Psychosocial Factors Associated with Relapse in Patients with Alcohol Dependence.

INTRODUCTION: Despite the recent developments in the biology of addiction, a significant part of relapse and its management is still influenced by psychosocial factors and the interplay between them. This study aims at finding the extent of association of various psychosocial factors with relapse in patients of alcohol dependence.

MATERIALS AND METHODS: It is a cross-sectional study of two groups of alcohol dependence patients: abstinence (n = 31) and relapse (n = 35). Demographic, clinical, and psychosocial variables were compared between the two groups. Statistical analyses were aimed at finding the extent of association between various factors and relapse.

RESULTS: Demographic variables such as family history of substance dependence (odds ratio [OR] =2.09; confidence interval [CI] =0.74-5.90) and past history of ≥2 relapses (OR = 2.71; CI = 0.83-8.87) were associated with relapse in alcohol dependence. Clinical variables such as younger age of onset of dependence (Mean difference = -3.93; 95% CI = -7.66 - -0.21; P = 0.038) and shorter time to develop dependence (Mean difference = -3.08; 95% CI = -5.53 --0.63; P = 0.014) were significantly associated with relapse. Of the psychosocial variables, coping behavior (OR = 6.54; CI = 1.17-36.74) had the highest association with relapse followed by relapse precipitants (OR = 1.42; CI = 1.16-1.74).

CONCLUSION: Coping behaviors to adverse situations have greater association with relapse among psychosocial variables than the number of high-risk situations a patient experiences. Interventions targeted at improving coping skills can help patients stay abstinent.