Skip to main content

Advertisement

Log in

Quality of life, alcohol detoxification and relapse: Is quality of life a predictor of relapse or only a secondary outcome measure?

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To estimate variations in Overall Quality Of Life (OQOL) within 12 months following alcohol detoxification and to evaluate the predictive value of OQOL for relapse and alcohol use severity.

Methods

Alcohol use disorders and four OQOL domains (physical health, psychological health, social relationships and environment) were assessed in 199 patients entering in-patient alcohol detoxification. Follow-up assessments were performed at 6 and 12 months after discharge. Cross-sectional and longitudinal analyses explored the relationship between OQOL and alcohol use severity, examining differences between abstinent and relapsed patients. The predictive value of OQOL was analyzed by logistic and linear regression.

Results

Correlation between OQOL and Alcohol Use Disorders Identification Test scores was confirmed at all stages of observation. Abstinent patients showed a significant improvement in all OQOL domains at 6 months after discharge, whereas OQOL domains did not undergo any significant change in relapsed patients. Baseline OQOL did not prove to be predictive of either relapse or alcohol use severity.

Conclusions

Overall quality of life changed in parallel with alcohol use severity throughout the duration of the study, confirming it to be a useful and sensitive measure of secondary outcome for alcohol detoxification. Conversely, none of the OQOL baseline scores functioned as predictors of relapse within 12 months following discharge or alcohol use severity in relapsed patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Babor, T. F., Kranzler, H. R., & Kadden, R. M. (1986). Issues in the definition and diagnosis of alcoholism: Implications for a reformulation. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 10(2), 113–128.

    Article  CAS  PubMed  Google Scholar 

  2. Daeppen, J. B., Krieg, M. A., Burnand, B., & Yersin, B. (1998). MOS-SF-36 in evaluating health-related quality of life in alcohol-dependent patients. The American journal of drug and alcohol abuse, 24(4), 685–694.

    Article  CAS  PubMed  Google Scholar 

  3. Morgan, T. J., Morgenstern, J., Blanchard, K. A., Labouvie, E., & Bux, D. A. (2003). Health-related quality of life for adults participating in outpatient substance abuse treatment. The American Journal on Addictions/American Academy of Psychiatrists in Alcoholism and Addictions, 12(3), 198–210.

    Article  PubMed  Google Scholar 

  4. Foster, J. H., Marshall, E. J., & Peters, T. J. (1998). Predictors of relapse to heavy drinking in alcohol dependent subjects following alcohol detoxification: The role of quality of life measures, ethnicity, social class, cigarette and drug use. Addiction Biology, 3(3), 333–343. doi:10.1080/13556219872146.

    Article  Google Scholar 

  5. Foster, J. H., Marshall, E. J., Hooper, R., & Peters, T. J. (1998). Quality of life measures in alcohol dependent subjects and changes with abstinence and continued heavy drinking. Addiction Biology, 3(3), 321–332. doi:10.1080/13556219872137.

    Article  Google Scholar 

  6. Frischknecht, U., Sabo, T., & Mann, K. (2013). Improved drinking behaviour improves quality of life: A follow-up in alcohol-dependent subjects 7 years after treatment. Alcohol and Alcoholism,. doi:10.1093/alcalc/agt038.

    PubMed  Google Scholar 

  7. Johnson, B. A., Ait-Daoud, N., Akhtar, F. Z., & Ma, J. Z. (2004). Oral topiramate reduces the consequences of drinking and improves the quality of life of alcohol-dependent individuals: A randomized controlled trial. Archives of General Psychiatry, 61(9), 905–912. doi:10.1001/archpsyc.61.9.905.

    Article  CAS  PubMed  Google Scholar 

  8. Johnson, B. A., Rosenthal, N., Capece, J. A., Wiegand, F., Mao, L., Beyers, K., et al. (2008). Improvement of physical health and quality of life of alcohol-dependent individuals with topiramate treatment: US multisite randomized controlled trial. Archives of Internal Medicine, 168(11), 1188–1199. doi:10.1001/archinte.168.11.1188.

