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Journal of Clinical and
Basic Psychosomatics Alcohol use disorder relapse: Tools and factors

2.5. Structural review AUDIT is a semi-structured rating scale that assesses

For structural review, we assessed whether the title three dimensions: alcohol consumption and frequency,
accurately reflected the theme and whether the abstract alcohol dependence, and alcohol-related issues, with a
summarized the key points. The introduction was total of 10 items. The World Health Organization began
the collaborative development of AUDIT in 1982. Nearly
examined for its explanation of the background and 2,000 drinkers from six countries participated in its testing,
purpose, whereas the logic of the main body was evaluated
for clarity. The conclusion was assessed to determine and its use has been promoted globally since 1989. The
whether it reasonably summarized the key content. AUDIT was first introduced and translated into Chinese
by the Institute of Mental Health at Peking University in
2.6. Methodological review 1999. It was tested on male workers and cadres in 2000 and
confirmed to have good reliability and validity in China.
The literature search process was appraised for (ii) Diagnostic and Statistical Manual of Mental Disorders,
comprehensiveness, the screening methods were assessed for Fifth Edition, Text Revision (DSM-5-TR): According to the
scientific rigor, and the overall review process was evaluated DSM-5, AUD severity is classified based on the number of
to ensure that the quality of the review was maintained.
clinical symptoms. Two to three symptoms indicate mild
3. Current situation and assessment AUD, four to five symptoms indicate moderate AUD, and
instruments for AUDs six or more symptoms indicate severe AUD (Table 2).
(iii) The ICDs, Tenth Revision, Clinical Modification
According to the diagnostic criteria of the Diagnostic (ICD-10-CM): The ICD-10 coding system labels AUDs as
and Statistical Manual of Mental Disorders (DSM- follows: F10.10 for mild AUD and F10.20 for moderate and
5), a patient can be diagnosed with AUD if they have severe AUD.
experienced significant distress or impairment due to
alcohol consumption within 12 months, and meet at least 4. Assessment tools for alcohol relapse
two of the 11 clinical symptoms outlined. According to the Patients with AUDs are often prone to relapse after receiving
International Classification of Diseases (ICD-10), AUDs treatment and successfully quitting drinking. The relapse
can be categorized into the following types: acute alcohol rate of AUDs patients following abstinence is extremely
poisoning, harmful use of alcohol, alcohol dependence high, with most relapses occurring within 3 months
syndrome, alcohol withdrawal syndrome, alcohol-induced after discharge. The main reason for this is that alcohol-
psychiatric disorders, alcohol-induced mood disorders, related cues and the stress induced by consuming even
alcohol-induced neurocognitive disorders, and other small amounts of alcohol can significantly undermine the
related conditions (Table 1). patient’s determination to quit and negatively affect their
quality of life. 11,12 The severity of relapse can be evaluated
3.1. Current situation of AUDs
across multiple dimensions, such as the frequency and
8
A comparative risk assessment study in 2018 revealed amount of alcohol consumption, the degree of alcohol
that approximately 3 million people worldwide die each craving, and the impact of relapse on the patient’s daily life
year due to harmful alcohol use, accounting for 5.3% of and social functioning.
all causes of death. In addition, about 132.6 million people
experience a reduction in life expectancy due to disability 4.1. Current situation of relapse
caused by alcohol consumption. Drinking has thus become Research from multiple expert and scholar teams
one of the leading causes of death, disability, and disease worldwide indicates that, after professional treatment
burden globally. A cross-sectional study conducted in and care, the relapse rate for AUD patients who have quit
9
10
2019 reported that the annual prevalence rate of AUDs in drinking for one year generally remains around 60%. 12-14
the general population of China was 1.8%, with a lifetime Studies on the relapse rate of AUD patients in China are
prevalence rate of 4.4%. also ongoing. Zhao et al. found a relapse rate of 63.7%.
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A study by Yuan et al. reported a 1-year relapse rate close
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3.2. Assessment instruments for AUDs to 50%, with 27.2% of patients relapsing within 1 month
The assessment of the severity of AUDs includes both of discharge. According to a survey by Wang et al., the
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subjective and objective instruments. Clinically, multiple relapse rates for AUDs patients who had quit drinking and
assessment tools, developed by different organizations, are were discharged from the hospital were 35.1%, 50.3%, and
often used in combination to comprehensively evaluate 60.3% at 1 month, 3 months, and 6 months, respectively,
the severity of AUDs in patients. These tools include with a 6-month mortality rate of 1%. A survey by Shao
the following: (i) AUD Identification Test (AUDIT): the et al. found that relapse occurred between 42 and 75 days
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Volume 3 Issue 2 (2025) 13 doi: 10.36922/jcbp.6559