| Objective:To investigate the risk factors of relapse of alcoholism and explore the correlation between cognitive function and relapse, and to find its pathological psychological mechanism of relapse and prevent alcoholics from relapse during withdrawal period by clinical doctors, who can be guided by objective evidences for making early diagnosis and reasonable treatment.Method: In this present study, we selected patients with chronic alcohol dependence as alcohol dependence group(n=60). In the alcohol dependence group, patients with an abstinent period for 1 year and without a relapse as non-relapse group, and patients with recurrent alcohol dependence within 1 year’s withdrawal as relapse group(n=60). The control group was selected from the same area or community as the alcohol dependence group. Meanwhile, patients with other severe neuropsychiatric disorders were excluded. The two groups were matched by age and gender. Chi-square test was applied to analysis categorical variate, and continuous variable used t test and analysis of variance. Multiple logistic regression model was applied for multiple factors. Inspection level was 0.05.Then the alcohol dependence group and control group were assessed by Family Environment Scale-Chinese Version(FES-CV) for their socio-demographic information. We used the Wisconsin Card Sorting Test, Tower of London Test, Digital sequence test and digital span test, visual memory test to assess the subjects’ executive function, memory and attention.Results: In the comparation between the relapse group and non-relapse group, the relapse group demonstrated lower score in expression(t=-3.67, P<0.01), the degree of intimacy(t=-3.13, P<0.01),independence(t=-3.34, P<0.01), organization(t=-2.81, P<0.01), control(t=-3, P<0.01), and higher score in the contradiction(t=2.87, P<0.01)compared with non-relapse group, and the difference was statistically significant(P<0.01). In the Wisconsin Card Sorting Test, alcohol dependence should result in the total(129.21±15.10VS107.33±16.30,t=7.53,P<0.01), to complete the first category should be the answer(t=10.6, P<0.01), continuous should answer(36.20±13.89VS24.00±12.56,t=4.98, P<0.01) and continuity errors(t=6.09, P<0.01) three scores were higher than those in the control group, The relapse related risk factors were analyzed by multi factor Logistic regression analysis and showed that marital status, harmony, daily drinking frequently, poor independence were important risk factors for relapse,(OR=3.11, 95%CI:1.98~7.86),6.89(CI:3.10~16.77) and 2.32(CI:1.25~6.54). Control is a protective factor of relapse occurred in patients with alcohol dependence withdrawal period, OR is 0.26(CI:0.07~0.63), and cognitive dysfunction is relapse risk factors of alcohol dependence in heavy medium of heavy, cognitive impairment is heavier, the higher the rate of relapse.Conclusion:1 Cognitive impairment, low control force, disharmony marital status is an important risk factor in patients with relapse in alcohol dependent;2 Most alcoholics with relapse had poorer family environment than alcoholics without relapse, so the relapse group need to improve family environment and family function, it is great important to reduce the rate of recurrence of drinking for alcoholics;3 Alcoholics who drunk frequently and whose family marital was disharmony should strengthen control over drinking for family and reduce alcohol exposure as far as possible. |
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