[Factors associated with dropout from a group cognitive behavioral therapy for substance use disorder].

BACKGROUND: Dropout represents one of important issues in psychosocial treatments for substance use disorders. In Japan, group therapies based on cognitive behavioral therapies such as Serigaya Methamphetamine Relapse Prevention Program (SMARPP) have been conducted. Little is known, however, about factors associated with dropout from group cognitive behavioral therapies for substance use disorders. AIMS: The purpose of the present study is to clarify factors which are associated with dropout in group cognitive behavioral therapies for substance use disorders. In this study, dropout is defined as being absent of the final session and attending to less than 9 of 28 sessions. METHODS: Fifty-three patients with substance use disorder participated in this study. The group program conducted in this study is a group cognitive behavioral therapy. Variables related to demographic (age, gender, education level, marital status, and criminal record), drug use (age at which s/he used drug and the length during which s/he is abstinent from using drugs), and the initial session (mood states before and after the session, and satisfaction with the session) were compared between 20 patients who dropped out (dropout group) and 33 completers (complete group). RESULTS: Compared to the participants in the complete group, those in the dropout group were more likely to be female and showed a shorter period during which s/he had been abstinent from using drugs. CONCLUSION: These results suggest that additional attention need to be paid to participant with these characteristics for preventing dropout.

Verification of the addiction severity index Japanese version (ASI-J) as a treatment-customization, prediction, and comparison tool for alcohol-dependent individuals.

OBJECTIVE: To demonstrate the usefulness of the Addiction Severity Index Japanese Version (ASI-J) in Japanese alcohol-dependent individuals. The ASI is a frequently used clinical and research instrument that measures severities in seven functional domains in people with substance abuse disorders. METHODS: A total of 370 male inpatients with a history of alcohol dependence participated in the study. Forty-nine participants were excluded in the final analysis due to lack of reliability (i.e., patient misrepresentation or inability to understand). We used the ASI-J and a series of indexes that determined patient states during and post-treatment. RESULTS: The correlations between ASI Composite Scores (CSs), which were calculated through a weighted formula and indicated the severity of each problem area, were significant but low in eight relations and not significant in 13 relations, indicating substantial independence of the problem areas. Significant differences were found in Family/Social CSs between abstinent and relapsed alcohol-dependent individuals. The questions of undesirable attitude were significantly related to the CSs of Employment, Drug use, Family/Social, and Psychiatric sections. Significant differences were observed in patient demographics, CS, and ASI Severity Rating (SR) and interviewer's subjective scoring between alcohol-dependent individuals and drug abusers. CSs in Japanese alcohol-dependent individuals were generally similar to corresponding CSs in individuals from other countries, with the exception of The Netherlands. CONCLUSIONS: This study demonstrated that the ASI-J is useful for understanding individual profiles of problems for each patient and planning customized treatment. The ASI-J served as a predictive tool for relapse and compliance to treatment afterward and was shown to be useful as a comparison tool in clarifying similarities and differences between substance abuser groups.