Cognitive dysfunction in the prediction of relapse in alcoholics.

Abstract

To assess the importance of cognitive dysfunction relative to other factors in the prediction of treatment outcome, 106 inpatients at Queen Mary Hospital, Hanmer Springs, New Zealand, were given a battery of psychological tests during the 1st and last 2 wk of treatment and were contacted at 3 mo. and at 1 yr after discharge. At 3 mo. (103) 28% had relapsed, 16% had reduced or controlled their drinking and 56% were abstinent; at 1 yr (100), corresponding percentages were 48, 14 and 38. Results of a stepwise regression analysis of scores on the Patterned Cognitive Impairment Test (PCIT) and the booklet version of the Rod and Frame Test(BRF) and measures of sociodemographic background, drinking pattern, drinking-related symptoms at intake and a number of psychological processes and attitudes yielded a multiple correlation coefficient of 0.62, explaining 38% of the variance in the dependent variable, the number of weeks between discharge from treatment and the 1st posttreatment drink. Two of the 6 predictor variables significant at the 0.05 level were measures of cognitive dysfunction: the interaction of PCIT and BRF scores and the interaction of BRF scores and scores on a measure of internal-external locus of control. Stepwise discriminant function analyses, using drinking status at 3 mo. and 1 yr as a measure of outcome corroborated the regression analysis finding that cognitive impairment during treatment is associated with poor posttreatment outcome.