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References

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Appendices

Appendix A. Admission . . . . . . . . .

Appendix B. Discharge ......... .

Appendix C. Six-Month Follow-Up ..

Appendix D. Eighteen-Month Follow-Up ..

Appendix T. Treatment Variables ..... .

Appendix U. Course (Changes Over Time) .

Appendix P. Prognosis. . . . . . .

Appendix I. Indication ........ .

Indication Variables in Men . . . . . .

288

295

302

309

318

333

337

346

346

Indication Variables in Women . . . . . . . . . . . . . . . . . . .. 366

287

A. Admission

Table AI. Living arrangements Table A2. Number of children

n % n %

Living alone 341 24.6 0 532 38.2 Living with spouse 652 46.9 1 326 23.4 Living with partner 115 8.3 2 311 22.3 Living with parents 166 12.0 3 131 9.4 Separated from partner 69 5.0 4 or more, 93 6.7 Sharing a fiat/house 46 3.3

Total 1393 Total 1389

Table A3. Population of home town Table A4. Fit for work

n % n %

<2000 199 14.4 No 211 15.1 <:100000 709 51.2 Yes 1023 73.4 >100000 477 34.4 Conditionally 159 11.4


Table AS. Number of jobs in past 2 years Table A6. Religion

n (%) n (%)

o (unemployed) 227 16.4 Roman catholic 636 46.0 1 857 62.0 Lutheran 600 43.4 2 151 10.9 Other christian 13 0.9 3 77 5.6 Other 7 0.5 4 or more 7-1 5.1 None 128 9.2


288

Table A7. Active practising of religion

No Yes

Total

1070 307

1377

77.7 22.3

Table A9. Alcohol occupation a

No In last 6 months Earlier

Total

n

1205 42

143

1390

(%)

86.7 3.0

10.3

aLe. concerned with the production or sale of alcoholic drinks.

Table All. Age when started abu-sing alcohol (years)

n (%)

Under 15 66 4.7 15-19 313 22.5 20-29 541 38.9 30-39 346 24.9 40-49 112 8.1 50-59 12 0.9

Total 1390

Table A13. Level of alcohol consumption in the last 2 years

n (%)

Steady 442 32.3 Increasing 695 50.8 Decreasing 230 16.8

Total 1367

Table AS. Voluntary vs. compulsory admission

Voluntary Compulsory

Total

n

1384 10

1394

(%)

99.3 0.7

Table AIO. Alcohol risk occupations

No. In the last 6 months Earlier

Total

n

946 192 251

1389

(%)

68.1 13.8 18.1

a I.e. Building trade, merchant navy, travelling representative, etc.

Table A12. Number of weeks of abstinence before admission

n (%)

0 527 38.0 1-4 390 28.1 5-8 210 15.1 9-12 104 7.3 13-16 56 4.1 17-20 38 2.7 21-24 10 0.7 25-26 53 3.8

Total 1388

Table A14. Frequency of alcohol consumption in the last 2 years

n (%)

Daily, fairly steady amount 689 49.6 Daily, increased at weekends 255 18.4 Almost daily 247 17.8 Only at the weekend 35 2.5 Periodically 163 11.7

Total 1389

289

Table AIS. Amount of alcohol consumed Table A16. Amount of alcohol con-per drinking day sumed per week

Pure Pure alcohol n (%) alcohol n (%)

9 9

Up to 30 14 1.0 1-500 135 11.2 31-60 51 3.7 501-1000 305 24.7 61-120 348 25.4 1001-1500 472 38.9 121-240 654 47.7 1501-2000 155 12.7 More than 240 304 22.2 2001-3000 118 9.7

3001-5000 21 1.7

Total 1371 5001-7000 7 0.6

Total 1213

Table A17. Number of times Table AIS. Number of days in last alcohol consumed per month 6 months on which more than 60 g

(men) or 30 g (women) pure alcohol n (%) consumed

3 0.2 n (%) 2-4 36 2.7 5-8 37 2.7 0 29 2.2 9-12 57 4.2 1-6 2 0.1

13-16 22 1.7 7-30 47 3.4 17-20 244 18.2 31-60 42 3.0 21-30 946 70.4 61-90 58 4.3

91-120 242 18.1 Total 1345 121-180 924 69.0

Total 1344

Table A19. Medicaments used

Occasionally Regularly

n % n %

Sleeping tablets 204 14.8 117 8.51

Painkillers 322 23.2 116 8.4 Opiates and opiate derivatives 17 1.2 17 1.2 Neuroleptics and antidepressants 201 14.5 192 13.9 Amphetamines 47 3.4 19 1.4

290

Table A20. Illegal drugs used


n % n %

Hallucinogens 21 1.15 5 0.4 Cannabis 58 4.2 18 1.3 Other 55 4.0 79 5.7

Table A21. Medical and psychosocial help received


n % n %

Family doctor 668 48.1 330 23.7 Psychiatrist 281 20.4 93 6.7 Counselling centre 482 34.8 338 24.4 Health authority 184 13.4 35 2.5 Other health facilities 109 8.2 48 3.6 Alcoholics Anonymous 242 17.6 108 7.8 Other self-help groups 266 19.4 241 17.5

Table A22. Previous experience of therapeutic treatment


n % n %

Psychoanalyt. group therapy 21 1.5 21 1.5 Behavioural group therapy 21 1.5 34 2.5 Client-centred group therapy 56 4.1 81 5.9 Other group therapy 66 4.8 75 5.4 Professional after-care group 22 1.6 54 3.9 Psychoanalyt. individual therapy 24 1.7 23 1.7 Behavioural individual therapy 17 1.2 11 0.8 Client-centred individual therapy 110 7.9 106 7.6 Other individual therapy 60 4.3 75 5.4

291

Table A23. Previous admissions to a Table A24. Previous admissions to general hospital psychiatric clinic

Number of Number of admissions n (%) admissions n (%)

0 406 29.5 0 873 63.3 1-5 802 58.2 1 306 22.2 6-10 127 9.3 2-5 175 12.7

11-15 33 2.4 6-10 14 1.1 16-20 9 0.6 11-15 8 0.5

16-20 3 0.2 Total 1377

Total 1379

Table A2S. Previous admissions to ad- Table A26. Previous admissions to diction clinic sanatorium

Number of Number of admissions n (%) admissions n (%)

0 1069 77.6 0 1118 81.8 1 227 16.5 1 182 13.3 2 58 4.2 2 42 3.1 3 12 0.9 3 14 1.0 4-8 11 0.9 4-6 10 0.7


Table A27. Life events (LEL)

Stress scoreb

Mean na % stress score 0 2 3 4

1 Death of spouse/partner 30 2.2 1.48 12 10 2 Divorce 121 8.8 2.21 25 8 9 48 16 3 Separation from spouse/partner 277 19.9 2.52 33 16 38 121 46 4 Prison term 64 4.6 1.79 19 7 5 17 8 5 Death of close relative 301 21.6 2.11 44 32 58 121 14 6 Own illness on injury 704 50.5 2.09 69 118 195 260 28 7 Marriage 100 7.2 0.52 59 9 2 8 1 8 Loss of job 499 35.9 2.26 69 59 67 225 47

292

Table A27 (continued)

Stress score b Mean

n" % stress score 0 2 3 4

9 Reconciliation with partner 334 24.0 1.84 60 51 80 116 3 after serious conflict

10 Retirement 30 2.2 1.15 16 3 7 1 3 11 Serious change in the health 196 14.1 1.93 44 14 40 74 8

of a family member 12 Own pregnancy 43 3.1 0.62 28 1 2 6 6 13 Sexual difficulties 323 23.2 2.27 15 46 103 126 16 14 Addition to the family 77 5.5 1.08 32 9 9 8 4 15 Changes at work 131 9.4 1.60 31 25 33 32 3 16 Major change in income 414 29.7 1.88 78 55 105 125 20 17 Death of a close friend 148 10.6 2.11 19 12 39 61 2 18 Change of job 180 11.6 1.86 30 28 44 52 7 19 Change in frequency of 448 32.2 2.09 64 61 110 158 34

quarrels with partner 20 Taking out a loan over 105 7.5 1.74 24 13 20 31 3

DM 30000 21 Calling in of a loan 59 4.2 1.48 19 7 10 14 2 22 Change in area of responsibility 321 23.1 1.55 86 51 77 83 3

at work 23 Children leaving home 146 10.5 1.80 31 23 33 40 9 24 Trouble with relatives by 237 17.0 1.98 34 37 62 65 18

marriage 25 Major personal success 104 7.5 1.46 31 12 27 22 1 26 Partner starting/ceasing 118 8.5 1.22 44 22 15 26 11

to work 27 Starting/finishing course of 78 5.6 0.87 39 5 9 8 2

studies 28 Change in standard of living 339 24.4 1.78 50 64 109 82 7 29 Change in personal habits 556 40.0 1.67 100 120 161 134 7 30 Trouble with superiors at work 422 30.3 2.10 33 77 125 141 20 31 Major change in work time 269 19.3 1.68 49 57 79 68 3

and conditions 32 Moving home 306 22.0 1.81 62 50 71 84 18 33 Change of college/university 22 1.6 1.37 8 3 2 5 1 34 Change in leisure habits 466 33.5 0.18 377 18 18 8 0 35 Change in church-going habits 110 7.9 1.15 40 14 22 13 2 36 Change in social habits 419 30.1 1.59 82 92 114 90 4 37 Taking out a loan less than 224 16.1 1.57 31 78 49 44 4

DM 30000 38 Change in sleeping habits 670 48.2 2.07 49 118 221 210 26 39 Change in frequency of 443 32.0 1.74 76 87 134 106 13

contact with family 40 Change in eating habits 732 52.7 1.77 110 135 253 181 7 41 Holiday 484 34.9 1.18 178 93 122 66 2 42 Minor infringements of the law 391 28.1 1.85 60 89 84 111 22

"The incidence of individual stress scores does not agree with the figure for total incidence, because of missing data. bO, no stress; 1, a little stressful; 2, moderately stressful; 3, very stressful; 4, unbearable.

293

Table A2S. Differences between men and women in stress scores for life events

Mean stress score

Life event Men Women p

Serious change in the health of a 1.8 2.4 0.0137 member of the family

Additions to the family 0.9 1.8 0.0187 Change of job 1.7 2.4 0.0021 Change in frequency of quarrels 1.9 2.5 0.0000

with partners Change in area of responsibility at 1.5 1.9 0.0137

work Children leaving home 1.5 2.5 0.0000 Difficulties with superiors at work 2.0 2.3 0.0197 Change in working hours 1.6 2.1 0.0005 Moving home 1.7 2.2 0.0010

294

B. Discharge

Table 81. Marital status (changes) Table 82. Living arrangements (changes)

n (%) n (%)

No change 1259 95.7 No change 1160 88.2 Divorced 31 2.4 Separated 62 4.7 Married 23 1.7 Living with partner/spouse 48 3.7 Widowed 2 0.2 Sharing a flat/house 30 2.3

Living with parents 15 1.1 Total 1315

Total 1315

Table 83. Work situation (changes)

n (%)

No change 1007 76.5 Unemployed 137 10.4 New workplace, similar position 59 4.5 New workplace, better position 29 2.2 New workplace, worse position 13 1.0 Same workplace, worse position 15 1.1 Same workplace, better position 20 1.5 New occupation 13 1.0 In vocational training 14 1.1 Retired 10 0.8

Total 1317

Table 84. Income (changes)

Table 8S. Vocational training (changes) n (%)

n (%) Unchanged 1132 86.8 Risen 53 4.1 No new training 1282 97.4 Dropped 119 9.1 Training completed 10 0.8

Training broken off 2 0.2 Total 1304 New training, begun 21 1.6

295

Table 86. Living conditions (changes) Table B7. Actual length of treatment (weeks)

n (%) n (%)

No change 1201 91.5 Not homeless 68 5.2 1--4 5 0.4 Better home 40 3.0 5-8 350 25.1 Patient a home-owner 3 0.2 9-12 29 2.1

1 0.1 13-16 180 12.9 17-20 158 11.4

Total 1313 21-24 76 5.4 25-28 574 41.3 29-32 2 0.1 33-36 6 0.1 37--40 11 0.8 41--49 1 0.1

Total 1392

Table 88. Premature discharge Table B9. Actual length of (drop-outs) treatment of drop-outs (weeks)

n (%) n (%)

No 1162 82.8 1--4 35 14.9 Yes 241 17.2 5-8 55 23.4

9-12 41 17.4 Total 1403 13-16 49 20.9

17-20 27 11.5 21-24 21 8.9 25 7 3.0

Total 235

Table BI0. Number of relapses Table B11. Number of days when during treatment alcohol consumed during treatment

n (%) n (%)

0 1169 90.1 0 1176 92.5 1 49 3.8 1 22 1.7 2 68 5.2 2 65 5.1 3 8 0.6 3 5 0.4 4 2 0.2 4 2 0.2 5 2 0.2 6 0.1


296

Table B12. Use of medicaments

Never Occasionally Regularly

Of these, Of these, no. medic. no. medic.

n % n % prescribed n % prescribed

Sleeping tablets 1255 99.4 7 0.6 5 1 0.1 Painkillers 1193 94.5 61 4.8 53 9 0.7 7 Neuroleptics and 1223 96.8 31 2.5 24 9 0.7 8

antidepressants Other 953 76.5 147 11.8 145 146 11.7 146

Table B13. Abuse of illegal drugs Table B14. Psychopathological symptoms

n (%) n (%)

Opiates 0 0.0 Delirium 15 1.2 Amphetamines 1 0.1 Blackout 122 9.4 Hallucinogens 1 0.1 Disorientation 87 6.7 Cannabis 2 0.2 Other 374 29.1

Table B15. Number of visits to Table B16. Persons of reference the doctor available

n (%) n (%)

0 521 41.0 None 409 31.4 1 165 12.9 Partner 521 40.0 2-4 297 23.4 Children 28 2.1 5-10 220 17.3 Parent(s) 101 7.8

11-20 53 4.1 Other 76 5.8 21--60 15 1.2 Several 168 12.9 70 1 0.1


297

Table B17. Number of individ-ual consultations with persons of reference during treatment

n (%)

0 600 46.2 1 298 22.9 2 198 15.2 3 117 9.0 4 44 3.4 5 19 1.5 6 9 0.7 7 5 0.4 8 10 0.8

Total 1300

Table B19. Involvement of persons of reference in treatment (hours overall)

n (%)

0 464 35.9 1-2 212 16.4 2-10 284 22.0

11-20 114 8.8 21-30 131 10.2 31-40 44 3.4 41-50 22 1.7 51-60 10 0.7 61-73 5 0.4 88 6 0.5

