Outcome of Different Types of Treatment of Alcoholics

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Abstract
An experimental comparison was made of the effect of two systems of treatment of alcoholics in outpatient clinics in Helsinki. Voluntary male patients, aged 26-55, were interviewed and given psychological tests. They were then divided at random into two groups, one of which (N=203) was assigned for treatment to a psychotherapeutic outpatient clinic (A-clinic) and the other (N=100) to an outpatient medical clinic (M-clinic). The A-clinic patients averaged 32 visits to the clinic, when they were seen on the average by the following therapists: nurses 20 times, social workers 7, physicians 3, group therapy 2, psychiatrists 0. The M-clinic patients averaged 10 visits, all to psychiatrists. Although the main feature of M-clinic treatment was administration of disulfiram, actually an equal proportion of A-clinic patients received disulfiram. In addition to these two groups of patients a normal control group of 402 males, representing a random sample comparable in terms of age and marital status to the patients, was similarly interviewed and tested. Among the normal controls 58 turned out to be alcoholics. Success of treatment was defined by two concepts, cured and changed. A person was regarded as cured if after treatment he either abstained or did not deviate from the control group in his drinking behavior; and changed, if he displayed, in comparison with the control group, considerably more changes in behavioral patterns over the experimental period. Change was measured by a composite score based on 21 social and psychological variables. Of the A-group, 174 subjects were seen in follow-up; of the M-group, 86; and of the controls, 349 (including 42 of the 58 alcoholics). In the A-group, 33 were evaluated as cured and changed, 5 as cured only, and 47 as changed only; in the M-group the corresponding numbers were 12, 4 and 23. The difference between the clinics was not significant. In the A-group, 85% of these results were attributed by evaluation to the treatment rather than to extraneous factors: in the M-group, 58%.

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