Longitudinal research on treated alcoholism: Systematic review of long-term follow-ups
DOI:
https://doi.org/10.20882/adicciones.187Keywords:
alcoholism, longitudinal studies, methodologyAbstract
Aims: To analyze the methodological design of long-term longitudinal studies of alcoholics who have undergone treatment. Methods: Systematic review of prospective longitudinal studies of treated alcoholics with follow-up periods of at least 8 years, and published in English, during the period 1983-2009. The review includes 9 studies which analyzed: follow-up evaluations, information sources, the period of reference in the final assessment, the measurement of alcohol use, the operationalization of drinking patterns, and data analysis. Results: 2434 patients (ranging between 57 and 850 per study) were studied on average for a period of 15.3 (D.T. = 3.2) years (range 8-20 years). Studies differ in the number of intermediate evaluations (0, 1, 3, 4) and the length of the period considered for the final evaluation (the whole period, the last 3 years, the last year, last 6 months, last month or present situation). Drinking patterns tend to be used as the main outcome variable, but they are operationalized in non-equivalent forms and the analysis is performed using classical cross-sectional statistical techniques. Alcoholism evolution is studied by analyzing the evolution of drinking patterns and patients’ life situation during the period under study. Conclusions: The scarce amount of data available on the evolution of treated alcoholism cannot be compared across studies due to considerable methodological differences. There is a need to promote common methodological criteria in relation to follow-up strategies. New statistical methods that permit longitudinal analysis for non-balanced and correlated data should also be incorporated.References
Arnau, J. y Balluerka, N. (2004) Análisis de datos longitudinales y de curvas de crecimiento. Enfoque clásico y propuestas actuales. Psicothema, 16, 156-162.
Babor, T.F., Longabaugh, R., Zweben, A., Fuller, R.K., Stout, R.L., Anton, R.F., et al. (1994). Issues in the definition and measurement of drinking outcomes in alcoholism treatment research. Journal of Studies on Alcohol, 12, 101-11.
Breslin, F.C., Sobell, S.L., Sobell, L.C. y Sobell, M.B. (1997). Alcohol treatment outcome methodology: state of the art 1989-1993. Addictive Behaviors, 22, 145-55.
Bryk, A.S. y Raudenbush, S.W. (1992). Hierarchical linear models: Applications and data analysis methods. Newbury Park, CA: Sage Publications.
Duckitt, A., Brown, D., Edwards, G., Oppenheimer, E., Sheehan, M. y Taylor, C. (1985). Alcoholism and the nature of outcome. British Journal of Addiction, 80, 153-62.
Edwards, G. (1989). As the years go rolling by. Drinking problems in the time dimension. British Journal of Psychiatry, 154, 18-26.
Edwards, G., Brown, D., Oppenheimer, E., Sheehan, M., Taylor, C. y Duckitt, A. (1988). Long term outcome for patients with drinking problems: the search for predictors. British Journal of Addiction, 83, 917-27.
Edwards, G., Duckitt, A., Oppenheimer, E., Sheehan, M. y Taylor, C. (1983). What happens to alcoholics? Lancet, 2, 269-71.
Ellingstad, T.P., Sobell, L.C., Sobell, M.B. y Planthara, P. (2002). Drug treatment outcome methodology (1993-1997) strengths,
weaknesses, and a comparison to the alcohol field. Addictive
Behaviors, 27, 319-30.
Gastfriend, D.R., Garbutt, J.C., Pettinati, H.M. y Forman, R.F. (2007). Reduction in heavy drinking as a treatment outcome in alcohol dependence. Journal of Substance Abuse Treatment, 33, 71-80.
Gibbs, L. y Flanagan, J. (1977) Prognostic indicators of alcoholism treatment outcome. International Journal of the Addictions, 12, 1097-1141.
Goldstein, H. (1995). Multilevel Statistical Models. New York: John Wiley and Sons.
Gual, A., Bravo, F., Lligoña, A. y Colom, J. (2009). Treatment for alcohol dependence in Catalonia: health outcomes and stability of drinking patterns over 20 years in 850 patients. Alcohol and
Alcoholism, 44, 409-15
Longford, N.T. (1993). Random coefficient models. Oxford, GB:
Clarendon Press.
Maisto, S.A., Sobell, L.C., Cooper, A.M. y Sobell, M.B. (1982).
Comparison of two techniques to obtain retrospective reports of drinking behavior from alcohol abusers Addictive Behaviors, 7, 33-38.
Mann, K., Shäfer, D.R., Längle, G., Ackermann, K. y Croissant, B. (2005). The long-term course of alcoholism, 5, 10 and 16 years after treatment. Addiction, 100, 797-805.
McCabe, R.J. (1986). Alcohol-dependent individuals sixteen years on. Alcohol and Alcoholism, 21, 85-91.
Moos, R.H. y Moos, B.S. (2005). Sixteen-year changes and stable remission among treated and untreated individuals with alcohol use disorders. Drug and Alcohol Dependence, 80, 337-47.
Nordström, G., Berglund, M. y Frank, A. (2004). Stability of successful long-term adjustment in alcohol dependence: a follow-up study 15 years after the first long-term follow-up. European Addiction Research, 10, 126-32.
O’Connor, A. y Daly, J. (1985) Alcoholics. A twenty year follow-up study. British Journal of Psychiatry, 46, 645-7.
Powell, B.J., Landon, J.F., Cantrell, P.J., Penick, E.C., Nickel, E.J., Liskow, B.I. et al. (1998). Prediction of drinking outcomes for male alcoholics after 10 to 14 years. Alcoholism: Clinical and
Experimental Research, 22, 559-66.
Taylor, C., Brown, D., Duckitt, A., Edwards, G., Oppenheimer, E. y Sheehan, M. (1985). Patterns of outcome: drinking histories
over ten years among a group of alcoholics. British Journal of
Addiction, 80, 45-50.
Twisk, J.W. (2003). Applied longitudinal data analysis for
epidemiology: A practical guide. Cambridge, UK: Cambridge
University Press.
Twitchell, G.R., Hertzog, C.A., Klein, J.L. y Schuckit, M.A. (1992). The anatomy of a follow-up. British Journal of Addiction, 87, 1327-33.
Vaillant, G.E. (1983). The natural history of alcoholism. Cambridge: Harvard University Press.
Vaillant, G.E. (1988) What can long-term follow-up teach us about relapse and prevention of relapse in addiction? British Journal of Addiction, 83, 1147-57.
Vaillant, G.E. (1995). The natural history of alcoholism revisited.
Cambridge: Harvard University Press.
Vaillant, G.E. y Hiller-Sturmhofel, S. (1996). The natural history of alcoholism. Alcohol Health and Research World, 20, 152-161.
Vaillant, G.E. y Milofsky, E.S. (1984). Natural history of male
alcoholism: paths to recovery. In Goodwin D.W., Van Dusen K.T,
Mednick S.A. (Eds.), Longitudinal research in alcoholism (pp.
-71), Boston: Kluwer-Nijhoff Publishing.


