Open Journal of Psychiatry, 2013, 3, 264-272 OJPsych http://dx.doi.org/10.4236/ojpsych.2013.32025 Published Online April 2013 (http://www.scirp.org/journal/ojpsych/ ) Factors associated with relapse and remission of alcohol dependent persons after community based treatment Mary Wangari Kuria Department of Psychiatry, University of Nairobi, Nairobi, Kenya Email: mkuria@uonbi.ac.ke , wangari2@yahoo.com Received 9 December 2012; revised 31 January 2013; accepted 9 February 2013 Copyright © 2013 Mary Wangari Kuria. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Knowledge of factors associated with relapse and re- mission after treatment for alcohol dependence en- ables the clinician to offer better individualized treat- ment. It also enables the clinician to predict which patients are likely to relapse and therefore offer ap- propriate and effective treatment to prevent relapse. Objective: This study sought to determine the factors associated with remission and relapse in a group of alcohol dependent persons undergoing Community Based Detoxification and Rehabilitation of alcohol dependent persons. Method: One hundred and eighty eight (188) persons with Alcohol Use Disorder Identi- fication Test (AUDIT) positive were subjected to outpatient detoxification for 10 days using a pair of ampoules of high potency Vitamin B and C intrave- nously daily for 3 consecutive days, diazepam 5 mg and carbamazepine 200 mg for 5 and 10 consecutive nights respectively on an outpatient basis. The par- ticipants were visited twice a week (at home) by the community based health workers and reviewed once a week by the principal investigator and attended a bimonthly group therapy session conducted in groups of 20 s as part of the rehabilitation process. The groups were converted to self-help groups after 4 months to generate income for the participants. Re- sults: Factors significantly associated with relapse to alcohol use included severity of alcohol use and crav- ing for alcohol at intake and the age of onset of alco- hol drinking. Further there was a statistically signifi- cant predictive value in the mean score of alcohol re- lated problems in the community based group (health, social, financial and legal). Conclusion: Identifying factors that are associated with relapse after alcohol dependence treatment is likely to improve the effec- tiveness of treatment and prevent relapse in persons at risk. Keywords: Alcohol Dependence; Remission; Relapse; Kenya 1. INTRODUCTION In Africa, many people abstain from alcohol but those that drink, drink a lot [1]. In Kenya, alcohol consumption is the highest in poor communities where potent home brewed alcohol is cheap and readily available. Quality control is weak, and ethanol content can at times be dangerously high [2], examples of such home made brews include, “muratina”, “mnazi”, “changaa”, “mban- gari”, “busaa”, and “kumikumi”. There is spread of heavy use of illicit drug (including illicit alcohol) from urban and historically advantaged groups to rural areas and disadvantaged groups (poor communities) [3]. The recorded per capita consumption of alcohol in Kenya is 1.74 litres of ethanol per capita with an unrecorded con- sumption of 5 litres per capita [4-8]. Additionally treat- ment options are few in Kenya and traditionally residen- tial with less than a total of 1000 bed capacity for a population of 40 million. The recorded per capita con- sumption of alcohol in Kenya is 1.74 litres of ethanol per capita with an unrecorded consumption of 5 litres per capita [4,9]. Despite using different methods, various studies have identified factors associated with remission from alcohol dependence. These factors include: older age at assess- ment, married, female gender, good social support, younger age at onset of alcohol dependence, less drink- ing amounts, less severity of drinking [10-14]. Among treated individuals, greater social pressure, more severe alcohol related problems, lack of self efficacy, poor cop- ing skills, co-morbid mood disorder and anxiety disorder have been associated with short-term relapse [1,5-11, 15-23]. Individuals who have experienced more drinking problems and tried previously to reduce their drinking OPEN ACCESS