Outpatient treatment may be as effective as inpatient treatment if clients are retained, especially in the early phase. On the contrary, dropping out from treatment predicts relapse in alcohol dependence. We investigate early predictors of retention in a cohort of alcoholics undergoing a day-hospital rehabilitation programme.

A consecutive sample of 85 patients entered this prospective study by completing an intensive start-up phase. The main characteristics of the sample were: mean age 43.1± 10.7; 65% male; 68% employed; 27% polyabuser; 76% ongoing psychopharmacological therapy. Clients were assessed (AWRS, VAS for alcohol craving, OCDS, SCL-90-R) at baseline, T30, T60, T120 and T180. The statistical significance of comparisons was tested by Chi square and Mann-Whitney.

The overall retention rate was: 60 pts (70%) at T30, 54 pts (63%) at T60, 42 pts (49%) at T120, 35 pts (41%) at T180. The following comparisons reached statistical significance: the VAS score for craving at baseline was lower among retained clients at T30 (p=0.01) and T60 (P=0.02), and so was the OCDS compulsion score at baseline among retained clients at T30 (p=0.04); those receiving a psychopharmacological therapy after the start-up phase showed a better retention at T30 (p=0.01) and at T60 (p=0.04).

According to this preliminary analysis, alcohol-related symptom distress at baseline and lack of psychiatric medication after the intensive treatment phase are more frequently observed in early drop-out. Further analysis is necessary to identify true predictors of retention in a multivariate model.