[Long-term Effectiveness of Psychodynamic Outpatient Treatment of Addiction]

Background: The aim of this study is to make an evaluation of the effectiveness of long-term outpatient treatment for addiction on the basis of abstinence, cognitive functions, and changes in personality structure.

Methods: This is a prospective cohort study of 259 patients with registration of the German core data set "addiction", a 12-month follow-up and neuropsychological testing (personality inventory, intelligence and cognitive functions).

Results: One year after the end of the long-term treatment we see an abstinence rate (DGSS4) of 57.5 %. The most substantial factors in abstinence are the participation in a self-help-group (β = 0.734, p < 0.0001). Known negative predictors such as unemployment (β = - 0.093, p < 0.01) and problematic debts over 15,000 $ (β = - 0.104, p < 0.01 just show a small negative correlation with abstinence. The results seems to indicate that patients have better overall performance and achieve better results in the neuropsychological testing at the end of the rehabilitation. The ideal and self-image may be changed positively. We see also unspecific changes classified by a reduction of the psychological test values regarding conversion symptoms, depressive mood, psychasthenia and social isolation. At the end of the long-term treatment the patients show significantly better cognitive functions and an improvement in their ideals and self-images. Conversion symptoms, depressive mood and reduced values for psychasthenia and social isolation can be decreased.

Discussion: These results of a psycho-dynamic outpatient treatment of addiction seem to show its high effectiveness in terms of abstinence and processing of drug structures. The cognitive functions could increase. This could be determinate of a condition for the conservation and restoration of working capacity. Further studies should differentiate the effect of insight into the dependency structure from the abstinence as an specific or unspecific effect.