Page 22 - JCBP-3-2

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

prognosis during AUD outpatient treatment. According shown that AUD patients who live in rural areas (hazard
to a follow-up survey, among the 449 AUD patients, ratio [HR] = 0.674, 95% CI: 0.532 – 0.852), have a broken
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425 (94.7%) were male, whereas only 25 (5.3%) were marriage (OR = 1.76, 95% CI: 1.20 – 2.59), exhibit low
females, highlighting the significantly higher proportion family intimacy (OR = 0.872, 95% CI: 1.236 – 5.187), or
of male patients. Although clinical data consistently show have a family history of alcoholism (OR = 1.82, 95% CI:
that males have a higher incidence of AUDs than females, 1.24 – 2.69) are more likely to experience higher relapse
with increasing social pressures, the prevalence of alcohol rates. These patients often face challenges such as limited
abuse and AUDs among females has been rising year by access to medical care, lower health-care quality, and
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year, which warrants greater attention. After reviewing inadequate emotional support, and necessary supervision
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24 original studies, Newberry et al. concluded that no and management. In addition, they are more likely to
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systematic gender differences in treatment response were encounter alcohol-related cues, further increasing the risk
found. At present, males remain the primary population of relapse.
affected by AUDs, and further research is needed to clarify 5.2. Individual factors
the relationship between gender and AUDs.
5.2.1. Physical disease factors
5.1.2. Age factor
Long-term heavy drinking can lead to various physical
The impact of age on relapse is relatively complex, and diseases, including liver and cardiovascular conditions.
there is currently no definitive conclusion regarding its Some AUD patients may, due to worsening physical
effect. Zhang et al. suggest that there is no significant symptoms and concerns about further alcohol
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relationship between age and relapse. However, a logistic consumption exacerbating their health problems, actively
regression analysis conducted by Cao et al. found that choose to reduce or quit drinking. Therefore, the treatment
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being older (odds ratio [OR] = 1.026, 95% confidence of AUD patients should not be limited to the cessation of
interval [CI] = 1.005 – 1.047) is a protective factor against alcohol use alone. Other physical diseases should also be
relapse, possibly due to the decline in elderly patients’ treated simultaneously. In addition, health education
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ability to develop tolerance and withdrawal reactions. On should be strengthened to help AUD patients recognize the
the other hand, a large number of studies have indicated benefits of quitting alcohol. This awareness can enhance
that starting to drink at a young age (OR = 0.94, 95% CI their subjective intention to quit, which is beneficial
= 0.91 – 0.98) is a significant risk factor for relapse. 27,32 in prolonging the withdrawal period and significantly
This particular finding highlights the importance of reducing the relapse rate.
public education, with parents taking responsibility for
guardianship and society as a whole working to prevent 5.2.2. Sleep factors
minors from drinking alcohol, thus reducing the risk of Patients with AUDs often experience poor sleep quality
AUDs in youth. (OR = 1.158, 95% CI = 1.024 – 1.324). After consuming

5.1.3. Addiction severity factor alcohol, the blood alcohol concentration rises with the
amount ingested, leading to feelings of pleasure and
The severity of a patient’s addiction, including factors such excitement. However, as alcohol is metabolized, blood
as the duration of alcohol use, drinking methods, and daily alcohol level decreases, producing a sedative effect. This
consumption, is an important determinant in relapse risk. phenomenon causes many AUD patients to mistakenly
Studies by Zhang et al. and Shao et al. have shown that believe that alcohol helps them fall asleep. Wen et al.
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the more severe the addiction, the higher the likelihood of confirmed that AUD patients who scored higher on the
relapse. Specifically, longer drinking periods (OR = 1.243, Self-Rating Scale of Sleep were more likely to relapse. The
95% CI = 1.082 – 1.404), a higher frequency of drinking on worse the sleep quality, the more frequent the alcohol
an empty stomach (OR = 1.380, 95% CI = 1.124 – 1.636), consumption, and the higher the relapse rate among AUD
and greater daily alcohol consumption (OR = 0.875, 95% patients seeking high-quality sleep. Therefore, improving
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CI = 0.645 – 0.978) contribute to more severe psychological the sleep quality among AUD patients can help reduce
problems and greater social harm, which in turn increase their cravings and dependence on alcohol.
the relapse risk.
5.2.3. Personality and mental illness factors
5.1.4. Family factors
Many AUD patients exhibit personality characteristics
Family-related factors such as the patient’s place of residence, that deviate from the norm, such as being solitary, self-
family environment, and family history of alcoholism centered, nervous, irritable, aggressive, impulsive, sensitive,
significantly impact the relapse rate. Studies 17,34,35 have and suspicious, and often have poor self-control. 38-40 In

Volume 3 Issue 2 (2025) 16 doi: 10.36922/jcbp.6559