Total 1292

Table B21. Optional additional kinds of therapy

No Yes

n (%)

912 374

70.9 29.1

Total 1286

298

Table B18. Partners' participation in partner seminars

n (%)

Participated 716 54.8 Did not participate 590 45.2

Total 1306

Table B20. Patients' participation in treatment

n (%)

Very active 165 12.8 Active 554 42.9 Less active 356 27.6 Passive 189 14.6 Reluctant 28 2.2

Total 1292

Table B22. Clinical prognosis

n (%)

Impossible to predict 156 12.1 Good 476 37.0 Doubtful 487 37.8 Poor 169 13.1

Total 1288

Table 823. Additional symptoms recorded by therapists

Whole group Men Women Syndrome or disturbance n % n % n % Significance"

01 Eating disturbances 84 6.3 45 4.7 39 10.8 *** 02 Anorexia 4 0.3 4 1.1 ** 03 Tobacco abuse 4 0.3 4 0.4 n.s. 04 Withdrawal symptoms 42 3.2 32 3.3 10 2.8 n.s 05 Other symptoms of 5 0.4 3 0.3 2 0.6 n.s.

addiction 06 Anxiety states 148 11.2 101 10.5 47 13.0 n.S. 07 Depression 32 2.4 17 1.8 15 4.1 * 08 Aggressiveness 14 1.1 9 0.9 5 1.4 n.s. 09 Suicidal tendencies 6 0.5 0.1 5 1.4 ** 10 Obsessional symptoms 6 0.5 5 0.5 0.3 n.s. 11 Sexual disturbances 2 0.2 1 0.1 1 0.3 n.s. 12 Problems of self-worth 14 1.1 11 1.1 3 0.8 n.s. 13 Disturbances of drive 17 1.3 11 1.1 6 1.7 n.S. 14 Other affective 5 0.4 5 0.5 n.s.

disturbances 15 Disturbances of 15 1.1 14 1.5 0.3 n.s.

achievement 16 Disturbances of 2 0.2 2 0.2 n.s.

consciousness 17 Sleep disturbances 20 1.5 14 1.5 6 1.7 n.s. 18 Psychoautonomic 60 4.5 39 4.1 21 5.8 n.s.

disturbances 19 Funktional 16 1.2 10 1.0 6 1.7 n.S.

disturbances 20 Physical complaints 27 2.0 20 2.1 7 1.9 n.S. 21 Psychosomatic 6 0.5 4 0.4 2 0.6 n.s.

illness 22 Organic illness 4 0.3 3 0.3 0.3 n.S. 23 Other perceptive 4 0.3 3 0.3 0.3 n.s.

disturbances e.g. itching

24 No significance as 31 2.3 25 2.6 6 1.7 n.S. 'symptom'

25 Seizures 9 0.7 6 0.6 3 0.8 n.s. 26 Behavioural disturbance 9 0.7 7 0.7 2 0.6 n.s. 27 Probably alcohol- 2 0.2 0.1 0.3 n.s.

related organic illness

"X 2 test.

299

Table B24. Secondary psychiatric diagnoses (ICD-9)

Only centres with more than 10% secondary

All diagnoses (n=423) ICD-9 centres

Diagnosis no. n n %

Alcoholic psychoses: 291 24 24 5.7 Delirium tremens 291.0 3 3 0.7 Korsakoff's syndrome 291.1 1 1 0.2 Other alcoholic dementia 291.2 6 6 1.4 Alcoholic hallucinosis 291.3 1 1 0.2 Other 291.8 11 11 2.6 No precise details 291.9 2 2 0.5

Transitory organic psychoses 293 2 0.2 Schizophrenic psychoses 295 2 1 0.2 Affective psychoses 296 3 3 0.7 Neuroses 300 50 46 10.9 Personality disturbances 301 105 104 24.6 Medicament/drug dependence 304 54 51 12.1 Medicament/drug abuse 305 88 86 20.3 Physical functional disturbances of 306 6 6 1.4

psychic origin Special symptoms or syndromes 307 7 7 1.7 Psychogenic reaction 309 6 5 1.2 Other 310 0.2

311 0.2 317 0.2

Table B25. Multidimensional Alcohol Questionnaire (MDA)

Standard Scale Mean score deviation

Motivation for drinking 23.377 3.959 Attitude to changing drinking habits 17.360 6.019 Ability to control drinking 11.978 5.004 Self-image under influence of alcohol 25.273 7.105 Social resonance of drinking 32.121 6.247

Table B26. Life Event List

Mean stress Stress score

n % 0 2 3 4

1 Death of spouse/partner 17 1.6 1.6 6 1 2 5 1 2 Divorce 43 4.3 2.0 10 3 8 19 2 3 Separation from spouse/partner 96 9.0 2.1 17 11 15 36 9 4 Prison term 9 0.8 1.4 5 0 1 1 2 5 Death of close relative 96 9.0 1.8 22 10 21 31 3

300

Table 826 (continued)


n % 0 2 3 4

6 Own illness on injury 213 19.9 1.8 25 53 64 48 7 7 Marriage 28 2.6 0.5 22 0 3 3 0 8 Loss of job 120 11.2 2.2 16 17 20 48 10 9 Reconciliation with partner 215 20.1 1.6 63 21 43 61 3

after serious conflict 10 Retirement 14 1.3 1.0 7 2 2 1 2 11 Serious change in the health 66 6.2 1.7 19 6 13 16 4

of a family member 12 Own pregnancy 11 1.0 0.7 7 1 0 2 0 13 Sexual difficulties 107 10.0 2.0 7 18 33 32 2 14 Addition to the family 24 2.2 0.6 15 1 1 3 0 15 Changes at work 63 5.9 1.6 18 8 18 18 0 16 Major change in income 151 14.1 1.8 26 25 51 40 2 17 Death of a close friend 59 5.5 2.1 8 6 11 21 2 18 Change of job 80 7.4 1.8 17 9 24 21 3 19 Change in frequency of 172 16.1 1.5 50 30 39 36 5

quarrels with partner 20 Taking out a loan over 22 2.1 1.6 6 5 2 6

DM 30000 21 Calling in of a loan 17 1.6 1.2 6 1 3 1 22 Change in area of responsibility 114 10.7 1.4 31 22 26 22


marriage 25 Major personal success 262 24.5 1.3 101 30 41 66 0 26 Partner starting/ceasing 40 3.7 1.0 19 6 6 6 0

to work 27 Starting/finishing course of 33 3.1 0.5 20 2 3 0

studies 28 Change in standard of living 185 17.3 1.4 46 47 43 30 29 Change in personal habits 665 61.2 1.3 183 142 157 116 2 30 Trouble with superiors at work 50 4.7 1.1 20 10 10 5 1 31 Major change in work time 105 9.8 1.2 33 22 28 13 0

and conditions 32 Moving home 121 11.3 1.6 25 31 22 29 5 33 Change of college/university 10 0.9 1.2 5 0 2 1 1 34 Change in leisure habits 561 52.3 0.2 440 32 17 13 2 35 Change in church-going habits 132 12.3 0.9 51 32 19 13 0 36 Change in social habits 323 30.1 1.2 106 60 75 47 2 37 Taking out a loan less than 31 2.9 1.1 12 9 4 4

DM 30000 38 Change in sleeping habits 279 26.0 1.4 75 50 75 49 2 39 Change in frequency of 255 23.8 1.3 77 57 49 45 1

contact with family 40 Change in eating habits 584 54.5 1.3 117 117 139 104 4 41 Holiday 153 14.3 1.1 54 37 24 20 0 42 Minor infringements of the law 61 5.7 1.2 24 16 4 14 1

301

C. Six-Month Follow-Up

Table Ct. Marital status (changes) Table C2. Living arrangements (changes)

n (%)

No change 1109 94.8 No change Divorced 41 3.5 Separated Married 13 1.1 Living with partner/spouse Widowed 7 0.6 Sharing a flat/house

Living with parents Total 1170 Without children

Total

Table C3. Living conditions (changes) Table C4. Work situation (changes)

n (%)

No change 961 81.9 Same occupation Better home 156 13.3 Different occupation Worse home 57 4.9 Unemployed

Total 1174 Total

Table CS. Place of work and occupational situation

n

640 117

1

758

n

952 79 77 33 24 3

1168

(%)

84.4 15.4 0.1

n (%) Table C6. Number of jobs in the last 6 months

Same workplace 543 45.7 Different workplace 198 16.7 n (%) Unemployed 250 21.1 Housewife 104 8.8 740 92.6 In training 28 2.4 2 55 6.9 Retired 27 2.3 3 3 0.4 Not working 37 3.1 6 0.1


302

(%)

81.5 6.8 6.5 2.8 2.1 0.3

Table C7. Position at work Table CS. Professional qualification

n (%) n

Same 455 61.6 No change 43 Better 249 33.7 New training begun 49 Worse 35 4.7 Training completed 6

One training completed, a new 3 Total 739 one begun

Training broken off One training broken off, a new

one begun None 1083

Total 1186

Table C9. Satisfaction with work situation Table CIO. Income

n (%)

Very satisfied 1 272 23.7 2 312 27.2 3 232 20.2 4 101 8.8 5 64 5.6

Very dissatisfied 6 166 14.4

Total 1147

Table Cll. Satisfaction with personal financial situation

n (%)

Very satisfied 1 160 13.6 2 305 25.9 3 282 23.9 4 166 14.1 5 89 7.6


Total 1178

n

Unchanged 638 Risen 263 Dropped 265

Total 1166

(%)

3.6 4.1 0.5 0.3

0.1 0.1

91.3

(%)

54.7 22.6 22.7

303

Table C12. Availability of a person of reference

n (%j

No person of reference 137 11.6 available

Person of reference 1047 88.4 available

Total 1184

Table C13. Presence of spouse/partner

n (%)

Patient had spouse/partner Patient had no spouse/partner

Total

372 811

1184

Table C14. Origin of long-term partnerships

n

Partnership begun before index 687 treatment

Partner met during index treatment 44 Partner met after discharge 72 No partner

Total 804

31.4 68.6

(%)

85.4

5.5 6.1 0.1

Table C16. Satisfaction with partner relationship

n (%)

Very satisfied 1 329 40.2 2 257 31.4 3 131 16.0 4 47 5.7 5 20 2.4


Total 819

304

Table CIS. Qualitative changes in partnership

Partnership n (%)

Same 186 25.8 Improved 473 65.6 Deteriorated 61 8.5

Total 720

Table C17. Number of friends

n (%)

Same 572 48.5 More friends now 329 27.9 Fewer friends now 279 23.6

Total 1180

Table CIS. Satisfaction with friends Table C19. Length of time from discharge to first drink

n (%) n (%)

Very satisfied 258 22.2 2 451 38.8 More than 3 months 141 36.2 3 287 24.7 Up to 3 months 105 27.0 4 84 7.2 Up to 1 month 68 17.5 5 44 3.8 Up to 1 week 34 8.7

Very dissatisfied 6 37 3.2 Drank on 1st day 41 10.5


Table C20. Drinking frequency after discharge Table C21. Drinks consumed

n (%) n (%)

Once only 89 23.3 Beer 179 46.5 Less than once a month 65 17.0 Wine 55 14.3 Once or more a month 71 18.6 Spirits 77 20.0 Once or more a week 86 22.5 Other 20 5.2 Daily or almost daily 71 18.6 Several 54 14.0

Total 392 Total 385

Table C22. Amount of alcohol con-sumed per drinking day

Pure alcohol n (%)

20 53 14.1 21-30 50 13.4 31-60 72 19.2 61-90 59 15.7 91-120 25 6.7

121-150 29 7.7 151-180 29 7.7 181-210 11 3.0 211-240 9 2.4 241-270 9 2.4 271-300 5 1.3 Over 300 24 6.4

Total 375

305

Table C23. Use of medicaments


Of these Of these no. medic. no. medic.


Sleeping tablets 1071 93.6 63 5.5 25 10 0.9 5 Tranquillizers 1022 90.1 85 7.5 44 27 2.4 20 Painkillers 870 77.3 233 20.7 79 23 2.0 16 Stimulants 1134 99.2 5 0.4 1 4 0.3 3 Appetite depressants 1126 98.8 9 0.8 0 5 0.4 2 Clomethiazole 1078 95.6 38 3.4 24 12 1.1 12 Neuroleptics and 1078 95.3 29 2.6 20 24 2.1 22

antidepressants Other 842 77.0 119 10.9 81 132 12.1 124

Table C24. Use of hashish Table C25. Use of heroin

n (%) n (%)

Never 1131 98.3 Never 1145 99.7 Occasionally 18 1.6 Occasionally 2 0.2 Regularly 0.1 Regularly 0.1


Table C26. Use of LSD Table C27. Use of cocaine

n (%) n (%)

Never 1143 99.6 Never 1146 99.9 Occasionally 4 OJ Occasionally 0.1 Regularly 1 0.1 Regularly 0 0.0


Table C28. Use of other drugs Table C29. Use of tobacco

n (%) n (%)

Never 1138 99.9 Never 279 23.7 Occasionally 0.1 Occasionally 62 5.3 Regularly 0.1 Regularly 837 71.1

Total 1139 Total ,1178

306

Table C30. Number of cigarettes Table C31. Medical treatment received smoked per day

n (%) Never

0-5 16 1.9 Once 5-10 62 7.4 Several times

11-20 311 37.0 Regularly 21-30 263 31.2 31-40 143 17.0 Total 40 or more 46 5.5

Total 841

Table C32. Types of self-help group attended

n (%)

Alcoholics Anonymous 268 32.4 Blaukreuz' 63 7.6 Kreuzbund' 157 19.0 Indep. Order of Good Templars' 18 2.2 Ex-patient groupsb 177 14.9 Other 90 10.9 Combination 42 5.1

Total 815

'Self-help groups operated by various temperance societies. bSelf-help groups for ex-patients, connected to the various treatment centres

n (%)

354 30.1 267 22.7 333 28.3 222 18.9

1176

Table C33. Attendance at psychotherapy groups

Table C34. Individual psychotherapy received

n (%) n (%)

Never 1054 89.9 Never 971 82.8 Occasionally 50 4.3 Occasionally 129 11.0 Regularly 68 5.8 Regularly 72 6.1


Table C3S. Multidimensional Alcohol Questionnaire (MDA)

Only two Mean Standard scales administered score deviation

Symptomatic drinking 1.037 2.215 Complaints 1.179 1.921

307

Table C36. Life events (LEL; n= 1183)

