Integrated Treatment at the First Stage: Increasing Motivation for Alcohol Patients with Comorbid Disorders during Inpatient Detoxification

• Published in: Alcohol and alcoholism (Oxford) Vol. 53; no. 6; pp. 719 - 727
• Main Authors: Ostergaard, Mathias, Jatzkowski, Leonie, Seitz, Raffaela, Speidel, Samantha, Weber, Tanja, Lübke, Norbert, Höcker, Wolfgang, Odenwald, Michael
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.11.2018
• Subjects: Adult; Alcoholism - epidemiology; Alcoholism - psychology; Alcoholism - therapy; Combined Modality Therapy - methods; Comorbidity; Early Medical Intervention - methods; Early Medical Intervention - trends; Female; Follow-Up Studies; Hospitals, Psychiatric - trends; Humans; Inpatients - psychology; Longitudinal Studies; Male; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - therapy; Middle Aged; Motivation - physiology; Patient Acceptance of Health Care - psychology; Random Allocation
• ISSN: 0735-0414; 1464-3502
• DOI: 10.1093/alcalc/agy066

Interventions increased utilization of post-detoxification treatment and reduced alcohol-related readmissions. Higher depression or trauma scores were associated with higher rates of utilization of treatment. Abstract Aims Co-occurring mental disorders can complicate the detoxification treatment process and outcome. The aim of this study is to examine whether a brief psychoeducational group counseling session during detoxification treatment can increase the motivation for and utilization of subsequent treatments. Short summary Interventions increased utilization of post-detoxification treatment and reduced alcohol-related readmissions. Higher depression or trauma scores were associated with higher rates of utilization of treatment. Methods Patients received either a brief manualised group intervention on the interrelation of alcohol use disorder (AUD) and major depression (MD) or AUD and post-traumatic stress disorder (PTSD) or a cognitive training session (control group). Of the 784 patients treated in the study period, 171 participants were quasi-randomly allocated to groups. Self-reported motivation was measured before and after intervention, transition into AUD treatment and readmissions were collected after detoxification treatment. Results Participating in any of the intervention groups increased the utilization of AUD treatment after inpatient detoxification (χ2 = 6.15, P = 0.02) and decreased readmissions 6 months after discharge (χ2 = 7.46, P = 0.01). Depression and trauma scores moderated the effect: associations with the utilization of post-detoxification treatment were found in participants with higher depression (OR = 5.84, 95% CI = 1.17–29.04) or trauma scores (OR = 10.17, 95% CI = 1.54–67.1). Conclusions An integrated intervention approach for dual diagnosis at the beginning of the treatment can increase motivation for continued AUD treatment. Especially affected dual diagnosis patients can benefit from this treatment.