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Thursday, August 2, 2012

Commentary on Boschloo et al. (2012): Persistence, natural recovery and recurrence of those with alcohol use disorders – does treatment make a differe

Longitudinal studies of samples affected by alcohol use disorders are relatively rare. These studies suggest that most of those who have substance use problems recover without treatment, and most of those who receive treatment do not recover in the medium term [1,2]. While we have some understanding of the natural history of alcohol use disorders, and the evidence suggests that natural recovery from these disorders is the norm, the extent of natural recovery and the implications for policy and practice warrant more discussion.

In the current issue, Boschloo and colleagues [3] report the findings of a 2-year follow-up of a selectedsample of people who met the criteria for an alcohol use disorder. Boschloo et al. administered the Composite International Diagnostic Interview (CIDI) to assess whether the respondent had ever had an alcohol disorder.

At the 2-year follow-up they determined whether the alcohol use disorder was still present (i.e. persistent disorder) or whether it had remitted and/or subsequently recurred. Importantly, treatment could be excluded as a reason for remission, as only 4.8% of the sample reported
ever receiving treatment for their disorder. Boschloo et al. found that of those who had ever had an alcohol use disorder, 65.2% had remitted by the baseline interview, while 34.8% met the criteria for an alcohol disorder in the last year (persistent group). Of those who were classified
as remitted at baseline, 14.6% had a recurrence of their alcohol disorder in the 2-year follow-up. Male gender and the severity of the disorder were the main predictors of persistence and recurrence. > > > > Read More