Mean Stress stress

n % score 0 2

1 Death of spouse/partner 13 1.1 2.9 1 1 1 2. Divorce 143 12.1 0.0 6 0 0 3 Separation from spouse/partner 131 11.1 2.4 10 18 25 4 Prison term 20 1.7 2.9 0 5 Death of a near relative 107 9.0 2.4 2 14 27 6 Own illness or injury 272 23.0 2.2 16 42 72 7 Marriage 20 1.7 1.4 5 4 3 8 Loss of job 163 13.8 2.4 12 17 24 9 Reconciliation with partner 174 14.7 2.3 15 17 31

after serious conflict 10 Retirement 18 1.5 1.9 0 6 4 11 Serious change in the health 87 7.4 2.7 3 2 17

of a family member 12 ~n pregnancy 16 1.4 1.5 5 2 13 Sexual difficulties 204 17.2 2.2 4 48 60 14 Addition to the family 35 3.0 1.8 7 4 8 15 Changes at work 118 10.0 1.9 17 22 33 16 Major change in income 333 28.1 2.0 40 60 87 17 Death of a close friend 61 5.2 2.3 3 5 20 18 Change of job 963 81.4 0.9 114 65 23 19 Change in frequency of quarrels 199 16.8 2.1 24 35 38

with partner 20 Taking out a loan over DM 30000 36 3.0 2.0 6 6 11

21 Calling in of a loan 18 1.5 2.1 4 2 1

22 Change in area of responsibility 201 17.0 1.5 43 54 49

of work 23 Children leaving home 63 5.3 1.9 19 15 9

24 Trouble with relatives by marriage 103 8.7 1.9 9 27 29

25 Major personal success 227 19.2 1.5 67 30 49

26 Partner starting/ceasing to work 43 3.6 1.7 12 7 4

27 Beginning/completing college/ 38 3.2 1.7 7 4 9

university 28 Change in standard of living 289 24.4 1.7 54 72 65

29 Change in personal habits 568 48.0 1.3 145 163 145

30 Trouble with superiors at work 116 9.8 2.1 5 27 34

31 Major change in work times 219 18.5 1.3 60 68 44

and conditions 32 Moving home 195 16.5 1.6 53 35 37

33 Change of school/university 15 1.3 1.3 3 4 3 34 Change in leisure habits 526 44.5 1.0 208 133 106

35 Change in church-going habits 75 6.3 1.1 31 15 13 36 Change in social habits 410 34.7 1.2 148 103 74

37 Taking out a loan less than 89 7.5 1.3 25 24 26

DM 30000 38 Change in sleeping habits 280 23.7 1.9 27 75 71 39 Change in frequency of contact 240 20.3 1.5 65 58 58

with family 40 Change in eating habits 494 41.8 1.1 190 117 94

41 Holiday 258 21.8 0.9 128 46 30 42 Minor infringements of the law 83 7.0 1.8 16 17 11

D. Eighteen-Month Follow-Up

Table DI. Marital status

n (%)

Single 268 23.8 Married 596 53.0 Divorced 232 20.6 Widowed 28 2.5

Total 1124

Table D3. Living conditions

n

No change 865 Better 201 Worse 57

Total 1123

Table D5. Work situation

Same occupation Different occupation Not working

Total

(%)

no 17.9

5.1

n

611 124 394

1129

Table D2. Living arrangements

n (%)

Living alone 248 22.0 Living with spouse/partner 650 57.6 Sharing a flat/house 45 4.0 Living with parents 99 8.8 Living with other(s) 86 7.6

Total 1128

Table D4. Satisfaction with living conditions

n (%)

Very satisfied 1 361 32.5 2 380 34.2 3 208 18.7 4 78 7.0 5 48 4.3


Total 1110

Table D6. Place of work and occupational situation

n (%)

Same workplace 531 52.1 (%) Different workplace 165 16.2

Unemployed 171 16.8 54.1 Housewife 75 7.4 11.0 In vocational training 35 3.4 34.9 Retired 43 4.2

Total 1020

309

Table D7. Number of jobs in TableD8. Position at work the last 6 months

n (%) n (%)

Same 435 62.9 1 619 87.1 Better 225 32.5 2 79 11.1 Worse 32 4.6 3 10 1.4 4 2 0.3 Total 692 6 0.1

Total 711

Table D9. Professional qualifications

n (%)

No change 74 47.7 New training begun 43 27.7 Training completed 25 16.1 One training completed, 3 1.9

a new one begun Training broken off 8 5.2 One training broken off,

a new one begun 2 1.3

Total 155

Table DIO. Satisfaction with work situation

n (%)

Very satisfied 254 23.3 2 304 27.9 3 219 20.1 4 80 7.3 5 84 7.7

Very dissatified 6 149 13.7

Total 1090

Table DB. Income

n (%) n (%)

Same 642 69.0 646 57.5 Risen 155 16.7 284 25.3 Dropped 133 14.3 194 17.3

Total 930 1124

310

Table D12. Source of living income during 18 months of follow-up

1st 6 mo.

n %

Own work 657 61.9 Pension 39 3.7 Unemployment benefit 202 19.0 State grant for vocational training 12 1.1 Other state support 35 3.3 Savings 10 0.9 Supported by partner 83 7.8 Supported by friends 7 0.7 Other 17 1.6

Total 1062

Table D13. Satisfaction with personal financial situation

n (%j

Very satisfied 138 12.3 2 340 30.4 3 301 26.9 4 102 9.1 5 89 8.0


Total 1119

Table D14. Availability of a person of reference

n (%j

No person of reference 125 11.1 Person of reference 1001 88.9

available

Total 1126

Table DIS. Pressure of spouse/partner

Patient had spouse/partner Patient had no spouse/partner

Total

n (%j

796 328

1124

70.8 29.2

2nd 6 mo.

n %

646 62.2 48 4.6

171 16.5 24 2.3 33 3.2 9 0.9

81 7.8 3 0.3

23 2.2

1038

3rd 6 mo.

n %

663 61.9 57 5.3

166 15.5 28 2.6 44 4.1

5 0.5 89 8.3 2 0.2

17 1.6

1071

311

Table D16. Origin of long-term partnerships

n (%j

Partnership begun before 608 77.6 index treatment

Partner met during 45 5.7 index treatment

Partner met during 46 5.9 1st 6 months after treatment

Partner met during 85 10.8 last 12 months

Total 784

Table DIS. Satisfaction with friends

n (%j

Very satisfied 1 197 18.0 2 441 40.2 3 284 25.9 4 87 7.9 5 50 4.6


Total 1096

Table D20. Alcohol consumed

n reI. (%j

Never; totally abstinent Yes

Total

618 512

1130

54.6 45.4

Table D21. Frequency of drinking

1st 6 months

n %

Never 191 41.3 Only once 59 13.7 Less than once a month 40 8.7 Once or more a month 53 11.5 Once or more a week 47 10.2 Almost daily 72 15.9

Total 462

312

Table D17. Satisfaction with partner relationship

n (%j

Very satisfied 1 297 36.7 2 299 36.9 3 127 15.7 4 47 5.8 5 24 3.0


Total 810

Table D19. Satisfaction with hobbies

n (%j

Very satisfied 1 251 22.5 2 403 36.1 3 230 20.6 4 116 10.4 5 64 5.7


Total 1115

2nd 6 months 3rd 6 months

n % n %

131 28.3 98 20.2 40 8.6 57 11.8 57 12.3 46 9.5 82 17.7 93 19.2 75 16.2 92 19.0 78 16.8 98 20.2

463 484

Table D22. Longest drinking bout Table D23. Amount of alcohol con-sumed per day

n (%) Pure alcohol

Less than a day 161 33.1 (g) n (%) 1-3 days 100 20.5 1 week 68 14.0 20 47 9.4 2 weeks or more 158 32.4 21-30 57 11.4

31-60 99 19.7 Total 487 61-90 83 16.7

91-120 52 10.4 121-150 33 6.7 151-180 48 9.6 181-210 21 4.2 211-240 17 3.4 241-270 15 3.0 271-300 9 1.8 Over 300 18 3.6

Total 499

Table D24. Frequency of intoxication

1st 6 months 2nd 6 months 3rd 6 months

n % n % n %

Never 278 59.3 295 64.0 338 69.5 Once 58 12.4 46 10.0 50 10.3 Once or more a month 84 17.9 74 16.0 51 10.5 Once or more a week 34 7.2 30 6.5 30 6.2 Daily or almost daily 15 3.2 16 3.5 17 3.5

Total 469 461 486

Table D25. Signs of pathological drinking

Item n (%)

Excitability under alcohol 215 43.3 n=497 Blackouts 203 41.1 n=494 Alcohol to cope with stress 213 43.0 n=495 Alcohol to stop trembling 198 40.0 n=498 Loss of control 143 28.8 n=497

313

Table D26. Use of medicaments


Of these, Of these, no. medic. no. medic.


Sleeping tablets 986 91.1 80 7.4 36 16 1.5 11 Tranquillizers 939 87.3 98 9.1 54 39 3.6 33 Painkillers 737 68.1 316 29.2 121 29 2.7 24 Stimulants 1065 99.2 6 0.6 0 3 0.3 2 Appetite depressants 1057 98.4 12 1.1 0 5 0.5 Clomethiazole 997 93.8 50 4.7 37 16 1.5 15 Neuroleptics and anti- 1 ()()() 94.1 36 3.4 19 27 2.5 26

depressants Other 726 72.3 121 12.1 83 157 15.6 142

Table D27. Use of illegal drugs during the follow-up period


Total

Hashish n %

1094 98.5 12 1.1 5 0.5

1111

Table D28. Use of tobacco

n

Never 278 Occasionally 48 Regularly 803

Total 1129

314

Heroin n %

1093 99.5 5 0.5 o 0

1098

%

24.6 4.3

71.1

LSD Cocaine Other n % n % n %

1092 99.6 1092 99.8 1053 99.9 3 0.3 2 0.2 1 0.1

0.1 o 0 o 0

1096 1094 1054

Table D29. Number of cigarettes smoked per day

n %

1-5 21 2.6 6-10 61 7.5

11-20 323 39.8 21-30 228 28.2 31-40 136 16.7 40 or more 42 5.2

Total 811

Table D30. Medical treatment received Table D31. Types of self-help group attended

Never Once Several times Regularly

Total

n %

226 237 411 249

1123

20.1 21.1 36.6 22.2

Table D32. Attendance at psychotherapy groups

Alcoholics Anonymous Blaukreuz" Kreuzbund" Indep. Order of Good

Templars (IOGT)" Ex-patient groups" Other Combination

Total

"See Table C32, footnotes.


n % n % n %

Never 945 90.3 966 93.0 1018 93.1 Occasionally 35 3.4 22 2.1 20 1.8 Regularly 66 6.3 51 4.9 55 5.0

Total 1046 1039 1093

Table D33. Individual psychotherapy received


n % n % n %

Never 926 88.7 917 88.1 968 89.1 Occasionally 71 6.8 72 6.9 64 5.9 Regularly 47 4.5 52 5.0 55 5.1

Total 1044 1041 1087

n %

236 34.0 49 7.1

131 18.9

17 2.4 131 18.8 95 13.7 35 5.0

694

315

Table D34. Life events (LEL; n = 1111)


n % score 0 1 2 3 4

1 Death of spouse/partner 11 1.0 2.2 2 0 2 4 2 Divorce 81 7.3 2.0 11 16 13 27 7 3 Separation from spouse/partner 127 11.4 2.5 9 14 21 64 14 4 Prison term 16 1.4 2.5 2 2 6 4 5 Death of close relative 136 12.2 2.4 7 13 45 59 8 6 Own illness on injury 300 27.0 2.1 26 58 79 109 16 7 Marriage 42 3.8 0.7 23 3 5 1 2 8 Loss of job 188 16.9 2.6 t2 16 34 90 24 9 Reconciliation with partner 131 11.8 2.4 to 12 28 66 6

after serious conflict 10 Retirement 36 3.2 2.0 5 6 7 14 11 Serious change in the health 111 10.0 2.6 3 7 26 61 5

of a family member 12 Own pregnancy 18 1.6 1.6 5 3 2 6 0 13 Sexual difficulties 182 16.4 2.3 4 25 57 84 4 14 Addition to the family 52 4.7 1.4 16 10 10 11 1 15 Changes at work 107 9.6 1.9 16 21 24 33 3 16 Major change in income 301 27.1 2.0 51 43 64 105 23 17 Death of a close friend 83 7.5 2.3 8 35 27 2 18 Change of job 129 11.6 1.6 32 26 26 33 4 19 Change in frequency of 165 14.9 2.4 11 18 38 73 12

quarrels with partner 20 Taking out a loan over 44 4.0 1.5 12 8 8 9 2

DM 30000 21 Calling in of a loan 39 3.5 1.8 9 4 8 12 2 22 Change in area of responsibility 213 19.2 1.5 49 58 44 50 4


marriage 25 Major personal success 213 19.2 1.4 79 26 35 51 5

26 Partner starting/ceasing 47 4.2 1.0 18 13 5 4 2

to work 27 Starting/finishing course of 50 4.5 1.5 10 11 14 10 0

studies 28 Change in standard of living 250 22.5 1.9 41 43 69 71 11

29 Change in personal habits 362 32.6 1.5 97 86 72 78 8

30 Trouble with superiors at work 110 9.9 2.1 8 28 28 36 7

31 Major change in work time 190 17.1 1.4 51 49 45 39 2

and conditions 32 Moving home 210 18.9 1.4 61 47 51 36 4

33 Change of college/university 19 1.7 1.7 2 4 8 3 0

34 Change in leisure habits 359 32.3 1.1 133 85 70 50 2

35 Change in church-going habits 68 6.1 1.2 28 13 9 12 2

36 Change in social habits 277 24.9 1.2 86 70 57 42 3

37 Taking out a loan less than 95 8.6 1.3 27 30 21 14 2

DM 30000 38 Change in sleeping habits 242 21.8 1.9 21 61 69 68 9

316

Table D34 (continued)


n % score 0 1 2 3 4

39 Change in frequency of 196 17.6 1.6 43 46 49 44 9 contact with family

40 Change in eating habits 300 27.0 1.2 88 94 62 44 2 41 Holiday 324 29.2 0.8 181 48 37 29 4 42 Minor infringements of the law 120 10.8 1.8 25 26 26 36 11

Table D3S. Coding of diagnoses relating to sick leave and in-patient treatment

The great variety of diagnoses noted in the records of the health insurance companies were divided into three large groups:

1-Illnesses that were very probably not alcohol-related 2-Illnesses that may have been alcohol-related 3-Illnesses that very probably were alcohol-related

Examples of how this coding worked are:

