B Löhnert

Ludwig-Maximilian-University of Munich, München, Bavaria, Germany

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Publications (7)4.16 Total impact

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    ABSTRACT: Rehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion. A total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity) at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncom-pleters for any reason. A total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be married but live separated. Rates of treatment noncompletion in inpatient and outpatient rehabilitation programs correspond to results from previous research. Noncompletion is a significant correlate of relapse 1 year after treatment, and noncompleters show an elevated level of psychopathology. These findings may help rehabilitation treatment facilities to tailor specific therapies for these individuals to reduce risk for treatment noncompletion.
    Substance abuse and rehabilitation. 01/2012; 3:35-42.
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    ABSTRACT: To study the prediction potential of demographic and psychopathological variables in the patient allocation context. This was a follow-up study of alcohol-dependent patients (n = 242) who were treated in an outpatient (n = 75), inpatient short-term (n = 88), or inpatient long-term (n = 79) setting between 2003 and 2004. Demographic and psychopathological variables were measured by psychiatric basic documentation and the European Addiction Severity Index (EuropASI) . Abstinence two years after discharge from treatment was the primary outcome criterion. Significant predictors of outcome were a higher secondary school qualification, a finished professional training, later onset of alcohol dependence, less number of treatments for physical illness as well as no history of suicide attempts. Both satisfaction with the family background and being employed were predictors with allocation potential.
    Fortschritte der Neurologie · Psychiatrie 09/2009; 77(8):451-6. · 0.85 Impact Factor
  • Fortschritte Der Neurologie Psychiatrie - FORTSCHR NEUROL PSYCHIAT. 01/2009; 77(08):451-456.
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    ABSTRACT: To study the validity of the EuropASI in the patient allocation context and to measure the alcohol severity changes with treatment. The examination based on three groups of alcohol-dependent patients (n = 242): outpatients (n = 75), inpatients in a short-term treatment (n = 88), and inpatients in a long-term treatment (n = 79). Treatments took place in two clinics. The European Addiction Severity Index (EuropASI)-Composite Scores were calculated for severity assessment of alcohol dependence. These scores are qualified for change measurement and scientific utilization. Assessments took place on admission and at discharge from the treatment unit. Analyses included the outset values comparison and the examination of both time as well as group effects. Mean age of patients was 45.3 years (SD = 8.6) and 26,4 % of the participants were females (n = 64). The three groups differed significantly in their completion of professional training, employment status, marital status, onset of alcohol dependence, daily alcohol intake in the past half year, previous detoxifications, previous rehabilitations, and at least one attempted suicide. Adjusted for these variables, the 3 groups differed in the alcohol domain at t0, and t0-t1-improvements resulted for the whole sample in the alcohol domain and the domain 'employment satisfaction'. The severity ratings by means of EuropASI-Composite Scores illustrated the assumption that the severity level gives information about the treatment needs: the more severe disorder the larger the treatment needs. Furthermore, a t0-t1-decrease of the Composite Scores was shown for the whole sample in the domains 'alcohol use' and 'employment satisfaction'. This points to a reduction of the addiction severity level due to treatment. In spite of some limitations regarding the Composite Scores, the EuropASI seems to be useful for patient allocation.
    Fortschritte der Neurologie · Psychiatrie 10/2007; 75(9):541-8. · 0.85 Impact Factor
