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LVR-Klinikum Düsseldorf Hospital of the Heinrich-Heine University ...

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<strong>LVR</strong>-KLINIKUM DÜsseLDORF – hOsPITaL OF The heINRIch-heINe UNIVeRsITY DÜsseLDORF<br />

Network, <strong>the</strong>re are close links with a lot <strong>of</strong> o<strong>the</strong>r working<br />

groups, based on joint participation in multi-centre projects.<br />

Projects<br />

Neuropsychological relapse predictors in<br />

persons with alcohol dependence<br />

Sub-project <strong>of</strong> <strong>the</strong> study “Acamprosat and integrative<br />

behavioural <strong>the</strong>rapy in <strong>the</strong> outpatient treatment <strong>of</strong> alcohol<br />

dependency” (Principal investigator: W. Gaebel)<br />

W. Wölwer, W. Gaebel in cooperation with <strong>the</strong> Dependence<br />

Disorders research group<br />

Project period: 2002–2007<br />

Financing: FMER funding 01 EB 0133<br />

Although cognitive disorders in people with alcohol<br />

dependence have been known for a long time, <strong>the</strong> question<br />

<strong>of</strong> <strong>the</strong> interaction <strong>of</strong> such disorders with <strong>the</strong> treatment<br />

process is still relatively unclear because <strong>of</strong> conflicting<br />

results. Some findings from a previous study in 120 patients<br />

with alcohol dependence, who, after inpatient detoxication,<br />

were randomly assigned to one <strong>of</strong> three six-month outpatient<br />

psycho<strong>the</strong>rapy conditions, indicate that those patients<br />

74<br />

Assessment <strong>of</strong> <strong>the</strong> electrophysiological correlates <strong>of</strong> facial affect<br />

decoding in <strong>the</strong> Experimental Psychopathology Research Laboratory<br />

relapsing already within this treatment period – independent<br />

<strong>of</strong> <strong>the</strong> treatment – demonstrated more pronounced cognitive<br />

impairments (particularly in verbal memory and visualmotor<br />

functions) already before <strong>the</strong>y entered <strong>the</strong> treatment<br />

than patients remaining abstinent. This finding could only<br />

partially be confirmed within <strong>the</strong> context <strong>of</strong> <strong>the</strong> present<br />

project involving 371 persons with alcohol dependence,<br />

who, after detoxification, were randomly assigned to one <strong>of</strong><br />

three six-month combination treatments with medication<br />

and psycho<strong>the</strong>rapy components (anti-craving medication<br />

plus cognitive behavioural <strong>the</strong>rapy or plus consultations<br />

during ward rounds, or placebo plus cognitive behavioural<br />

<strong>the</strong>rapy). Cognitive impairments had an impact, particularly<br />

in <strong>the</strong> sense <strong>of</strong> a reduced rate <strong>of</strong> successful treatment<br />

completions, if <strong>the</strong> anti-craving substance (acamprosat) was<br />

used without accompanying cognitive behavioural treatment.<br />

However, no predictive effect <strong>of</strong> cognitive impairments was<br />

identifiable under <strong>the</strong> two strategies based on behavioural<br />

<strong>the</strong>rapy, possibly because <strong>the</strong> <strong>the</strong>rapists had intuitively<br />

matched <strong>the</strong> psycho<strong>the</strong>rapy in individual settings to <strong>the</strong><br />

patients’ individual deficits and resources.

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