Infections (including tuberculosis) Rheumatic disease Hypotonia Neuralgia Anaemia Heart trouble Gastritis, enteritis Suicide attempts, medicament overdoses Injuries and accidents Cerebral seizures Confusion states of unknown origin Pancreatitis Depression Diarrhoea Neuroses, states of exhaustion, autonomic syndrome Gastroduodenal ulcer Blood circulation disturbances Liver disease, unless explicitly of non-alcohol-related origin AlI diagnoses directly referring to alcohol

2 2 2 2 2 2 2 2 2 2 2 3 3

317

T. Treatment Variables

Table Tl. Goals of treatment

Abstinence Controlled drinking Insight into drinking Fitness for work Helping patient find work Coping with family conflicts Psychic resilience Self-assertion Ability to communicate Leisure pursuits Clarification of the

social environment Physical resilience Other goals

Unimportant or does not apply

n

21

Table T2: Professional groups represented in the K-SEKT responders

Physicians Medical psychotherapists Psychologists Social workers Occupational and

work therapists Nursing Staff Others

318

11% 6%

22% 23% 8%

11% 19%

Rating of importance

Less Important Extremely important important

n n n

21

8 13 11 10

3 10 8 10 11 7 14

11 10 1 8 12 3 13 5 2 11 8

4 13 4 4

Table T3. Size of treatment centres

No. of beds No. of centres

up to 25 6 26-50 4 51-100 7 Over 100 4

Table T4. Distribution of professional groups

Of therapentic Of staff staff overall N=280 N=479

Professional group n % n

Nursing staff 142 Social workers 68 24.28 Work and occupational!

therapists Physicians altogether 64 22.85

of somatic medicine 29 10.35 psychotherapists 35 12.5

Psychologists 50 17.85 Lay therapists 34 12.14 Other therapists

Table TS. Treatment centres without staff from particular professional groups

Professional group

No psychologist No social education worker No work or occupational

therapist No lay therapist No pastoral carer No sports or physiotherapist

No. of Centres

3 2

3 7 9 2

68

65 64

50 34 36

%

29.64 14.19

13.56 13.36

10.43 7.09 7.51

319

Table T6. Time devoted to different kinds of therapy

No. of centres Mean time Offering the devoted" Range

Therapy therapy (min/week) (minutes)

Individual therapy 6 39.2 15-60 SD= 16.6

Group therapy 21 379.8 180--780 SD=170.9

Work therapy 15 948.0 120--1620 SD=438.5

Occupational therapy 14 266.8 120--600 SD=114.4

Alcohol information group 13 115.9 20--360 SD=129.5

Life plan and values 14 125.6 10--630 information group SD=161.9

Ward group 18 171.7 20--840 SD= 198.4

Sport * and physio-therapy* 21 247.4 20--900

SD=183.1

"Figures based only on those centres which offered the therapy on a regular basis.

Table T7. Various characteristics of treatment centres

Characteristic No. of centres Characteristic No. of centres

Admission ward 9 External supervision 11 Admission group 10 Total ban on smoking 5 List of regulations etc. 21 Possession of cash regulated 10 Each patient assigned to 13 Control of drugs received 9

one particular carer for by post (regularly) introduction to centre

Information about course 16 Involvement of 17 and goals of treatment self-help groups

Other introductory 8 Involvement of relatives 21 procedures (e.g. films) and significant others

Group meetings 13 Patients' participation in 16 without therapists everyday running of centre

Table T8. Involvement of relatives and significant Table T9. Criteria of exclusion from treatment others

None at all Individual consultations

(occasionally) Partner seminars

320

No. of centres

0 9

12

No. of centres

Psychoses 13 Drug dependence 11 Medicament dependence 2 Severe somatic disease 20 Other 9

Table TlO. Staff meetings and conferences

Mean time spent (h/month) Range

Therap. team meetings 16.0 4-38 (to discuss patients) (s=9.l)

Full staff meetings 9.2 1-20 (s=5.1)

Internal (post- 7.9 2-22 graduate) training (s = 5.4)

External supervision 5.9 3-10 (s=2.1)

Table Tll. Sanctions, privileges and patients' say in awarding them

Official system of sanctions

Patients' say in applying sanctions

Rewards and privileges for cooperation

Patients' say in awarding privileges

Phase model for structuring treatment

No. of centres

9

8

6

2

9

Table T12. Response to infringements of house regulations

Sanctions applied

Depending As a rule, on situation yes

Unpunctuality at 3 7 group meetings

Breaking gate hours 7 13 Breaking smoking 8 10

regulations Taking up forbidden 7 4

outside contacts Irregularities in 6 4

household chores Repeated lack 8

of co-operation

No. of centres

20

14

14

11

Matter taken up in therapy groups

Depending As a rule, on situation yes

5 12

6 13 6 11

7 11

9 8

4 17

321

w

Tab

le T

13.

Rat

ings

of

impo

rtan

ce a

nd i

mpl

emen

tati

on o

f fa

ctor

s in

the

the

rape

utic

atm

osph

eric

(K

-SE

KT

-A a

nd K

-SE

KT

-B)

N

N

Fac

tors

N

ot

Not

ver

y V

ery

(lis

ted

in

Mea

n sc

ore

impo

rtan

t im

port

ant

impo

rtan

t or

der

of

(doe

s no

t (d

oes

not

Impo

rtan

t (a

pplie

s im

port

ance

) Im

port

ance

Im

plem

enta

tion

ap

ply)

ap

ply

muc

h)

(doe

s ap

ply)

ab

solu

tely

)

3 R

espo

nsib

ilit

y tr

ansf

er-

3.8

3.4

1% (

9%)

21%

(44

%)

78%

(48

%)

red

to p

atie

nt

18 C

onfr

ont

conf

licts

and

3.

7 3.

5 2%

(14

%)

24%

(69

%)

73%

(16

%)

prob

lem

s 8

Rel

ativ

es i

nvol

ved

3.7

3.4

(2%

) 1%

(8%

) 27

% (

41 %

) 72

% (

50%

) 5

Pre

para

tion

for

the

tim

e 3.

6 3.

3 4%

(10

%)

32%

(46

%)

64%

(44

%)

afte

r tr

eatm

ent

15

Eff

ectiv

e tr

ansf

er o

f 3.

6 3.

1 2%

(16

%)

36%

(62

%)

62%

(22

%)

data

reg

ardi

ng e

ach

pati

ent

1 P

atie

nt a

ctiv

ely

enga

ged

3.6

3.0

2% (

14%

) 37

% (

69%

) 61

% (

16%

) in

tre

a tm

en t

13

Sta

ff g

et o

n w

ell

3.6

3.1

1% (

3%)

2% (

15%

) 37

% (

51%

) 61

% (

31%

) to

geth

er

2 O

penn

ess

and

3.6

3.3

1% (

13%

) 40

% (

41%

) 59

% (

46%

) sp

onta

neit

y en

cour

aged

16

Ins

ight

int

o dr

inki

ng

3.5

2.9

1% (

2%)

7% (

22%

) 34

% (

65%

) 58

%(1

1%)

beha

viou

r 4

Pat

ient

s en

cour

aged

to

3.5

3.3

(1%

) 3%

(12

%)

44%

(46

%)

54%

(42

%)

cope

wit

h pr

oble

ms

of

ever

day

life

17 I

nsig

ht i

nto

own

3.4

2.8

(1%

) 7%

(27

%)

44%

(60

%)

50%

(11

%)

prob

lem

atic

beh

avio

ur

7 D

esir

able

beh

avio

ur

3.3

3.3

(1%

) 9%

(9%

) 50

% (

49%

) 41

% (

41%

) re

info

rced

14

All

team

mem

bers

hav

e 3.

3 2.

9 1

%(4

%)

10%

(20

%)

53%

(57

%)

37%

(19

%)

equa

l ri

ghts

w

IV

w

10 C

ours

e of

trea

tmen

t tr

ansp

aren

t 6

The

rapi

sts

are

role

m

odel

s 11

St

aff c

ontr

ol p

atie

nts'

be

havi

our

12 P

lann

ing

the

cour

se

of tr

eatm

ent

9 T

horo

ugh

unde

rsta

nd-

ing

of tr

eatm

ent

goal

s an

d m

etho

ds

3.3

3.0

3.0

3.0

3.0

2.9

1% (

2%)

9% (

24%

) 58

% (

54%

) 32

% (

21%

)

2.9

2% (

3%)

24%

(24

%)

45%

(54

%)

29%

(19

%)

3.2

4% (

2%)

16%

(13

%)

54%

(48

%)

26%

(38

%)

3.1

2% (

1%)

21%

(16

%)

56%

(52

%)

21%

(30

%)

2.6

2% (

3%)

24%

(42

%)

53%

(49

%)

21%

(7%

)

Table T14. Cluster analysis of treatment centres (selected treatment variables, Ward method)

Index Cluster 1 Cluster 2 Cluster 3

Psychotherapeutic 15.43 16.63 12.17 orientation SD=1.90 SD=3.34 SD=3.66

Control of 11.14 11.38 6.5 patients SD=4.02 SD=3.20 SD=1.23

Self-activation 5.29 8.75 4.50 SD=2.06 SD=1.04 SD=1.64

Involvement of 5.14 5.50 4.33 relatives SD=1.107 SD=1.20 SD=0.82

Work and occupational 831.43 988.13 705.00 therapy SD=615.48 SD=589.21 SD=587.19

Table TIS. Clusters of treatment centres according to factors in the therapeutic climate (K-SEKT)

K-SEKT factor

Preparation for the time after treatment (item 5)

Role model function (item 6) Reinforce desirable behaviour

(item 7) Involvement of relatives

(item 8) Staff get on well together

(item 13) Conformation of conflicts

(item 18)

324

Significant comparison of factors

2 v~. 3

2 vs. 1; 2 vs. 3 2 vs. 1

2 vs. 1

2 vs. 1; 2 vs. 3

2 vs. 1; 2 vs. 3

Whole group

14.95 SD=3.44 9.91 SD=3.7 6.38

5.05

855 SD=579.12

Table T16. All treatment variables significant for the positive prognosis group (strategy 2)

Treatment variable

Segregation of sexes p=O.15152 X2 test

Bottom age limit p=O.0134 X2 test

Detoxification

p=O.0260

Length of treatment p=O.0498 X2 test

Individual therapy p=O.06667 X2 test

Participation of patients in everyday running of centre

p=O.06667 X2 test

Physical therapy p=O.14141 X2 test

Therapeutic techniques p=O.0498 X2 test

Psychodrama p=O.0547 X2 test

Possession of cash p=O.07071 X2 test

Checking the post p=O.0874 X2 test

Religious orientation p=O.OO77 X2 test

Sanctions for breaking smoking regulations

Successful centres N=4

3 with segregation

1 with bottom limit of 18 years 3 with bottom limit of 21 years

3 usually require previous detoxification

1 provides own detoxification facilities

4 gave long-term treatment

Less successful centres N=8

2 with segregation

5 with bottom limit of 16 years 3 with bottom limit of 18 years

1 always requires previous detoxification

6 provide own detoxification facilities

2 gave short-term treatment 4 gave medium-term treatment 2 gave long-term treatment

1 never offered individ. therapy 7 never offered individ. therapy 3 offered regular individ. therapy 1 offered regular individ. therapy

3 had no patient participation 1 had patient participation

4 offered physical therapy

4 used predominantly verbal and group dynamo exercises and creative techniques

1 did not use psychodrama 2 sometimes used psychodrama 1 regularly used psychodrama

4 usually controlled possession of cash

1 never checked post 1 usually checked post 2 said 'depends on situation'

1 had none 3 had a relig. orientation

3 usually applied sanctions 1 said 'depends on situation'

1 had no patient participation 7 had patient participation

4 offered physical therapy 4 did not offer phys. therapy

1 used verbal techno only 5 used predominantly verbal

and creative techniques 2 used predom. verbal and group

dynamo exercises and creative techniques

7 did not use psychodrama 1 regularly used psychodrama

3 usually controlled possession 5 did not control possession

5 usually did not check 3 usually checked

6 had none 2 had a relig. orientation

2 do not usually apply sanctions 1 usually applies sanctions

325

Table T16 (continued)

Treatment variable

p=0.0874 .x.> test

Sanctions for taking up forbidden outside contacts

p=0.0498 X2 test

Unpunctuality 'worked at' in therapy

p=0.0519 X2 test

No. of beds p=0.0912 (ANOVA: p=0.39)

No. of part-time staff (ANOVA: p=0.249)

No. of full-time staff (ANOVA: p=0.1886)

Additional therapies p=O.OI; t test (AN OVA: p=O.l125)

Waiting list p = 0.408; t test (ANOVA: p=0.0131)

Work and occupational therapy (index)

p = 0.0528; X2 test (ANOVA: p=0.0653)

Involvement of relatives (index)

(ANOVA: p=0.0402)

326



5 said 'depends on situ;

2 usually did not apply sanctions 4 usually did not apply 2 usually applied sanctions 4 said 'depends on situ;

1 usually did this 2 said 'depends on situation' 1 no data

Average no.: 72 Range: 58-97

M=0.25; SD=0.500 Range: Q.-.l

M=8 Range: 6--12

M = 15 min/week Range: Q.-.30 min/week

M = 15.8 weeks Range: 7-24 weeks

M=3 (no variation)

M=2 (no variation)

6 usually did not do th 1 usually did do this 1 no data

Average no.: 48 Range: 15-169

M = 1.125; SD = 1.3562 Range: Q.-.4

M=4.75 Range: 2-14

M = 209 min/week Range: 30.-.640 min/wee

M=5.8 weeks Range = Q.-.12 weeks

M=2.25 Range: 1-3

M = 1.375 Range: 1-2

Table T17. All treatment variables significant for the negative prognosis group (strategy 2)

Treatment variable

Segregation of sexes p=0.07143 X2 test Drug dependence p=0.07143 X2 test

Decision on treatment lengths made individually for each patient

p=0.07143 X2 test No. of part-time staff (ANOVA: p=0.1274) No. of full-time staff (ANOVA: p=0.6177) Life planning groups p=0.0907; t test (ANOVA: p=0.0905) Waiting list p = 0.0202; t test (ANOVA: p=0.0316) Patient: staff ratio p=0.0515; t-test (ANOVA: p=0.0448) Therap. team meetings p=0.0455; t test (ANOVA: p=0.0498) Life planning (index) p = 0.0325; t test (ANOVA: p=0.0170)


3 with segregation 1 men and women together

4 drug depend. not a criterion for exclusion

1 no individual decision 3 individual decision

M=0.75 Range: 0-2 M=6.75 Range: 3-10 M = 200 min/week Range: 0-420 SD=181.2 M = 19.5 weeks Range: 8-36 weeks

