Stable measures of psychological functioning require a considerable period of abstinence. However, the duration of inpatient detoxification programs has decreased dramatically in most health care systems, posing a novel challenge for clinical evaluation of patients. The present study was carried out to examine whether factors predicting short–term prognosis can be identified in alcohol dependent subjects during early stages of inpatient detoxification. Self–reports of mood states were obtained, and executive cognitive functioning was examined. Outcome was studied at 2–3 months. No correlation was found between self–reported symptoms of depression, hopelessness, and anxiety, and percentage of nondrinking days. A significant positive correlation was found between Wisconsin Card Sorting Test (WCST) performance and short–term prognosis measured by this parameter. Thus, in addition to transient withdrawal–related effects, impairments of WCST performance in early stages of alcohol detoxification may reflect more long standing deficits in problem–solving strategies, of possible relevance for matching patients to treatment services.
RegierDA, FramerME, RaeDS, LockeBZ, KeithSJ, JuddLL and GoodwinFK. 1990. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologicál Catchment Area (ECA) Study. J Am Med Assoc, 264: 2511–2518.
2.
SheehanMF. 1993. Dual diagnosis. Psychiatr Q, 64: 107–134.
3.
TollefsonGD. 1991. Anxiety and alcoholism: A serotinin link. Br J Psychiatry, 159: 34–39.
4.
RossHE, GlaserFB and GermansonT. 1988. The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry, 45: 1023–1031.
5.
GlennSW and ParsonsOA. 1991. Prediction of resumption of drinking in posttreatment alcoholics. Int J Addictions, 26: 237–254. 1991
6.
SellmanJD and JoycePR. 1996. Does depression predict relapse in the 6 months following treatment for men with alcohol dependence?. Aust N Z J Psychiatry, 30: 573–578.
7.
BrownSA and SchuckitMA. 1988. Changes in depression among abstinent alcoholics. J Stud Alcohol, 49: 412–417.
8.
WilloughbyFW and EdensJF. 1996. Construct validity and predictive utility of the stages of change scale for alcoholics. J Subst Abuse, 8: 275–291.
9.
IsenhartCE. 1997. Pretreatment readiness for change in male alcohol dependent subjects: Predictors of one–year follow–up status. J Stud Alcohol, 58: 351–357.
10.
AllenDA, GoldsteinG and SeatonBE. 1997. Cognitive Rehabilitation of Chronic Alcohol Abusers. Neu–ropsychol Rev, 7: 21–39.
11.
SmithDE and McGradyBS. 1991. Cognitive impairment among alcoholics: Impact on drink refusal skill acquisition and treatment outcome. Addict Behav, 16: 265–274.
12.
EckardtMJ, RawlingsRR, GraubardBI, FadenV, MartinPR and GottschalkLA. 1988. Neuropsychological Performance and Treatment Outcome in Male Alcoholics. Alcoholism: Clin Exp Res, 12: 88–93.
13.
ParsonsOA. 1993. “Impaired neuropsychological cognitive functioning in sober alcoholics”. In Alcohol–Induced Brain Damage, National Institute on Alcohol Abuse and Alcoholism Research Monograph No. 22 Edited by: HuntWA and NixonSJ. 173–194. Bethesda, MD: The Institute. NIH Publication No. 93–3549
14.
LuriaAR. 1973. The Working Brain, New York: Basic Books.
15.
ShalliceT. 1982. “Specific impairments in planning”. In The Neuropsy–chology of Cognitive Function, Edited by: BroadbentDE and WeiskrantzL. 199–209. London: The Royal Society.
16.
American Psychiatric Association. 1994. Diagnostic, and Statistical Manual of Mental Disorders, 4th edn., Washington, DC: APA.
17.
BerglundM, BergmanH and SweneliusT. 1986. Alkoholvaneinventoriet—ett nytt frågeformulär för differ–entierad diagnostik vid alkoholberoende (The Alcohol Use Inventory—a new questionnaire for differential diagnosis regarding alcohol dependency). Läkartidningen, 83: 1278–81.
18.
