Factors Influencing Relapse Among Alcohol Dependent Patients - A Mixed Method Study

Background Alcohol use disorders are chronic, and relapses occur due to neurobiological and psychosocial factors. This study was conducted to elicit the prevalence of psychiatric co-morbidities, severity of dependence, craving, and level of motivation in alcohol-dependent subjects who have relapsed and to elicit factors resulting in relapse using a mixed method. Method Eighty-two alcohol dependence syndrome patients (ADS) with a history of relapse were recruited after obtaining consent. A mixed method-concurrent parallel design was adopted. Mini-International neuropsychiatric interview (M.I.N.I), Penn Alcohol Craving Scale (PACS), Severity of Alcohol Dependence Questionnaire (SADQ), and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) questionnaires were administered. Six in-depth interviews (IDI) and 5 focus group discussions (FGD) were conducted, and the data from the two phases were analyzed. Results The mean age of the participants was 44.45 years. 53.7 % had co-morbid tobacco use, 43.9 % had borderline personality disorder and 47.6% had mild dependency. 41.5 % had only moderate levels of motivation to quit. A significant association was obtained between the severity of dependence and craving (p= 0.016). Qualitative data identified 1) Drinking Motives, 2) Self-perception, 3) Misconceptions related to alcohol use, and 4) Social factors leading to relapse. Conclusion The study shows that co-morbid tobacco use and the presence of borderline personality disorders were higher in patients with relapse and that severe dependence was associated with higher craving. Motives related to usage, self-perception about alcohol use, misconceptions related to alcohol use, and social factors also led to relapse. Funding: Self funded Conflict of Interest: None