M=3.5 Range: 2-4

M=I; SD=O

M=2.750; SD=0.5 Range: 2-3


4 men and women together

1 drug depend. not an exclusion criterion

3 drug depend. on exclusion criterion

4 no individual decision

M=2.5 Range: 1-14 M=5 Range: 2-14 M = 15 min/week Range: 0-60

M=2.5 weeks Range: 0-6 weeks

M = 1.75 Range: 1-3

M=2; SD=0.8165 Range: 1-3

M = 1.5; SD = 0.05774 Range: 1-2

327

Table TI8. Correlations between treatment variables and treatment centres' abstinence rates (for positive prognosis and negative prognosis groups)

Positive Negative prognosis prognosis

Treatment variable groups groups

Part-time doctors r =0.4990 (somatic medicine) p=O.Oll

Part-time psychologists r= -0.5226 p=0.OO8

Part-time social workers r= -0.4977 p=O.Oll

Part-time work and occu- r=0.3650 pational therapists p=0.052

Part-time chaplain r=0.4341 p=0.025

Part-time nursing staff r=0.4065 p=0.034

Full-time nursing staff r= -0.3977 r= -0.4099 p=0.037 p=0.033

Medical psychotherapists r= -0.4423 p=0.022

Inexperienced social workers r= -0.3657 p=0.052

Other therapists r=0.4145 p=0.031

Inexperienced nursing staff r= -0.3871 r= -0.4329 p=0.042 p=0.025

Total number of r= -0.5039

inexperienced staff p=O.OlO

Psychologists trained in r=0.5720 psychotherapy p=0.OO3

Social workers trained r=0.4898 in psychotherapy p=0.012

Sexual segregation r= -0.3123 r= -0.4724 p=0.084 p=0.015

Age limits r=0.5958 p=0.OO2

Voluntary admission r= -0.4025 p=0.035

Percentage of r=0.4514

voluntary admissions p=0.023

Drug dependence an r= -0.4561

exclusion criterion p=0.019

Serious somatic disease r=0.3637 an exclusion criterion p=0.053

Occupational therapy r= -0.3656 p=0.052

328

Table TIS (continued)

Positive Negative prognosis prognosis

Treatment variable groups groups

Life planning groups r=0.5231 p=0.OO7

Groups on religious or r=0.4119 value-oriented themes p=0.032

Physical therapy r=0.3701 p=0.041

Overall length of treatment r=0.4196 p=0.029

Individual therapy r=0.4281 p=0.026

Therapeutic media r=0.3790 p=0.045

Hypnosis r= -0.3637 r= -0.3451 p=0.053 p=0.063

Psychodrama r=0.3929 p=0.039

Acupuncture r= -0.3637 r= -0.3451 p=0.053 p=O;063

Other additional ;ypes r=0.4792 r=0.2955 of therapy p=0.014 p=0.097

Relapse a reason for r= -0.4161 discharge p=0.030

No smoking r=0.3961 p=0.038

Post checked for drugs r=0.4253 p=O.027

Referral from r=0.3506 counselling centre p=0,060

Direct admission r=0.3650 p=0.052

Waiting list (weeks) r=0.3072 r=0.5624 p=0.088 p=0.004

Unpunctuality 'worked r=0.5985 r=0.4753 at' in therapy p=0.004 p=0.023

Patients' say in r=0.3684 sanctions p=0.05

Staff: patient ratios r=0.5017 p=0.010

Team meetings r= -0.4008 p=0.036

r=0.4112 p=0.032

329

Table TIS (continued)

Treatment variable

Life plan

Sanctions

Involvement of significant others ( time)

Length of treatment

Involvement of significant others (index)

No. of part-time staff

No. of staff with special training

Positive prognosis groups

r=0.3967 p=0.037

r=0.3994 p=0.036

r=0.4707 p=0.016

r= -0.2453 p=0.142

r=0.4469 p=0.021

Negative prognosis groups

r==0.5116 p=0.009

r=0.6313 p=0.010

r=0.3477 p=0.061

r= ~0.4024 p=0.035

r=0.3590 p==0.055

All significant correlations (product-moment correlations) were selected. We are aware that the result of the significance test is in some cases questionable because of the different scale levels of the variables. The analysis of scatter diagrams of correlations to show up the influence of extreme values was not taken into account.

Table T19. Prognosis index and attendance at self-help groups during follow-up period

Prognosis index 1st 6 mo. 2nd 6 mo. 3rd 6 mo.

Attendance M W M W M W

Regular 6.35 2.94 6.39 2.67 6.37 2.76 Irregular 6.00 2.53 5.96 2.66 6.04 2.55 Never 6.05 2.56 6.09 2.75 6.12 2.76

Analysis of variance 0.0651 0.0134 0.1038 0.8521 0.2180 0.600 p value

330

Table T20. Attendance at self-help groups in first 6 months of follow-up and prognosis index (men)

Attendance

Prognosis index Regular Irregular Never n % n % n %

0-3 29 34.5 28 33.3 27 32.7 4-6 115 35.1 88 26.8 125 38.1 7-9 166 42.6 96 29.6 128 32.8

X2 test, p = 0.1548

Table T21. Attendance at self-help groups in second 6 months offollow-up and prognosis index (men)

Attendance


0-3 20 26.0 14 18.2 43 55.8 4-6 79 27.0 36 12.3 178 66.8 7-9 110 30.1 43 11.8 212 58,1

X2 test, p = 0.52

Table T22. Attendance at self-help groups in third 6 months of follow-up and prognosis index (men)

Attendance


0-3 24 32.4 14 18.9 36 48.6 4-6 79 27.8 38 13.4 167 58.8 7-9 116 33.9 43 12.6 183 53.5

X2 test, p=0.2752

331

Table T23. Attendance at self-help groups in first 6 months of follow-up and prognosis index (women)

Attendance


0-1 15 45.5 8 24.2 10 30.3 2 41 45.6 26 28.9 23 25.6 3-5 101 63.1 28 17.5 31 19.4

X' test, p = 0.0533.

Table T24. Attendance at self-help groups in second 6 months of follow-up and prognosis index (women)

Attendance


0-1 11 35.5 5 16.1 15 48.4 2 33 38.4 16 18.6 37 43.0 3-5 54 40.3 17 12.7 63 47.0

X' test, p = 0.8030

Table T25. Attendance at self-help groups in third 6 months and prognosis index (women)

Attendance


0-1 12 40.0 5 16.7 13 43.3 2 33 41.3 13 16.3 34 42.5 3-5 53 42.7 17 13.7 54 43.5

X' test, P =0.9868

332

U. Course (Changes Over Time)

Table VI. Course of FPI scales

Patients

Mean Stanine values Scale score SD O-J 4-6 7-9

Nervousness

Admission 6.67 1.99 7.4% 35.0% 57.6% Discharge 4.95 2.16 26.7% 48.3% 25.0% 6-mo follow-up 4.38 2.22 36.6% 44.6% 18.8% 18-mo follow-up 4.08 2.30 46.5% 36.3% 17.2%

Spontaneous aggressiveness

Admission 6.07 1.77 10.0% 46.9% 43.1% Discharge 5.06 2.01 24.0% 55.0% 21.0% 6-mo. follow-up 4.93 1.91 26.6% 51.7% 21.7% 18-mo. follow-up 4.48 1.86 33.9% 54.5% 11.6%

Depressiveness


Excitability


Sociability


Calmness


333

Table VI (continued)

Patients

Mean Stanine values Scale score SD 0-3 4-6 7-9

Reactive aggressiveness


Inhibition Admission 5.88 2.05 14.3% 42.3% 43.3% Discharge 5.40 2.12 17.5% 47.9% 34.6% 6-mo. follow-up 4.67 2.22 35.1% 40.7% 24.2% 18-mo. follow-up 4.60 2.24 29.9% 47.6% 22.5%

Openness


Extraversion


Emotional lability


Masculinity


334

Table U2. Course over time of Self-Assertiveness Questionnaire scores

Distribution of scores

Central Mean SD Low region" High score (%) (%) (%)

Fear of criticism

Admission 39.174 16.639 8.0 44.0 48.0 Discharge 29.443 15.868 19.9 55.2 24.9 6-mo. follow-up 25.761 16.437 28.7 51.5 19.8 18-mo. follow-up 26.185 16.872 29.5 48.4 22.1

Fear of contact


Being able to make demands


Not being able to say no


Guilt feelings


Social decency


" ± 1 SD of normal group.

335

fable U3. Course over time of Beschwerden-Liste scales

Distribution of scores"

Central Mean SD Low region High score (%) (%) (%)


"The Stanine scores are categorized as follows: 0-3 low; 4--6 central region; 7-9 high.

336

P. Prognosis

Table PI. Intercorrelations between predictors of abstinence (admission; men")

Living Size One Un- Home Hostel/ Never No No with of job in employed owner homeless lost suicide previous spouse home last job attempts treatment

townb 2 years through in an alcohol addiction

2 3 4 5 6 7 8 9

1 -0.085 0.Q25 -0.271 0.287 -0.179 0.237 0.137 0.045 2 1 -0.056 0.083 -0.246 0.106 -0.074 -0.079 -0.097 3 1 -0.454 0.167 -0.097 0.395 0.130 0.056 4 1 -0.122 0.118 -0.361 -0.040 -0.064 5 -0.134 0.150 0.149 0.060 6 1 -0.051 -0.093 -0.091 7 0.136 0.169 8 1 0.102 9 1

"The sample size was on average 1010 patients, with minor fluctuations. The 5% level of significance was reached at about r=0.05. bPopulation below 100000.

Table P2. IntercorreJations between predictors of abstinence (admission; women")

No previous treatment SAQ 'Being

Less than 2 in an Amount able to make SAQ'Social suicide addiction of alcohol demands' decency' attempts unit per week (low score) (high score)

1 2 3 4 5

1 -0.046 -0.048 0.010 -0.043 2 0.Q15 0.011 0.041 3 0.014 0.085 4 1 0.300 5

"The sample size was on average about 360 patients, with minor fluctuations. The 5% level of significance was reached at about r=0.09.

337

fable P3. Patient variables (admission) as risk factors for dropping out of treatment (men)

Drop-out rate" (%) when variable

Frequency of Variable characteristic present absent

Marital status: single 449 0.09 19.8 13.5** Work situation: a) unemployed at least 3 months 251 0.10 22.7 14.2** b) not a salaried employee 759 0.08 18.1 11.0**

or civil servant Occupation: a) unski11ed worker 149 0.08 23.5 15.1 * b) not an artisan 409 0.08 20.0 13.9** Loss of job (in connection with alcohol, 373 0.14 22.5 12.2***

once or more) One or more suicide attempts 199 0.10 23.6 14.2** Psychosocial problems: score 4 78 0.07 24.4 14.9* Certification, taking into care etc. 59 0.09 28.8 15.3**

Legal offences 351 0.13 23.4 13.2***

Prison sentence 75 0.14 34.7 15.3***

Moving home 240 0.14 26.3 13.8***

Change in leisure habits 363 0.12 22.6 13.5***

Change in standard of living 282 0.10 22.7 14.4**

Illness of a family member 165 0.09 24.2 15.2**

More than 4 weeks abstinence before 353 0.08 18.4 12.2**

admission to index treatment Cannabis: occasional or regular use 61 0.10 31.1 15.3**

FPI: Spontaneous aggressiveness: 99 0.08 17.5 8.1*

stanine value FPI: Depressiveness: Stanine value 7 738 0.07 18.0 12.5*

FPI: Excitability: Stanine value 7 443 0.08 20.1 13.8**

EZB: Fear of therapy: score 8 229 0.07 21.0 15.2*

Complaints List: score 4 255 0.08 22.0 14.8***

"Whole patient sample; X2 test.

338

Table P4. Predictors at admission and discharge of complaints score (Beschwerden-Liste) at 18-month follow-up (men)

Predictor r' p

Admission:

Fit for work: yes -0.201 0.000 Disorientation: no -0.158 0.000 Neuroleptics and antidepressants: no -0.179 0.000 Sanatorium: no -0.158 0.000 Pancreatitis in last 6 months: no 0.129 0.000 FPI: Nervousness 0.355 0.000 SAQ: Fear of contact 0.191 0.000 Complaints score: low (first quartile) -0.294 0.000 Complaints cScore: high (fourth quartile) 0.306 0.000 Overall motivation (coded into three -0.152 0.000

levels)

Discharge

Neuroleptics and antidepressants (no, 0.121 0.001 occasionally, regularly)

Other symptoms (yes, no) 0.140 0.000 Number of visits to doctor for 0.121 0.001

physical complaints Participation of patient in treatment 0.093 0.005

(rating 1-5) Clinical prognosis (rating 1-5 is negative) 0.223 0.000 FPI: Nervousness 0.441 0.000 FPI: Depressiveness 0.319 0.000 FPI: Excitability 0.248 0.000 FPI: Sociability -0.180 0.000 FPI: Calmness -0.201 0.000 FPI: Reactive aggressiveness FPI: Inhibition 0.261 0.000 FPI: Openness 0.140 0.000 FPI: Emotional lability 0.290 0.000 FPI: Masculinity -0.252 0.000 SAQ: Fear of criticism 0.300 0.000 SAQ: Fear of contact 0.259 0.000 SAQ: Being able to make demands -0.117 0.000 SAQ: Not being able to say no 0.205 0.000 SAQ: Guilt feelings 0.210 0.000 SAQ: social decency 0.204 0.000 Complaints score 0.547 0.000 .

• Rank correlations were calculated throughout.

339

Table P5. Predictors at admission and discharge of work situation at I8-month follow-up (employed vs: unemployed; men)

Employment rate (%) when variable": r

(product-moment Predictor present absent correlation)

Admission:

Living with spouse 90.4 70.3*** 0.26 Fit for work 83.6 70.9*** 0.13 Unemployed (excluding housewives, 63.0 85.4*** -0.23

pensioners) Income in last 6 months (DM 9600 = 1) 87.5 71.1 *** 0.20 Not in an alcohol profession 82.5 66.2*** 0.13 No use of painkillers 83.9 71.0*** 0.14 Never lost a job because of alcohol 86.6 70.1 *** 0.19

Discharge:

Marital status: single 69.3 84.2*** -0.16 Marital status: married 88.5 68.8*** 0.24 Living with spouse 90.3 70.5*** 0.25 Employed 87.4 61.6*** 0.29 Unemployed vs. rest 60.5 87.0*** -0.28 Living conditions: home owner 88.4 76.9*** 0.14 Dropped out 64.9 83.0*** -0.15 Contact with relatives or signif. ors. 84.8 71.8*** 0.15 Participated in partner seminars, 88.0 74.6*** 0.17

therapy, etc. Involvement of relatives or signif. ors. 3-level n.s. 0.13

in treatment (Oh = 0; I-2h = 1; 2h or more =2)

Active participation of patient in therapy 3-level ** -0.13 (1 = very active to 5 = unwilling)

Clinical prognosis (1 = good, 3-level *** -0.13

2 = questionable\ 5 = poor) No use of painkillers 83.9 72.1 *** 0.13 Occasional use of painkillers 72.5 82.6** -0.10

"For predictors with several levels, only the significance of the X2 test and (in the righthand column) the correlation coefficient are given (product-moment correlation without determination of significance). bThe category 'Impossible to judge' was included in the category 'Doubtful'.