BerglundM, BergmanH and SweneliusT. 1988. The Swedish Alcohol Use Inventory (AVI), A Self–Report Inventory for differentiated diagnosis in alcoholism. Alcohol Alcohol, 23: 173–178.
19.
BeckAT, WardCH, MendelsonM, MockJ and ErbaughJ. 1961. An inventory for measuring depression. Arch Gen Psychiatry, 4: 461–471.
20.
BeckAT, BrownG and SteerRA. 1989. Prediction of eventual suicide in psychiatric inpatients by clinical ratings of hopelessness. J Consult Clin Psychol, 57: 309–10.
21.
BeckAT, EpsteinN, BrownG and SteerRA. 1988. An Inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol, 56: 893–897.
22.
ProchaskaJ and DiClementeC. 1986. “Toward a comprehensive model of change”. In Treating Addictive behaviors: Processes of Change, Edited by: MillerW and HeatherN. 4–27. New York: Plenum.
23.
RollnickS, HeatherN, GoldR and HallW. 1992. Development of a short “readiness to change”; questionnaire for use in brief, opportunistic interventions among excessive drinkers. Br J Addict, 87: 743–54.
24.
LezakMD. 1982. The problem Of assessing executive functions. Int J of Psychol, 17: 281–297.
25.
BergEA. 1948. A simple objective test for measuring flexibility in thinking. J Gen Psychol, 39: 15–22.
26.
GrantDA and BergEA. 1948. A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl–type card sorting problem. J of Exp Psychol, 41: 23–29.
27.
HeatonKR, CheluneGJ, TalleyJL, KayGG and CurtissG. 1993. Wisconsin Card Sorting Test Manual, Florida: Psychological Assessment Resources.
28.
SobellLC and SobellMB. 1996. Timeline Followback User's Guide, Toronto: Addiction Research Foundation.
29.
AxelrodBN, GoldmanRS, SeatonRK, CurtisG, ThompsonLL, CheluneGJ and KayGG. 1996. Discriminabil–ity of the Wisconsin Card Sorting Test using the standardization sample. J Clin Exp Neuropsychol, 18: 338–342.
30.
ParsonsOA, SchaefferKW and GlennSW. 1990. Does neuropsychological test performance predict resumption of drinking in posttreatment alcoholics. Addict Behav, 15: 297–307.
31.
CasterDU and ParsonsOA. 1977. Locus of control in alcoholics and treatment outcome. J Stud Alcohol, 38: 2087–2095.
32.
MarlattAA and GordonJR. 1985. Relapse Prevention, New York: Guilford Press.
33.
ParsonsOA and NixonSJ. 1993. Neurobehavioral sequelae of alcoholism. Behav Neurol, 11: 205–218.
34.
DavidsonKM. 1995. Diagnosis of depression in alcohol dependence: Changes in prevalence with drinking status. Br J Psychiatry, 166: 199–204.
35.
WeinsteinCS and ShafferHJ. 1993. Neurocognitive aspects of substance abuse treatment: A psychotherapist's primer. Psychother, 30: 317–333.
36.
O'MahonyJF and DohertyB. 1996. Intellectual impairment among recently abstinent alcohol abusers. Br J Clin Psychol, 35: 77–83.
37.
ZihlJ, GrönG and BrunnauerA. 1998. Cognitive deficits in schizophrenia and affective disorders: Evidence for a final common pathway disorder. Acta Psychiatr Scand, 97: 351–357.
38.
BatesME. 1997. Stability of neuropsychological assessments early in alcoholism treatment. J Stud Alcohol, 58: 617–621.
39.
AndersonS, DamasioH, JonesRD and TrustD. 1991. Wisconsin Card Sorting Test as a measure of frontal lobe damage. J Clin Exp Neuropsychol, 13: 909–922.
40.
MountainMA and SnowWG. 1993. Wisconsin Card Sorting Test as a measure of frontal pathology: A review. Clin Neuropsychol, 7: 108–118.
41.
AbbruzzeseM, FerriS and ScaroneS. 1995. Wisconsin Card Sorting Test performance in compulsive disorder: No evidence for involvement of dorsolateral prefrontal cortex. Psychiatry Res, 58: 37–43.
