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Cloninger Type 2 Score and Lesch Typology Predict Hospital Readmission of Female and Male Alcohol‐Dependent Inpatients During a 24‐Month Follow‐Up
Author(s) -
Weinland Christian,
Braun Birgit,
Mühle Christiane,
Kornhuber Johannes,
Lenz Bernd
Publication year - 2017
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.13468
Subject(s) - typology , alcohol , psychology , hospital readmission , psychiatry , clinical psychology , medicine , demography , emergency medicine , sociology , biology , biochemistry , anthropology
Background Relapse after detoxification treatment is a common problem in alcohol dependence. However, its prediction still lacks reliability. We here investigated whether the easily accessible clinical Cloninger and Lesch classifications predict alcohol‐related hospital readmission following inpatient withdrawal treatment. Methods In this bicentric prospective clinical study, 67 female and 84 male alcohol‐dependent inpatients were characterized according to the Cloninger items and the Lesch typology. The patients’ records were followed for 24 months. Because of the well‐established sex differences in alcohol dependence, we studied females and males separately. Results Overall, 54% of the female patients and 67% of the male patients sustained at least 1 alcohol‐related hospital readmission during the follow‐up. Readmission was related to a higher Cloninger type 2 score than nonreadmission (females, p = 0.007, males p = 0.044). In females, the Cloninger type 2 score correlated with the number of readmissions ( ρ = 0.384, p = 0.001) and the days to first readmission ( ρ = −0.333, p = 0.006). The effects were stronger in patients with age at onset of alcohol dependence over 25 years. We found gender dimorphisms concerning the Cloninger items. In female patients, the 4 Lesch subtypes differed in their risk ( p = 0.010), the number ( p = 0.040), and the days to first readmission ( p = 0.031). Lesch type 1 was associated with an increased risk ( OR = 4.83, p = 0.041) and Lesch type 2 with a reduced risk ( OR = 0.07, p = 0.004). In addition, the number of previous inpatient alcohol withdrawals predicted the patients’ outcomes ( p < 0.05). Conclusions The Cloninger type 2 score and the Lesch typology are promising tools for the prediction of alcohol‐related readmissions. Our findings provide the basis to optimize relapse prevention in alcohol dependence.