Cognitive dysfunction in the prediction of relapse in alcoholics.

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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.

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