    Article  CAS  PubMed  Google Scholar 

  9. Foster, J. H., Peters, T. J., & Marshall, E. J. (2000). Quality of life measures and outcome in alcohol-dependent men and women. Alcohol, 22(1), 45–52. doi:10.1016/S0741-8329(00)00102-6.

    Article  CAS  PubMed  Google Scholar 

  10. Morgan, M. Y., Landron, F., & Lehert, P. (2004). Improvement in quality of life after treatment for alcohol dependence with acamprosate and psychosocial support. Alcoholism, Clinical and Experimental Research, 28(1), 64–77. doi:10.1097/01.ALC.0000108652.73143.4B.

    Article  CAS  PubMed  Google Scholar 

  11. Rippeth, J. (1997). Factors influencing health-related quality of life in alcoholics and stimulant abusers. San Diego, CA: University of San Diego.

    Google Scholar 

  12. Maisto, S. A., & McCollam, J. B. (1980). The use of multiple measures of life health to assess alcohol treatment outcome: A review and critique. Evaluating alcohol and drug abuse treatment effectiveness: Recent advances (pp. 15–76). New York: Pergamon Press.

    Chapter  Google Scholar 

  13. Cisler, R. A., & Zweben, A. (1999). Development of a composite measure for assessing alcohol treatment outcome: Operationalization and validation. Alcoholism, Clinical and Experimental Research, 23(2), 263–271.

    CAS  PubMed  Google Scholar 

  14. Cisler, R. A., Kivlahan, D. R., Donovan, D., & Mattson, M. E. (2005). Assessing nondrinking outcomes in combined pharmacotherapy and psychotherapy clinical trials for the treatment of alcohol dependence. Journal of Studies on Alcohol. Supplement, 15, 110–118. discussion 92–93.

    PubMed  Google Scholar 

  15. Laudet, A. B. (2011). The case for considering quality of life in addiction research and clinical practice. Addiction science & clinical practice, 6(1), 44–55.

    Google Scholar 

  16. Luquiens, A., Reynaud, M., Falissard, B., & Aubin, H. J. (2012). Quality of life among alcohol-dependent patients: How satisfactory are the available instruments? A systematic review. Drug and Alcohol Dependence, 125(3), 192–202. doi:10.1016/j.drugalcdep.2012.08.012.

    Article  CAS  PubMed  Google Scholar 

  17. LoCastro, J. S., Youngblood, M., Cisler, R. A., Mattson, M. E., Zweben, A., Anton, R. F., et al. (2009). Alcohol treatment effects on secondary nondrinking outcomes and quality of life: The COMBINE Study. Journal of Studies on Alcohol and Drugs, 70(2), 186–196.

    PubMed Central  PubMed  Google Scholar 

  18. Pal, H. R., Yadav, D., Mehta, S., & Mohan, I. (2007). A comparison of brief intervention versus simple advice for alcohol use disorders in a North India community-based sample followed for 3 months. Alcohol and Alcoholism, 42(4), 328–332. doi:10.1093/alcalc/agm009.

    Article  PubMed  Google Scholar 

  19. WHO—The World Health Organization. (1998). WHOQOL user manual. Geneva: World Health Organization.

    Google Scholar 

  20. Adamson, S. J., Sellman, J. D., & Frampton, C. M. A. (2009). Patient predictors of alcohol treatment outcome: A systematic review. Journal of Substance Abuse Treatment, 36(1), 75–86. doi:10.1016/j.jsat.2008.05.007.

    Article  PubMed  Google Scholar 

  21. Soyka, M., & Schmidt, P. (2009). Outpatient alcoholism treatment-24-month outcome and predictors of outcome. Substance abuse treatment, prevention, and policy, 4, 15. doi:10.1186/1747-597X-4-15.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Duckert, F. (1993). Predictive factors for outcome of treatment for alcohol problems. Journal of Substance Abuse, 5(1), 31–44.

    Article  CAS  PubMed  Google Scholar 

  23. Solomon, K. E., & Annis, H. M. (1990). Outcome and efficacy expectancy in the prediction of post-treatment drinking behaviour. British Journal of Addiction, 85(5), 659–665.