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    ABSTRACT: First results of a clinical and catamnestic investigation are reported for the efficiency of a highly structured outpatient therapy with alcohol-dependents. One hundred and two patients were included in the study. Of the patients,60% were male and 40% female. The average age was 45 years (+/-8). The average duration of alcohol dependence amounted to 15 years (+/-9), and the last average quantity of pure alcohol drunk was 193 g. Twenty-seven per cent of the patients had completed inpatient therapies in the past. Treatment retention amounted to n=74 (72.5%), and 18 of the 25 dropped out because of alcohol relapse. On average, relapsed dropouts indicated a longer abuse of alcohol and significantly more pretreatments than completers, and they also reported significantly stronger craving for alcohol (measured with the OCDS). Furthermore, they also achieved significantly higher total scores in the BDI (depression) and STAI (anxiety) scales at the beginning of therapy. At 6/12-month follow-ups, 90%-95% of the patients were successfully located and interviewed. Analyses revealed that 64% of the patients were still abstinent at 6-month follow-up evaluation, and 56% had remained abstinent until 12-month follow-up. Therapeutic implications of these satisfying therapy results are discussed, and the current knowledge on the efficiency of outpatient therapies is presented.
    Der Nervenarzt 04/2003; 74(3):226-34. · 0.80 Impact Factor
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    ABSTRACT: Berichtet werden erste Ergebnisse einer klinischen und katamnestischen Untersuchung zur Effizienz einer intensiven ambulanten Entwöhnungstherapie bei Alkoholkranken. In die Studie konnten 102 Patienten eingeschlossen werden.Die durchschnittliche Dauer der Alkoholabhängigkeit betrug 15 (±9) Jahre, die letzte durchschnittliche Trinkmenge 193 g reiner Alkohol. Die Haltequote betrug 72,5%, 18 der 25 Abbrüche erfolgten wegen Alkoholrückfällen. Rückfällige Therapieabbrecher wiesen im Mittel eine längere Alkoholbelastung und signifikant mehr Vorbehandlungen als Therapiebeender auf, berichteten bei Aufnahme auch über ein signifikant stärkeres Alkoholverlangen. Ferner erreichten sie auch bei Therapiebeginn signifikant höhere Summenscores im BDI (Depressivität) und STAI (Ängstlichkeit). Für die katamnestischen Zeitpunkte 6 bzw.12 Monate nach Therapiequote wurde eine hohe Ausschöpfquote mit ca.90% erreicht. Die Abstinenzquote beträgt 6 Monate nach Therapieende 64%.Über den gesamten 12-Monats-Katamnese-Zeitraum waren 56% der Patienten abstinent, 14% gebessert und 30% rückfällig.Therapeutische Implikationen dieses befriedigenden Therapieergebnisses werden diskutiert und der heutige Kenntnisstand zur Effizienz ambulanter Therapien bei Alkoholabhängigkeit dargestellt. First results of a clinical and catamnestic investigation are reported for the efficiency of a highly structured outpatient therapy with alcohol-dependents.One hundred and two patients were included in the study.Of the patients,60% were male and 40% female. The average age was 45 years (±8).The average duration of alcohol dependence amounted to 15 years (±9), and the last average quantity of pure alcohol drunk was 193 g.Twenty-seven per cent of the patients had completed inpatient therapies in the past.Treatment retention amounted to n=74 (72.5%), and 18 of the 25 dropped out because of alcohol relapse.On average, relapsed dropouts indicated a longer abuse of alcohol and significantly more pretreatments than completers, and they also reported significantly stronger craving for alcohol (measured with the OCDS).Furthermore, they also achieved significantly higher total scores in the BDI (depression) and STAI (anxiety) scales at the beginning of therapy. At 6/12-month follow-ups, 90%–95% of the patients were successfully located and interviewed. Analyses revealed that 64% of the patients were still abstinent at 6-month follow-up evaluation, and 56% had remained abstinent until 12-month follow-up. Therapeutic implications of these satisfying therapy results are discussed, and the current knowledge on the efficiency of outpatient therapies is presented.
    Der Nervenarzt 02/2003; 74(3):226-234. · 0.80 Impact Factor
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    ABSTRACT: This study tested the feasibility of outpatient abstinence treatment among alcohol dependent subjects on welfare. Patients had a long history of alcohol dependence and prolonged unemployment. Over a period of six months a total of 250 patients were approached by the social welfare office and asked to participate in the program. The program involved detoxification and a three month combined alcohol treatment and personal job training. Of the 250 persons approached 96 patients (about 40 %) appeared for the initial examination, 19 patients (13 %) finished detoxification and a total of 5 patients completed the program. The majority of a group of patients considered to be highly therapy resistant did not complete the program. Still it was important to demonstrate that a subgroup of patients did successfully complete this program. We consider this pilot project a successful starting point for further development of treatment approaches targeted more specifically at this group of patients.
    Fortschritte der Neurologie · Psychiatrie 09/2002; 70(8):429-37. · 0.85 Impact Factor