340

Table P6. Predictors at admission and discharge of satisfaction with work situation at IS-month follow-up (men)

Rate (%) of satisfaction" when variable: r"

(product-moment Predictor present absent correlation)

Admission:

Marital status: single 61.4 74.3*** -0.12 Marital status: married 7S.S 60.3*** 0.20 Marital status: divorced 56.7 74.1 *** -0.14 Living alone 60.0 74.6*** -0.13 Living with spouse 79.S 62.1 *** 0.20 Fit for work 75.0 59.S*** 0.15 Occupation: salaried employee, civil 74.7 60.9*** 0.13

servant Unemployed 5S.6 74.S*** -0.15 Only 1 job in last 2 years 77.2 5S.3*** 0.19 2 or more jobs in last 2 years 62.0 72.5* -0.075 Income in last 6 months DM 9600 or more 77.S 64.2*** 0.15 Living in rented accom. 53.4 73.6*** -0.14 Home owner SO.l 67.1 *** 0.13 Never attempted suicide 74.7 56.6*** 0.15 1 attempted suicide 60.2 72.S* 0.OS7 Amount of alcohol per week 65.1 74.2* 0.091 Amount of alcohol per drinking day 65.1 74.3* -0.091 EZB: Problem load: low (1st quartile) 77.0 69.5* 0.072

Discharge:

Employed 76.4 5S.7*** 0.404 Dropped out 26.5 41.0** -0.11 Participated in partner seminars, 33.S 22.5*** 0.12

therapy etc. Involvement of relatives or signif. ors. 3-level *** 0.16

(Oh=O; 1-2h=1; 2h or more =2) FPI: Nervousness 3-level ** -0.15 SAQ: Fear of criticism 3-level * -0.10 SAQ: Fear of criticism: low 30.6 19.7* 0.09 SAQ: Fear of contact: low 30.4 17.4** 0.10

"Both variables dichotomised, except where otherwise stated.

341

Table P7. Predictors at admission and discharge of satisfaction with partner relations

18-month follow-up

Predictor

Admission:

Home town pop. < 100000 No blackouts MDA: Ability to control drinking FPI: Spontaneous aggressiveness FPI: Depressiveness FPI: Sociability FPI: Calmness FPI: Openness FPI: Emotional lability FPI: Masculinity SAQ: Fear of criticism

Discharge:

Symptoms or disturbances during treatment

FPI: Depressiveness: high FPI: Calmness: low FPI: Openness: low SAQ: Fear of criticism: low SAQ: Fear of contact: low FPI: Openness FPI: Emotional lability SAQ: Fear of criticism SAQ: Fear of contact

Rate (%) of satisfaction" when variable:

present absent

94.9 86.9** 94.5 89.3*

85.8 99.8*

89.6 91.3 86.9 92.4* 97.2 89.3* 96.6 89.3* 97.7 89.5*

a Answer categories 1, 2 and 3 coded as 'satisfied'.

rb

0.14 0.082

-0.118 0.0 -0.112 0.0

0.161 0.0 0.118 0.0

-0.128 0.0 0.138 0.0 0.108 0.0

-0.123 0.0 0.129 0.0

-0.100

-0.027 -0.087

0.104 0.100 0.100 0.152 0.0 0.149 0.0 0.150 0.0 0.175 0.0

bProduct-moment correlations were calculated for both the continuous predictors al dichotomised predictors; in the latter case the 6-level satisfaction scale was also dichotomis

342

Table P8. Log linear model with abstinence, prognosis index, treatment length and prevIous treatment in an addition unit (saturated model, men, n = 765)

.l. Standard Significance Variable Effect error (5% level)

Prognosis index:

Poor -0.2736 0.0864 Signif. Moderate -0.0854 0.0653 n.s.

Previous treatment: -0.1524 0.0543 Signif.

Treatment length: Short -0.0837 0.0814 n.s. Medium -0.0575 0.0717 n.s.

Prognosis index + treatment length: Poor + short -0.12833 0.13631 n.s. Poor + medium 0.16695. 0.10838 n.s. Moderate + short 0.16145 0.09771 n.s. Moderate + medium -0.0934 0.08723 n.s.

Previous treatment + treatment length: Previous treatment + short -0.06768 0.0814 n.s. Previous treatment yes + medium -0.02817 0.0717 n.s.

Prognosis index + previous treatment + treatment length: Poor + prevo treat. + short -0.06845 0.1363 n.s. Poor + prevo treat. + medium -0.02620 0.1084 n.s. Moderate + prevo treat. + short 0.12474 0.09771 n.s. Moderate + prevo treat. + medium -0.00279 0.08772 n.s.

Table P9. Predictors at admission and discharge of work situation at 18-month follow-up (women)

Employment rate (%) when variable:

Predictor present absent r p

Admission:

Unemployed 52.4 85.7*** -0.336 0.000 Never lost a job because of alcohol 87.9 61.8*** 0.305 0.000 MDA: Complaints (score above 7) 74.6 80.6 -0.0689 0.1710

Discharge:

No change in professional qualifications 80.9* 33.3 -0.206 0.0022

343

Table PIO. Predictors at admission and discharge of satisfaction with work situation at follow-up (women)

Rate (%) of satisfaction variable:

Predictor present absent

Admission:

Marital status: divorced 54.0 76.1 ** -0.201 Unemployed 51.0 75.1 ** -0.198 No previous treatment in addiction 74.6 58.5* 0.147

unit

Discharge:

Marital status: married 81.2 60.4*** 0.229 Marital status: widowed 59.0 76.1 ** 0.969 Living with spouse/partner 84.4 60.8*** 0.257 Living conditions: better 71.7 69.4 n.s. 0.024 No change in prof. qualifications 72.2 33.3* 0.149 Depressiveness -0.182 Inhibition -0.172

Table PI I. Predictors at admission and discharge of satisfaction with partner relationship at 18-month follow-up (women)

Admission:

EZB: Overall motivation: low FPI: Openness

Discharge:

SAQ: Not being able to say no FPI: Nervousness: low

344

Rate (%) of satisfac. when variable:

present absent

75.0 88.2*

95.3 81.5*

r

-0.153 -0.229

-0.124 0.176

p

0.0107 0.000

0.050 0.0039

0.0 0.0 0.0

0.0

0.0 0.3 0.0 0.0 0.0

Table P12. Predictors at admission and discharge of complaints score at I8-month follow-up (women)

r p

Admission:

Marital status: divorced 0.1739 0.001 FPI: Nervousness 0.3614 0.000 FPI: Spontaneous aggressiveness 0.3022 0.000 FPI: Depressiveness 0.2871 0.000 FPI: Excitability 0.2247 0.000 FPI: Calmness -0.1647 0.002 FPI: Inhibition 0.2171 0.000 FPI: Openness 0.1880 0.001 FPI: Emotional lability 0.2529 0.000 FPI: Masculinity -0.2473 0.000 Fear of therapy 0.2537 0.000 Complaints List 0.4668 0.000

Discharge:

Marital status: widowed 0.1739 0.001 Relapse with medicaments 0.2609 0.048

(n=42) Symptoms during treatment 0.1882 0.001 FPI: Nervousness 0.5742 0.000 FPI: Depressiveness 0.3827 0.000 FPI: Excitability 0.2592 0.000 FPI: Reactive aggressiveness 0.2493 0.000 FPI: Inhibition 0.3517 0.000 FPI: Openness 0.2342 0.000 FPI: Emotional lability 0.3888 0.000 FPI: Masculinity -0.4128 0.000 Complaints List 0.6155 0.000 SAQ: Fear of criticism 0.2996 0.000 SAQ: Being able to make -0.2167 0.000

demands SAQ: Not being able to say no 0.2325 0.000

345

I. Indication

Note: + L *: positive interaction effect in the logit model (higher frequency of abstinence than statistically expected) - L *: negative interaction effect in the logit model Qower frequency of abstinence than statistically expected)

Indication Variables in Men

Good Prognosis Group

Table I 1. Indication variable 'One child' (good prognosis men)

Length of treatment

Short

Medium

Long

346

Indication variable present?

No Yes

-L* n=96 n=21 n=117 60.4% 85.7%

+L* n=47 n=21 n=68 66.0%- 42.9%

n=151 n=43 n=194 74.8% 74.4%

p=0.053 p=0.OO6

Table I 2. Indication variable 'Unskilled worker' (good prognosis men)

Indication variable present? Length of treatment No Yes

+L* Short n=l11 n=6 n=117

65.8% 50.0%

Medium n=56 n=12 n=68 51.8% 97.7%

Long n=158 n=36 n=194 72.2% 86.1%

p=0.0210 p=0.0608

Table 13. Indication variable 'Artisan, skilled worker' (good prognosis men)

Length of treatment

Short

Medium

Long


No Yes

n=51 n=66 n=117 66.7% 63.6%

+L* n=22 n=46 n=68 81.8% 47.8%

n=71 n=123 n=194 76.1% 74.0%

p=0.3251 p=0.OO55

347

Table I 4. Indication variable 'Low income' (good prognosis men)


+L* Short n=105 n=6 n=l11

68.6% 16.7%

Medium n=60 n=5 n=68 58.3% 80.0%

Long n=176 n=6 n=182 75.0% 66.7%

p=0.0475 p=0.0784

Table IS. Indication variable 'No Realschule education" (good prognosis men)


Short n=16 n= 101 n=l17 87.5% 61.4%

Medium n=7 n=61 n=68 57.1% 59.0%

Long n=18 n=176 n=194 55.6% 76.7%

p=O.1066 p=0.OO54

a See Table 4.4, footnote b.

348

Table 16. Indication variable 'Realschule education completed" (good prognosis men)

Indication variable present? Length of treatment

Short

Medium

Long

No

n=l03 61.2%

n=65 58.5%

+L* n=178 76.4%

p=0.OO46

• See Table 4.4, footnote b.

Yes

n=14 92.9%

n=3 66.7%

n=16 56.3%

p=0.0779

n=117

n=68

n=194

Table 17. Indication variable 'Apprenticeship completed' (good prognosis men)


-L* Short n=43 n=74 n=117

60.5% 76.6%

Medium n=34 n=34 n=68 67.6% 50.0%

Long n=66 n=128 n=194 83.3% 70.3%

p=0.0242 p=0.0809

349

Table 18. Indication variable 'Member of Roman Catholic Church' (good prognosis men)


+L** Short n=73 n=44 n=l17

72.6% 53.3%

-L* Medium n=28 n=39 n=67

46.4% 69.2%

Long h=91 n=103 h= 194 71.4% 77.7%

p=0.0271 p=0.OO88

Table 19. Indication variable 'Member of Protestant Church' (good prognosis men)


-L** Short n=58 n=59 n=117

56.9% 72.9%

Medium n=47 n=20 n=67 66.0% 45.0%

Long n=109 n=85 n=194 78.0% 70.6%

p=O.l5 p=0.0553

350

Table I 10. Indication variable 'Amount of alcohol: moderate' (good prognosis men)


Short n=55 n=61 n=1l6 69.1% 62.3%

Medium n=28 n=40 n=68 39.3% 72.5%

Long n=90 n=l00 n=190 77.8% 74.0%

p=0.OOO6 p=0.2711

Table 111. Indication variable 'Intoxicated 4-9 times per month' (good prognosis men)


+L** Short n=85 n=29 n=1l4

72.9% 48.3%

-L* Medium n=45 n=22 n=67

51.1% 72.7%

Long n=133 n=58 n=191 74.4% 77.6%

p=0.OO99 p=0.0189

351

Table 112. Indication variable 'Uses sleeping tablets' (good prognosis men)


+L* Short n=97 n=19 n=116

61.9% 78.9%

Long n=60 n=6 n=66 61.7% 33.3%

Medium n=160 n=34 n=194 75.6% 70.6%

p=0.0292 p=0.1043

Table I 13. Indication variable 'Uses neuroleptics and/or antidepressants' (good prognosis men)

Length of treatment

Short

Medium

Long

352


No Yes

n=93 n=22 n=115 65.6% 63.6%

-L* n=59 n=7 n=66 64.4% 14.3%

+L* n=165 n=29 n=194 72.7% 86.2%

p=0.3394 p=0.OO09

Table 114. Indication variable 'Previous treatment in psychiatric clinic' (good prognosis men)

Length of treatment

Short

Medium

Long


No Yes

n=98 n=19 n=117 68.4% 47.4%

n=59 n=9 n=68 62.7% 33.3%

-L* n=143 n=51 n=194 72.7% 80.4%

p=0.3616 p=0.OO24

Table I 15. Indication variable 'Previous liver disease' (good prognosis men)


-L* Short n=93 n=23 n=116

61.3% 78.3%

Medium n=58 n=7 n=65 58.6% 42.9%

Long n=143 n=45 n=188 76.9% 66.7%

p=0.OO485 p=0.2036

353

Table I 16. Indication variable 'EZB: Moderate insight into change' (good prognosis men)

Length of treatment

Short

Medium

Long


No Yes

+L* n=53 n=63 no: 116 75.5% 55.6%

-L* n=42 n=26 n=68 52.4% 69.2%

n=108 n=83 n=191 75.0% 74.7%

p=0.0157 p=0.0498

Table 117. Indication variable 'MDA: Motivation for drinking-moderate score' (good prognosis men)


Short n=54 n=61 n=115 61.1% 67.2%

Medium n=30 n=34 n= 64 46.7% 70.6%

Loqg +L* n=85 n=l00 n=185 78.8% 73.0%

p=0.OO26 p=0.7356

354

Table 118. Indication variable 'MDA: Alcohol-related com· plaints - high score' (good prognosis men)

Length of treatment

Short

Medium

Long


No Yes

n=83 n=34 n=1l7 57.8% 82.4%

+L* n=45 n=21 n=66 62.2% 57.1%

n=147 n=45 n=192 70.1% 88.9%

p=0.1580 p=0.0101

Table I 19. Indica,tion variable 'Self-Assertiveness Questionnaire: Not being able to say no-moderate score' (good prognosis men)

Length of treatment

Short

Medium

Long


No Yes

n=62 n=53 n=1l5 66.1% 64·2%

+L* n=29 n=37 n=66 72.4% 48.6%

n=85 n=106 n=191 69.4% 80.2%

p=0.8201 p=0.OOO9

355

Table I 20. Indication variable 'FPI: Openness - moderate score' (good prognosis men)

Length of treatment

Short

Medium

Long


No Yes

n=61 n=56 68.9% 60.7%

n=29 n=37 69.0% 51.4%

-L* n=98 n=93 71.4% 78.5%

p=0.9302 p=0.OO47

Moderate Prognosis Group

n=117

n=66

n=191

Table 121. Indication variable 'Single' (moderate prognosis men)


Short n=48 n=24 n=72 52.1% 45.8%

Medium n=68 n=33 n=101 45.6% 36.4%

Long n=87 n=45 n=132 39.1% 57.8%

p=0.3355 p=0.1687

356

Table I 22. Indication variable 'Married' (moderate prtlgnosis men)


Short n=44 n=28 n=72 52.3% 46.4%

Medium n=56 n=45 n=101 41.1% 44.4%

Long n=82 n=50 n=132 56.1% 28.0%

p=0.2150 p=1534

Table I 23. Indication variable 'Population of home town less than 100 000' (moderate prognosis men)


Short n=35 n=37 n=72 57.1% 43.2%

Medium n=66 n=36 n=102 45.5% 38.9%

Long n=58 n=74 n=132 36.2% 52.7%

p=0.1422 p=0.3453

Table I 24. Indication variable 'Only one job in the last 2 years' (moderate prognosis men)


Short n=30 n=42 n=72 56.7% 45.2%

Medium n=46 n=56 n=102 45.7% 41.1%

Long n=68 n=64 n=132 38.2% 53.1%

p=0.2341 p=0.4053

357

Table I 25. Indication variable 'Realschule education completed" (moderate prognosis men)


Short n=58 n=14 n=72 44.8% 71.4%

Medium n=93 n=8 n=102 46.2% 12.5%

Long n=115 n=16 n=131 45.2% 43.8%

p=O.9828 p=O.27

• See Table 4.4, footnote b.

