dependence occurs in about 9% of men in India. It is a major contributor to premature death and disability. Several clinical factors may play a role in the short-term outcomes of alcohol dependence.

Methods: A total of N = 122 male patients with alcohol dependence as per ICD-10 DCR criteria were recruited in this study. They were assessed on socio-demographic and clinical parameters such as severity of alcohol dependence (SADQ), motivation to quit alcohol (SOCRATES), and global cognition (MoCA) and frontal cognition (FAB). The patients were then followed up at 1- and 3-month time points using the timeline follow-back method of enquiry into their last 30 days of drinking.

Results: The mean age of the patients was about 40.6 (SD = 7.6) years. The duration of alcohol use was 18.56 years (SD = 7.22), and the average use was 14.14 units (SD = 8.62) per day. They had moderately severe dependence with SADQ scores of 25.13 (SD = 12.01). Two-thirds (n = 82) (67.2%) had low MoCA scores, and nearly one-fourth (n = 27) (22.1%) scored low on FAB. About 30% of patients relapsed at 1 month, and 50% relapsed by the end of 3 months. Earlier age at dependence (p = .012) was associated with relapse at 1 month. At 3 months, patients who were married (p = .040), had previous abstinence attempts (p = .003), and had higher MoCA scores (>26) (p = .042) were more likely to remain abstinent.

Conclusions: About 30% of patients with alcohol dependence relapse within 1 month, whereas 50% relapse by the end of 3 months. Early age at onset of dependence predicted relapse at 1 month, and married status, past abstinent attempts, and intact global cognition predicted abstinence at 3 months.