Out-patient behaviour therapy in alcoholism: impact of personality disorders and cognitive impairments

Objective: We investigated whether alcoholic patients with comorbid persona lity disorders and those with cognitive impairments would benefit in a diff erent way from different behaviour therapy strategies. Method: After detoxification, 120 alcoholics were assigned randomly to one of three out-patient treatment programmes comprising 'coping skills trainin g', 'cognitive behaviour therapy' or unspecific supportive control therapy. Personality disorders and cognitive impairments were assessed at the begin ning of the 6-month treatment period. Results: The impact of concomitant personality disorders or cognitive impai rments was generally only moderate and mainly independent from treatment co ndition. However. alcoholic patients relapsing within 6 months after detoxi fication showed a higher rate of personality disorders (especially antisoci al and borderline) and slightly more cognitive deficits (especially in verb al memory and visuomotor functions) than abstainers even before therapy. Conclusion: The high amount of early relapses and drop-outs probably hinder ed larger differentiated treatment effects. Hypotheses will be retested in treatment completers using forthcoming follow-up data.