Table 126. Indication variable 'Not in an alcohol-risk occupation' (moderate prognosis men)


Short n=27 n=45 n=72 48.1% 51.1%

Medium n=37 n=64 n=101 62.2% 31.3%

Long n=55 n=77 n=132 36.4% 51.9%

p=O.0517 p=O.0292

358

Table 127. Indication variable 'Previously in an alcohol-risk occupation' (moderate prognosis men)


Short n=61 n=l1 n=72 49.2% 54.5%

Medium n=83 n=18 n=101 37.3% 66.7%

Long n=98 n=34 n=132 50.0% 32.4%

p=0.1866 p=0.0506

Table I 28. Indication variable 'Frequency of alcohol consumption: daily, more or less steady' (moderate prognosis men)


Short n=40 n=32 n=72 35.0% 68.8%

Medium n=47 n=55 n=102 36.2% 49.1%

Long n=65 n=66 n=131 50.8% 40.9%

p=0.1730 p=0.0352

Table I 29. Indication variable 'Frequency of alcohol consumption: daily, increased at the weekend' (moderate prognosis men)


Short n=57 n= 15 n=72 54.4% 33.3%

Medium n=76 n=26 n=102 48.7% 26.9%

Long n=107 n=24 n=131 43.0% 58.3%

p=0.3681 p=0.0642

359

Table I 30. Indication variable 'Frequency of alcohol consumption: almost daily' (moderate prognosis men)


Short n=57 n= 15 n=72 57.9% 20.0%

Medium n=92 n=10 n=102 42.4% 50.0%

Long n=111 n=20 n=131 43.2% 60.0%

p=0.1311 p=0.0574

Table 131. Indication variable 'No loss of driving licence' (moderate prognosis men)


Short n=53 n=19 n=72 47.2% 57.9%

Medium n=83 n=17 n=loo 48.2% 23.5%

Long n=102 n=26 n=128 44.1% 53.8%

p=0.8477 p=0.0759

Table I 32. Indication variable 'Uses sleeping tablets' (moderate prognosis men)


Short n=19 n=53 n=72 57.9% 47.2%

Medium n=14 n=88 n=102 57.1% 40.9%

Long n=30 n=101 n=131 33.3% 48.5%

p=0.1557 p=0.5550

360

Table 133. Indication variable 'Uses painkillers' (moderate prognosis men)


Short n=61 n=l1 n=72 44.3% 81.8%

Medium n=81 n=20 n=101 44.4% 35.0%

Long n=106 n=26 n=132 45.3% 46.2%

p=0.9895 p="0.0409

Table 134. Indication variable 'Liver disease within last 6 months' (moderate prognosis men)


Short n=44 n=28 n=72 61.4% 32.1%

Medium n=61 n=34 n=95 41.0% 44.1%

Long n=49 n=80 n=129 40.8% 48.8%

p=0.0713 p=0.3137

Table I 35. Indication variable 'Previous gastric disease' (moderate prognosis men)


Short n=51 n=21 n=72 41.2% 71.4%

Medium n=74 n=22 n=96 44.6% 31.8%

Long n=93 n=30 n=123 46.2% 43.3%

p=0.8429 p=0.0275

361

Table 136. Indication variable 'Previous delirium tremens' (moderate prognosis men)


Short n=67 n=5 n=72 47.8% 80.0%

Medium n=88 n=10 n=98 46.6% 10.0%

Long n= 111 n= 16 n=127 48.6% 18.8%

p=0.9592 p=0.0091

Table 137. Indication variable 'Vocational training completed' (moderate prognosis men)


Short n=14 n=58 n=72 21.4% 56.9%

Medium n=40 n=61 n=101 57.5% 34.4%

Long n=31 n=l00 n=131 35.5% 48.0%

p=0.0338 p=0.0454

Table 138. Indication variable 'FPI: Depressiveness - high score' (moderate prognosis men)


Short n=18 n=53 n=71 55.6% 47.2%

Medium n=20 n=77 n=97 25.0% 46.8%

Long n=33 n=99 n=132 54.5% 42.4%

p=0.0755 p=0.7938

362

Table 139. Indication variable 'FPI: Sociability -low score' (moderate prognosis men)


Short n=34 n=38 n=72 61.8% 39.5%

Medium n=35 n=62 n=97 31.4% 48.4%

Long n=65 n=67 n=132 53.8% 37.3%

p=0.0288 p=0.4184

Table 140. Indication variable 'FPI: Openness -low score' (moderate prognosis men)


Short n=63 n=9 n=72 52.4% 33.3%

Medium n=87 n=lO n=97 43.7% 30.0%

Long n= 113 n=19 n= 132 42.5% 63.2%

p=0.4210 p=0.1480

Table 141. Indication variable 'FPI: Openness - high score' (moderate prognosis men)


Short n=38 n=34 n=72 39.5% 61.8%

Medium n=59 n=38 n=97 44.1% 39.5%

Long n=77 n=55 n=132 48.1% 41.8%

p=0.6778 p=0.1095

363

Table 142. Indication variable 'FPI: Masculinity -low score' (moderate prognosis men)


Short n=22 n=50 n=72 54.5% 48.0%

Medium n=27 n=70 n=97 22.2% 50.0%

Long n=35 n=97 n=132 57.1 % 41.2%

p=0.0139 p=0.4950

Table 143. Indication variable 'MDA: Willingness to change drinking habits-low score' (moderate prognosis men)


Short n=58 n=13 n=71 55.2% 30.8%

Medium n=79 n=22 n=101 40.5% 54.5%

Long n=103 n=24 n=127 41.7% 54.2%

p=0.1739 p=0.3238

Table 144. Indication variable 'MDA: Complaints and functional disturbances - high score' (moderate prognosis men)


Short n=51 n=21 n=72 41.2% 71.4%

Medium n=67 n=35 n=102 41.8% 45.7%

Long n=83 n=49 n=132 50.6% 36.7%

p=0.4438 p=0.0283

364

Table 145. Indication variable 'Self-Assertiveness Questionnaire: Social decency-moderate score' (moderate prognosis men)


Short n=29 n=43 n=72 62.1% 41.9%

Medium -/I=S4 n=48 n=102 48.1% 37.S%

Long n=77 n=SS n=132 3S.1% 60.0%

p=0.03S2 p=0.OSI8

Table 146. Indication variable 'Self-Assertiveness Questionnaire: Social decency - high score' (moderate prognosis men)


Short n=S8 n=14 n=72 46.6% 64.3%

Medium n=82 n=20 n=102 40.2% SS.O%

Long n=88 n=44 n=132 S1.1% 34.1%

p=0.361S p=0.0809

365

Table 147. Indication variable 'Self-Assertiveness Questionnaire: Fear of criticism - high score' (moderate prognosis men)


Short n=52 n=19 n=71 53.8% 36.8%

Medium n=72 n=25 n=97 37.5% 56.0%

Long n=97 n=33 n=130 49.5% 36.4%

p=0.1483 p=0.2709

Indication Variables in Women

Negative Prognosis Group

Table I 48. Indication variable 'Profession: office clerk' (negative prognosis women)


Short n=26 n=ll n=37 11.5% 45.5%

Medium n=19 n=13 n=32 57.9% 23.1%

Long n=38 n=16 n=54 36.8% 50.0%

p=0.OO44 p=0.3082

366

Table I 49. Indication variable 'Only one job in last 2 years' (negative prognosis women)


Short n=19 n=20 n=39 15.8% 30.0%

Medium n= 15 n=17 n=32 33.3% 52.9%

Long n=31 n=23 n=54 51.6% 26.1%

p=0.0369 p=0.1801

Table I SO. Indication variable 'Church membership: Protestant' (negative prognosis women)


Short n=25 n=14 n=39 24.0% 21.4%

Medium n=13 n=19 n=32 69.2% 26.3%

Long n=24 n=30 n=54 37.5% 43.3%

p=0.0247 p=0.2640

Table I 51. Indication variable 'Gamma alcoholism type' (negative prognosis women)


Short n=5 n=28 n=33 40.0% 14.3%

Medium n=6 n=25 n=31 83.3% 32.0%

Long n=13 n=41 n=54 23.1% 46.3%

p=0.0464 p=0.0208

367

Table 152. Indication variable 'Does not use painkillers' (negative prognosis women)


Short n= 15 n=24 n=39 33.3% 16.7%

Medium n=19 n=14 n=33 57.9% 21.4%

Long n=24 n=30 n=54 33.3% 46.7%

p=0.2042 p=0.0416

Table 153. Indication variable 'Occasionally uses painkillers' (negative prognosis women)


Short n=27 n=12 n=39 14.8% 41.7%

Medium n=20 n=13 n=33 25.0% 69.2%

Long n=35 n=19 n=54 45.7% 31.6%

p=0.0267 p=0.1049

Table 154. Indication variable 'Liver disease in last 6 months' (negative prognosis women)


Short n=25 n=14 n=39 16.0% 37.5%

Medium n=22 n=9 n=31 50.0% 22.2%

Long n=17 n=32 n=49 29.4% 43.8%

p=0.0422 p=0.4898

368

Table 155. Indication variable 'Fear of contact ~ moderate score' (negative prognosis women)


Short n=21 n=18 n=39 14.3% 33.3%

Medium n=9 n=24 n=33 22.2% 50.0%

Long n=28 n=26 n=54 53.6% 26.9%

p=0.0116 p=0.2251

Table 156. Indication variable 'Guilt feelings ~ low score' (negative prognosis women)

Indication variable present? Length treatment No Yes

Short n=24 n=15 n=39 16.7% 33.3%

Medium n=25 n=8 n=33 52.0% 12.5%

Long n=41 n=13 n=54 43.9% 30.8%

p=0.0269 p=0.5435

Table I 57. Indication variable 'Guilt feelings~ high score' (negative prognosis women)


Short n=34 n=5 n=39 23.5% 20.0%

Medium n=23 n=10 n=33 30.4% 70.0%

Long n=43 n=111 n=54 44.2% 27.3%

p=0.1511 p=0.0750

369

Table I 58. Indication variable 'Problem load ~ moderate score' (negative prognosis women)


Short n=25 n=14 n=39 16.0% 35.7%

Medium n=17 n=16 n=33 29,4% 56.3%

Long n=36 n=18 n=54 50.0% 22.2%

p=0.0203 p=0.1217

Table 159. Indication variable 'Problem load - high score' (negative prognosis women)


Short n=20 n= 19 n=39 35.0% 10.5%

Medium n=19 n=14 n=33 52.6% 28.6%

Long n=28 n=26 n=54 28.6% 53.8%

p=0.2385 p=0.OO90

Table I 60. Indication variable 'Extraversion ~ low score' (negative prognosis women)


Short n=30 n=9 n=39 13.3% 55.6%

Medium n=28 n=4 n=32 42.9% 25.0%

Long n=46 n=6 n=52 39.1% 50.0%

p=0.0261 p=0.5882

370

Table I 61. Indication variable 'Extraversion - moderate score' (negative prognosis women)


Short n=18 n=21 n=39 44.4% 4.8%

Medium n=13 n=19 n=32 38.5% 42.1%

Long n=20 n=32 n=52 45.0% 37.5%

p=0.9246 p=0.0131

Table I 62. Indication variable 'Depression - moderate score' (positive prognosis women)


Short n=27 n=12 n=39 22.2% 25.0%

Medium n=21 n=l1 n=32 42.9% 36.4%

Long n=36 n=16 n=52 52.8% 12.5%

p=0.0487 p=0.3452

371

Positive Prognosis Group

Table 163. Indication variable 'No abstinence before index treatment' (positive prognosis women)


Short n=29 n= 17 n=46 69.0% 41.2%

Medium n=9 n=8 n= 17 66.7% 62.5%

Long n=57 n;=24 n=81 54.4% 75.0%

p=0.3894 p=0.0906

Table 164. Indication variable "Alcohol consumption steady over last 2 years' (positive prognosis women)


Short n=35 n=9 n'=44 54.3% 66.7%

Medium n=13 n=4 n= 17 76.9% 25.0%

Long n=52 n=27 n=79 51.9% 74.1%

p=0.2590 p=0.2337

372

Table 165. Indication variable 'Alcohol consumption risen in the last 2 years' (positive prognosis women)


Short n=l1 n=33 n=44 63.6% 54.5%

Medium n=6 n=l1 n=17 33.3% 81.8%

Long n=40 n=39 n=79 65.0% 53.8%

p=0.3269 p=0.4559

Table I 66. Indication variable 'Never been intoxicated' (positive prognosis women)