    Article  CAS  PubMed  Google Scholar 

  24. Staines, G., Magura, S., Rosenblum, A., Fong, C., Kosanke, N., Foote, J., et al. (2003). Predictors of drinking outcomes among alcoholics. The American journal of drug and alcohol abuse, 29(1), 203–218.

    Article  PubMed  Google Scholar 

  25. Zywiak, W. H., Longabaugh, R., & Wirtz, P. W. (2002). Decomposing the relationships between pretreatment social network characteristics and alcohol treatment outcome. Journal of Studies on Alcohol, 63(1), 114–121.

    PubMed  Google Scholar 

  26. Curran, G. M., & Booth, B. M. (1999). Longitudinal changes in predictor profiles of abstinence from alcohol use among male veterans. Alcoholism, Clinical and Experimental Research, 23(1), 141–143.

    Article  CAS  PubMed  Google Scholar 

  27. Shaw, G. K., Waller, S., Latham, C. J., Dunn, G., & Thomson, A. D. (1998). The detoxification experience of alcoholic in-patients and predictors of outcome. Alcohol and Alcoholism, 33(3), 291–303.

    Article  CAS  PubMed  Google Scholar 

  28. Sobell, M. B., Sobell, L. C., & Gavin, D. R. (1995). Portraying alcohol treatment outcomes: Different yardsticks of success. Behavior Therapy, 26(4), 643–669. doi:10.1016/S0005-7894(05)80037-1.

    Article  Google Scholar 

  29. Bottlender, M., & Soyka, M. (2005). Outpatient alcoholism treatment: Predictors of outcome after 3 years. Drug and Alcohol Dependence, 80(1), 83–89. doi:10.1016/j.drugalcdep.2005.03.011.

    Article  PubMed  Google Scholar 

  30. Glenn, S. W., & Parsons, O. A. (1991). Prediction of resumption of drinking in posttreatment alcoholics. The International journal of the addictions, 26(2), 237–254.

    CAS  PubMed  Google Scholar 

  31. Noda, T., Imamichi, H., Kawata, A., Hirano, K., Ando, T., Iwata, Y., et al. (2001). Long-term outcome in 306 males with alcoholism. Psychiatry and Clinical Neurosciences, 55(6), 579–586. doi:10.1046/j.1440-1819.2001.00909.x.

    Article  CAS  PubMed  Google Scholar 

  32. WHO—The World Health Organization. (2009). WHO|Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. Geneva: World Health Organization. Retrieved from http://www.wpro.who.int/publications/docs/ClinicalGuidelines_forweb.pdf?ua=1.

  33. Kosten, T. R., & O’Connor, P. G. (2003). Management of drug and alcohol withdrawal. New England Journal of Medicine, 348(18), 1786–1795. doi:10.1056/NEJMra020617.

    Article  CAS  PubMed  Google Scholar 

  34. American Psychiatric Association. (2006). American Psychiatric Association Practice Guidelines for the treatment of psychiatric disorders: Compendium 2006. Washington DC: American Psychiatric Pub.

    Google Scholar 

  35. Babor, T. F., de la Fuente, J. R., Saunders, J., & Grant, M. (2001). The alcohol use disorders identification test. Guidelines for use in primary care (2nd ed., Vols. 1–1). Geneva: World Health Organization.

  36. WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558.

    Article  Google Scholar 

  37. First, M. B. (1997). User’s guide for the Structured clinical interview for DSM-IV axis I disorders SCID-I: Clinician version. Washington DC: American Psychiatric Press.

    Google Scholar 

  38. Spielberger, C. (1983). Manual for the state-trait anxiety inventory (STAI) (Form Y: Self-evaluation questionnaire). Redwood City, CA: Mind Garden.

    Google Scholar 

  39. Beck, A. T., & Steer, R. A. (1978). Beck depression inventory: BDI. New York: Psychological Corp.

    Google Scholar 

  40. Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The Alcohol Use Disorders Identification Test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, 56(4), 423–432.

    CAS  PubMed  Google Scholar 

  41. Piccinelli, M., Tessari, E., Bortolomasi, M., Piasere, O., Semenzin, M., Garzotto, N., et al. (1997). Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: A validity study. BMJ (Clinical research ed.), 314(7078), 420–424.

