Page 23 - JCBP-3-2

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

addition, a high proportion of AUD patients suffer from health-care professionals to provide educational outreach
other mental disorders, such as anxiety (OR = 1.48, 95% in an accessible manner, raising awareness of AUDs among
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CI = 1.04 – 1.20), depression (OR = 1.1, 95% CI = 1.02 patients and the general public and emphasizing the
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– 1.18), paranoid (OR = 1.154, 95% CI = 1.053 – 1.264), dangers of alcohol misuse.
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and personality disorder (OR = 1.89, 95% CI = 1.29 –
1.77). These individuals often display emotional apathy 5.2.6. Employment and economic factors
and habitual dishonesty and are only interested in drinking Research by Yang et al. shows that employment
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alcohol. Consequently, the more severe the mental (HR = 0.61, 95%CI 0.41 – 0.92) acts as a protective
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disorder and the more deviated the patient’s personality factor for alcohol cessation. AUD patients who continue
traits from normal, the lower the subjective motivation to work after discharge are at a lower risk of relapse,
of AUD patients to seek treatment, resulting in poorer which may be because stable, moderate work enhances
treatment efficacy and a higher relapse rate. patients’ self-identity and increases their confidence
during rehabilitation. The demands of work often prevent
5.2.4. Treatment compliance factors drinking, and the work itself, along with colleagues and
Treatment compliance can predict the likelihood of relapse supervisors, can play a supervisory and management role.
in patients. Adherence to outpatient follow-up (OR = 0.29, In addition, employment occupies patients’ free time,
95% CI =0.13 – 0.63) has a positive effect on maintaining distracts their thoughts of alcohol, and leaves them with
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abstinence and reducing the relapse rate in AUD patients. less energy for drinking-related behavior. Meanwhile,
On one hand, regular participation in outpatient treatment research indicates that patients with AUDs who are unable
indicates that the patient has a firm intention to quit to work and maintain only a low income (OR = 1.252, 95%
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drinking and can adhere to the treatment plan prescribed CI = 1.074 – 3.426) face higher relapse rates. Unstable
by the healthcare facility. On the other hand, consistent income prevents them from covering basic living expenses
outpatient visits provide personalized, scientifically- or treatment costs, leading them to drink alcohol as a
based advice, helping them follow oral medication means of avoiding reality. Therefore, patients who are
regimens and participate in psychotherapy, exercise unemployed or have low incomes are more likely to relapse.
therapy, music therapy, and other forms of treatment. 5.3. Social factors
Both pharmacological and non-pharmacological
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approaches can assist in shaping a positive psychological 5.3.1. Social support factors
state, alleviating stress from various life and work-related In addition to individual factors, social factors also play
pressures, and improving the patient’s mental outlook, a significant role in influencing the relapse rate among
which helps them cope with the challenges of life and reduce patients. Related studies show that the level of social
alcohol cravings. At the same time, doctors and nurses support in AUD patients (HR = 0.891, 95% CI = 0.832
are among the few sources of social support for patients, – 0.954) is negatively correlated with negative automatic
helping them feel less emotionally isolated, boosting their thinking patterns, suggesting that a lack of social support
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confidence in quitting alcohol, and providing supervision is a primary factor contributing to negative thinking in
and management. AUD patients. AUDs severely impair patients’ social
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functioning, with many lacking stable employment and
5.2.5. Educational level factor experiencing reduced economic income. Moreover,
The educational level can affect the relapse rate in patients’ abnormal personality traits and mental health
AUD patients. Patients with higher levels of education issues contribute to a lack of emotional support from
(OR = 0.785, 95% CI = 0.543 – 1.027) have a lower relapse family and friends, often resulting in strained relationships
rate, while those with an education level below high school and a significant decline in objective social support. In
have a higher relapse rate. This occurrence is primarily addition, AUD patients tend to have low self-confidence
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because patients with lower education levels may not fully and frequently adopt negative coping strategies to deal
understand the harms of alcohol. In contrast, patients with with difficulties encountered in their work and personal
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higher education levels tend to have a greater knowledge lives. These patients are less able to fully utilize external
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base and are more receptive to new information related supervision and emotional support, resulting in decreased
to AUDs. They possess a comprehensive understanding utilization of social support and increased relapse rate.
of the potential damage that prolonged and excessive
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alcohol consumption can cause to the liver, nervous 5.3.2. Alcohol-suggestive factor
system, etc., which helps them restrain their desire to Compared to ordinary suggestions, AUD patients exhibit
drink and reduce their relapse risk. Thus, it is important for a greater desire to drink alcohol after receiving alcohol-

Volume 3 Issue 2 (2025) 17 doi: 10.36922/jcbp.6559