Short n=35 n=l1 n=46 65.7% 36.4%

Medium n=13 n=4 n=17 69.2% 50.0%

Long n=65 n=16 n=81 56.9% 75.0%

p=0.1802 p=0.0225

Table 167. Indication variable 'EZB: Overall motiv-ation - moderate' (positive prognosis women)


Short n=20 n=26 n=46 65.0% 53.8%

Medium n=9 n=7 n=16 88.9% 42.9%

Long n=38 n=42 n=80 57.9% 64.3%

p=0.2365 p=0.1840

373

Table I 68. Indication variable 'Problem load-moderate' (positive prognosis women)


Short n=27 n= 19 n=46 63.0% 52.6%

Medium n=7 n=lO n=17 85.7% 50.0%

Long n=40 n=40 n=80 50.0% 72.5%

p=0.1286 p=0.0554

Table I 69. Indication variable Complaints (Complaints List)-high score' (positive prognosis women)


Short n=16 n=30 n=46 50.0% 63.3%

Medium n=6 n=l1 n=17 33.3% 81.8%

Long n=24 n=57 n=81 66.7% 57.9%

p=0.1344 p=0.2607

Table 170. Indication variable 'FPI: Nervousness - moderate score' (positive prognosis women)


Short n=32 n=14 n=46 59.4% 57.1%

Medium n=10 n=6 n=16 80.0% 50.0%

Long n=45 n=34 n=79 51.1 % 73.5%

p=0.2118 p=O.l149

374

Table 171. Indication variable 'FPI: Spontaneous aggressiveness - moderate score' (positive prognosis women)


Short n=24 n=22 n=46 37.5% 81.8%

Medium n=5 n=l1 n=16 80.0% 63.6%

Long n=37 n=42 n=79 56.8% 64.3%

p=0.0851 p=0.0864

Table 172. Good prognosis men: indication indices and abstinence for the three lengths of treatment

Short treatment Medium treatment Long treatment N=117 N=68 N=194

Abstinence Abstinence Abstinence ST" MT" LT" Index n % Index n % Index n %

0 0 0 1 1 0 1 1 2 100 2 2 0 2 2 50 2 10 60 3 8 62.5 3 11 45.5 3 36 61.1 4 13 53.8 4 8 50 4 53 73.6 5 28 57.1 5 18 44.4 5 48 81.3 6 33 66.7 6 13 76.9 6 30 83.3 7 18 66.7 7 11 63.6 7 12 83.3 8 11 100 8 3 100 8 3 66.7 9 2 100 9 2 100

10 100 10 Overall abstinence rate 11 11 74.7%

"ST index: indication index for short-term treatment MT index: indication index for medium-term treatment LT index: indication index for long-term treatment

375

Table 173. Moderate prognosis men: indication indices and abstinence for the three lengths of treatment


Abstinence Abstinence Abstinence ST MT LT index n % index n % index n %

0 0 1 0 0 1 3 0 1 4 0 1 2 6 0 2 5 20 2 2 0 3 9 0 3 12 16.7 3 5 0 4 13 46 4 19 36.8 4 11 18.2 5 12 50 5 21 52.4 5 14 21.4 6 15 80 6 21 42.9 6 14 35.7 7 8 79 7 8 62.5 7 16 31.3 8 4 100 8 7 71.4 8 17 58.8 9 2 100 9 4 100 9 14 64.3

10 15 46.7 11 13 69.2 12 8 87.5 13 3 100

For abbreviations, see Table 172.

Table I 74. Positive prognosis women: indication indices and abstinence for the three lengths of treatment

ST index

0

Short treatment N=46

Abstinence

n %

24 37.5 22 81.8

X2 test: p=0.0060; r= -0.45

Medium treatment N=17

Abstinence MT

index n %

0 4 25.0 13 76.9

Fisher's exact test: p=0.09874; r= -0.46


376

Long-treatment N=

Abstinence LT

index n %

0 3 33.3 11 36.4

2 15 40.0 3 21 61.9 4 19 84.2 5 8 75.0 6 2 100 7 2 50

X2 Test p=0.0763; r= -0.32

Table I 75. Negative prognosis women: indication indices and abstinence for the three lengths of treatment


Abstinence Abstinence Abstinence ST MT LT index n % index n % Index n %

0 9 0 0 4 25.0 0 1 14 7.1 1 8 0 1 3 0 2 11 36.9 2 9 33.3 2 1 0 3 3 66.7 3 10 80.0 3 7 14.3 4 2 100 4 2 100 4 9 33.3

X2 test: . X2 test: 5 12 33.3

p=0.0035, r= -0.61 p=0.0043; r= -0.59 6 8 62.5 7 8 37.5 8 6 100 9

X2 test: p=0.0292; r= -0.45


377

Subject Index

abuse, drug 42, 53, 57, 76, 79, 168 abuse, medicament 42, 53, 57, 75-79, 213, 216,

217-219,221,230,232,234,269 abuse, secondary 76-79 action theory 277 acupuncture 30, 179, 252 addictive substances 39, 60, 69, 71-79, 213, 216,

219, 221, 230, 232, 234, 278 admission criteria 25 after-care (see also after-treatment) 10, 66-67,

84--85, 136, 173, 190, 200-201, 203, 279 after-treatment 10, 66-67, 84-85, 200-201, 203,

279 age 36, 153, 182, 188,202,255,272 alcohol anonymous 5, 85, 119, 173

consumed 39-40,73,74,94,96,141,170,212, 214, 216, 233-234, 235, 252

intoxication 40, 62, 74 sequelae 43, 74, 92, 147, 158, 212-214, 216,

217, 219, 229, 266 alcoholic hallucinations 43 anxiety 53, 57, 81, 120-124 attitudes to drinking behaviour 15,41, 51

treatment (EZB) 16,21,44-45, 118-124, 132, 219,229,256

blackout 41,62, 74

cafeteria plan 277 cardiomyopathy 43 catering 28, 179 causal analytic approach 10, 106-111,200 chain of therapy 137,262,276 church membership 39, 217, 229-230, 278 client-centred psychotherapy 28 cluster analysis 173-179 complaints 15, 54, 68, 85, 136, 150

list (BL) 15, 19, 21-22, 44, 68-69, 81-82, 86, 109-111, 149-150, 151, 156-159, 171, .t78, 197

complete linkage method 176 conceptual level 277 configuration frequency analysis (KF A) 208

378

control of drugs 183-184, 187-188,202, 273 COPES (Community-Oriented Programs En

vironment Scales) 13, 31 counselling (see also phychotherapy) 66, 276

centres 67, 69, 44, 84, 95 cross-validation 122-124, 127, 147,251

data protection 23 deads 58, 70 delinquency 42, 83 delirium tremens 43, 53, 212, 214 dendrogram 177 dependence alcohol 3,41 drugs 53, 57, 76-79, 86, 119,269

medicaments 53, 57, 75-79, 179 severity 257, 266 syndrom 157-160

detoxification 179 diagnoses (see also lCD-Diagnosis) 88

secondary 52-53,76-79,86 discharge 10, 49-57 discriminant analysis 147 disulfiram 4, 5, 271 DOSY-system V (Preface) 255, 258 drinking behaviour 6,17-18,21,40-41,60,69,

70-75,77,85,106-112,117 classification 18-19, 74-75, 261 controlled 18, 74, 260 pathological 41, 62, 74

drop-out 50-51, 111, 117, 121, 149-150, 163-171, 177,242,255,258,269

abstinence 163-167 out-patient treatment 259 reasons 50, 164

drugs illegal 42, 69, 76-79, 86, 259 dummy variables 139, 210

education 6, 38 eating disturbances 57 effect sizes 186-188,203 ego strength 16, 125-134, 263 empathy 125-134,263

employment 5,37,43,49,59,68,71,85,105-109, 136,149-150,168,170,197,198

epidemiology 257 experiences of therapy (TEL) 16, 22, 118,

125-134, 249, 263-264

factor analysis 120,125, 172-174 family 29-30, 209 field research 10, 248 financial circumstances 59-60 Freiburg personality inventory (FPI) 15,21-22,

42, 56, 64, 80-81, 86, 96, 112, 115, 117, 156-157, 168-169, 212, 215, 218, 220, 229, 256, 259

friends 46, 65, 71

gamma-type drinker 40, 143,230 gastric disease 43, 212 group therapy 29,67,84,179,242,271 guided affective imagery 179

health insurance institutions 82, 87-92, 94, 96, 97

hierarchical-agglomerative procedures 176 house rules 179 hunger attacks 53, 81, 262 HYPAG (hypotheses agglutination) 264

ICD diagnosis 52,76-79,86,93,257,269 indication 7, 178, 204f, 267, 276-278

adaptive 7 criterion 204 decision rules 205, 210, 222, 224, 238 index 210, 220, 223, 234, 235, 237, 238 length of treatment 206 model 210, 220-226, 234---241, 278 selective 7 variables 204-205, 278

individual changes 100~ 105, 113-115, 117 therapy 29-30,84,175,183,202,242,252,271

insight 125-134 interaction structural analysis 208 internal consistency 120, 147 IQ 6-7

Jellinek classification 13, 39, 229

K-SEKT-A/B/C 13,21,31,34 Korsakoff psychosis 43

leisure activities 71 life events 14,21-22,46,65-66,82-83,119,173,

244, 256 planning 174, 182, 274

liver diseases 43, 212, 218, 229 living situation 6,38,58,71,86,98, 102, 117, 140,

142, 170 log-linear models (Iogit analysis) 121, 124,

129-130, 139, 149, 155, 160, 163, 178, 191, 194---196,210

loss of appetite 81 control 41, 62, 74, 158 job (see also employment) 46,83,98,140-142,

158, 168

marital status 36, 58, 70-71, 86, 102-105, 117, 149

medicaments 42, 62, 75-79, 86 meta"analysis 2 milieu therapy 271 Minnesota Multiphasic Personality Inventory

(MMPI) 7, 15, 22 model, basic 9

causal 245 disease 249 medical 249 sociogenetic 9

motivation 41,44---45, 118-124, 164 multi-centre studies V (Preface) 2, 3, 248 Multidimensional Alcoholism Questionnaire

(MDA) 15,21-22,41, 51, 212, 259 myopathy 43

network of influence variables 245 non-experimental approach 10, 172

occupation therapy 175 outcome 16, 137, 179, 242-243, 248

criteria 17,68,85,100,107-111,121,125,131, 150, 172, 205, 252

pancreatitis 43 panel study 10, 100, 248 participation 54 partner relationship 5, 29-30, 46, 60, 65, 68, 70,

83, 86, 102, 106, 109-110, 136 patient selection 13, 97-99J 191, 254

variables 13, 126, 135, 172, 204 pension insurance institution (Preface) 87,

92-94, 96 person significant 54---55, 59, 65, 70, 82, 96, 150,

171,176,179,183,188,202,251,273

379

personality 17,20,42,80-82, 112-116,278 changes 63-65 traits 15-16

physical condition 6, 43, 65, 82 health 17, 19, 82 therapy 29, 184, 202

polyneuropathy 43 poly toxicomania 19, 79 predictors (see prognostic factors) profession 37 prognosis 4,98-99, 135-171

clinical 55, 149-150, 171 criteria 135-136 index 145-148, 178, 180-181, 193, 199,

206-207, 228 266-268, 275 statistical 152

prognostic factors 2, 5-7, 98, 99, 135-137, 140, 141, 264-266

reliability 13 7 validity 137

psychoneurosis 5, 6, 53 psychopathy 15, 206 psychosocial problems 42 psychosis 52 psychotherapeutic orientation 10, 26--27 psychotherapy (see also psychotherapeutic

orientation) 44,67, 102, 125 . .242-244

quasi-experimental approach 10, 249

RAND Report 260 refusal rate 36 relapse 3, 50, 56, 62, 72-75, 109, 149, 150, 164,

170-171,175,184-185,201,242-244,259 relatives (see persons significant) reliability 95-99, 120, 125-127,249-250,257 religious orientation 28, 39 representativeness 12, 249, 254-255 response- rate 36, 58, 70, 97-98, 166, 180 retirement 59, 86, 87, 93, 94, 103, 106

satisfaction partner relationship 60,68,85, 106, 109-110,

136, 150, 197-198 work situation 60, 68, 69, 85, 109-110, 150.

197-198 seizures 43 self-activation 174, 176

380

sell~assertiveness questionnaire (SAQ) 14,19,21, 22,42, 56, 57, 64, 69, 82, 86, 116, 136, 141, 156--157,169,212,215,220,229-230,256,259

self-efficacy 136, 263 self-help groups 29,66,69,86, 179, 190,200--202,

204,242 severity of Alcoholism 157-160 sexual disturbances 47, 65-66, 83. 258

segregation 12, 182-184,202,274 sick leave days 87-92, 94 sleep disturbances 81 smoking 63, 76 social, environment 9

integration 17, 19 stability 36,71, 86, 102, 148, 168-169 support 36

sociodemographic variables 6,14,21,36--39,49, 58-60,70-71,217

sociopathy (see also psychopathy) 15 spectrum of therapeutic techniques 183,202,274 spontaneous remission 2 sport 29, 179 staff 9, 24-25, 95, 174, 179

meetings 30 part-time 184, 202

stress psychic 14, 65-66, 74

suicide attempts 43, 140-144, 168, 170,258,266

therapeutic atmosphere 30-34 community 4, 28-29

therapist variables 10, 253 treatment

centres 11, 12,24, 172, 180, 191, 197,248,255, 272

compulsory 39 difficulty scale 267 goals 26, 128, 173 in-patient 67, 82, 85-92, 94, 119 length 11, 26, 89-91, 94, 121, 122, 124,

128-131, 137, 141-143, 160-162, 169, 171, 172, 188, 190-200,211-241,249,275-276

out-patient 44, 67, 84, 142, 144 previous 44, 160, 140f, 170, 255, 268-269 process 9, 10, 118, 173,206 variables 4, 13, 24-35, 172-190, 204, 241,

252-254, 270-274 types 2,4,7, 11,29.30,67,271

unemployment (see loss of job) 140-142 unfitness for work 88-92, 94 unpunctuality 188, 202, 273

validity 70, 95, 99, 120, 173, 249, 258 external 250 internal 147

variance explained 152, 186,203,245-247 varimax rotation 175 vocational training 59, 83, 93, 209

waiting list 182, 202, 274 WARD method 176

Ward Atmosphere Scale (see COPES) 13 Wechsler test 5,6 withdrawal symptoms (see also dependence on

alcohol) 53 work

situation (see also- employment) 209, 217, 261-262, 270

therapy 129, 188, 202

381

References - Springer978-3-642-74388-7/1.pdf · Finney I W, Moos R H (1981), Characteristics and...

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