    Article  CAS  Google Scholar 

  42. Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction, 88(6), 791–804.

    Article  CAS  PubMed  Google Scholar 

  43. Donovan, D., Mattson, M. E., Cisler, R. A., Longabaugh, R., & Zweben, A. (2005). Quality of life as an outcome measure in alcoholism treatment research. Journal of Studies on Alcohol. Supplement, 15, 119–139. discussion 92–93.

    PubMed  Google Scholar 

  44. Girolamo, G. D., Rucci, P., Scocco, P., Becchi, A., Coppa, F., D’Addario, A., et al. (2000). Quality of life assessment: Validation of the Italian version of the WHOQOL-Brief. Epidemiology and Psychiatric Sciences, 9(01), 45–55. doi:10.1017/S1121189X00007740.

    Article  Google Scholar 

  45. Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial A report from the WHOQOL Group. Quality of Life Research, 13(2), 299–310. doi:10.2307/4038089.

    Article  CAS  PubMed  Google Scholar 

  46. da Silva, B., Lima, A. F., Fleck, M., Pechansky, F., de Boni, R., & Sukop, P. (2005). Psychometric properties of the World Health Organization quality of life instrument (WHOQoL-BREF) in alcoholic males: A pilot study. Quality of Life Research, 14(2), 473–478. doi:10.1007/s11136-004-5327-1.

    Article  Google Scholar 

  47. Lobbestael, J., Leurgans, M., & Arntz, A. (2011). Inter-rater reliability of the structured clinical interview for DSM-IV axis I disorders (SCID I) and Axis II disorders (SCID II). Clinical psychology & psychotherapy, 18(1), 75–79. doi:10.1002/cpp.693.

    Article  Google Scholar 

  48. Donham, G. W., & Ludenia, K. (1984). Cross-validation of the State-Trait Anxiety Inventory with an alcoholic population. Journal of Clinical Psychology, 40(2), 629–631.

    Article  CAS  PubMed  Google Scholar 

  49. Lasa, L., Ayuso-Mateos, J. L., Vázquez-Barquero, J. L., Díez-Manrique, F. J., & Dowrick, C. F. (2000). The use of the Beck Depression Inventory to screen for depression in the general population: A preliminary analysis. Journal of Affective Disorders, 57(1–3), 261–265.

    Article  CAS  PubMed  Google Scholar 

  50. Dum, M., Pickren, J., Sobell, L. C., & Sobell, M. B. (2008). Comparing the BDI-II and the PHQ-9 with outpatient substance abusers. Addictive Behaviors, 33(2), 381–387. doi:10.1016/j.addbeh.2007.09.017.

    Article  PubMed  Google Scholar 

  51. McPherson, A., & Martin, C. R. (2010). A narrative review of the Beck Depression Inventory (BDI) and implications for its use in an alcohol-dependent population. Journal of Psychiatric and Mental Health Nursing, 17(1), 19–30. doi:10.1111/j.1365-2850.2009.01469.x.

    Article  CAS  PubMed  Google Scholar 

  52. Welsh, J. A., Buchsbaum, D. G., & Kaplan, C. B. (1993). Quality of life of alcoholics and non-alcoholics: Does excessive drinking make a difference in the urban setting? Quality of Life Research, 2(5), 335–340.

    Article  CAS  PubMed  Google Scholar 

  53. Foster, J. H., Marshall, E. J., & Peters, T. J. (2000). Application of a quality of life measure, the life situation survey (LSS), to alcohol-dependent subjects in relapse and remission. Alcoholism, Clinical and Experimental Research, 24(11), 1687–1692. doi:10.1111/j.1530-0277.2000.tb01970.x.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesco Oliva.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Picci, R.L., Oliva, F., Zuffranieri, M. et al. Quality of life, alcohol detoxification and relapse: Is quality of life a predictor of relapse or only a secondary outcome measure?. Qual Life Res 23, 2757–2767 (2014). https://doi.org/10.1007/s11136-014-0735-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-014-0735-3

Keywords

Navigation