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Treatment outcome and its predictors among Asian problem drinkers

Authors


Victoria Manning BSc, MSc, PhD (Psychology), Senior Research Manager, Adjunct Assistant Professor, Brenda Gomez BA (Psychology), Research Assistant, Puay Kee Koh BA (Psychology), Research Assistant, Andrew Ng BSocSc (Psychology), Research Assistant, Song Guo MBBS, MMed (Psychiatry), PhD (Psychopharmacology), Head (Research), Consultant Psychiatrist, Gomathinayagam Kandasami MBBS, MCRPsych, DPM, Chief, Consultant Psychiatrist, Kim Eng Wong MBBS, MCRPsych, FAMS (Singapore), Clinical Director, Emeritus Consultant Psychiatrist. Correspondence to Dr Victoria Manning, Institute of Mental Health, 10 Buangkok View, Singapore 539747. Tel: +65 6389 2378; Fax: +65 6389 2388; E-mail: victoria_manning@imh.com.sg

Abstract

Introduction and Aims

Evidence of treatment effectiveness for alcohol use disorders (AUD) have emerged predominantly from Western studies, using highly controlled trials that may not reflect real-world settings. This paper examines treatment outcome and its predictors among Asian problem drinkers participating in a treatment outcome monitoring program at an addiction treatment centre in Singapore.

Design and Methods

Data were collected at intake and 3, 6 and 12 months, although the focus of this paper is on reliable change at 3 months among the 70% who were followed up. Five hundred and forty-one AUD-diagnosed outpatients presenting for treatment, over a 2-year period, were assessed on drinking behaviours and administered the Addiction Severity Index-Lite, Personal Wellbeing Index (PWI) and Treatment Perceptions Questionnaire.

Results

At 3 months, drinking days, alcohol units and alcohol use severity had more than halved and 69% were either abstinent or had reliably reduced their drinking days. Baseline drinking days and treatment satisfaction predicted 3-month drinking frequency but not severity. Positive alcohol outcomes observed at 3 months were sustained among those followed up until 12 months. Mean PWI score improved significantly and fell within the ‘normal’ range. Treatment satisfaction also emerged as the only significant predictor of reliable positive change in both drinking days and PWI score.

Discussion and Conclusions

Significant reductions in drinking frequency and severity are possible for Asian problem drinkers after 12 weeks of outpatient treatment. The identified predictors suggest that more frequent drinkers and patients with past/current psychiatric comorbidities may require a more intensive treatment approach to optimise treatment outcomes.

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