A prospective multicentre study of in-patient treatment for alcoholics: 18- and 48-month follow-up (munich evaluation for alcoholism treatment, MEAT)

  • Wilhelm Feuerlein
  • Heinrich Küfner
Original Articles


In a prospective multicentre study of 1410 alcoholics (73% men) data were collected at five different times: admission, discharge, 6, 18 and 48 months after discharge. The details from the 21 treatment centres involved were acquired from staff-members; follow-up data on patients were collected by personal interviews and/or mailed questionnaires. In all, 85%, 84% and 81% of the patients could be traced, respectively. Additionally, data of patients' sick leave days and in-patient treatment were provided by the health insurance and pension insurance institutions, respectively. Outcome criteria were drinking behaviour, working and partner situation, and subjective complaints. The drinking behaviour was divided into three rough categories: abstinent, improved and unimproved. For 18 months 53% of the patients remained abstinent, 8.5% improved and 38% did not improve. For 48 months 46% remained abstinent, 12% improved and 42% did not improve. During the last 6 months prior to the 48-month data collection 66% were abstinent, 4% improved and 30% did not improve. Only 3% of patients succeeded in maintaining controlled drinking. The percentage of days of sick leave was reduced by 64% and of in-patient treatment from 34.7% to 14.6% during the 18-month period after discharge (in comparison with the 18-month period prior to treatment). Only 21% of the patients regularly attended self-help groups. Out of the patients' variables, ten for men and five for women could be identified as prognostically relevant. In the 48-month follow-up these factors were reconsidered. In men almost all, in women only three of the five factors were confirmed. The treatment variables were evaluated according to the prognosis factors (positive vs negative group). In the 48-month follow-up the treatment variables relevant in the 18-month follow-up were also reassessed. In the positive prognosis group five variables were confirmed, in the negative prognosis group only one. In addition, differentiated indication variables for the three treatment lengths were developed and applied to a model. The following appeared to be clues regarding the length of desirable treatment. For an unfavourable prognosis in both men and women no short-term treatment should be given; medium- or long-term treatment is to be preferred. For a medium prognosis men do better with short-term treatment; for women medium-treatment is preferred. For a favourable prognosis for men medium-term treatment should be avoided; long-term is preferred; for women short-term treatment may also be preferred.

Key words

Alcoholism, in-patient treatment Follow-up Patient variables Treatment variables 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Armor PI, Stambul MI (1976) Alcoholism and treatment. Rand Corporation Santa Monica, Calif.Google Scholar
  2. Baekeland F, Lundwall L, Kissin B (1975) Methods of the treatment of chronic alcoholism: a critical appraisal. In: Gibbins RJ, Israel Y, Kalant H, Popham RE, Schmidt W, Smart RG (eds) Research advances in alcohol and drug problems, vol 2. Wiley, New YorkGoogle Scholar
  3. Baumann U (ed) (1981) Indikation zur Psychotherapie. Urban und Schwarzenberg, MunichGoogle Scholar
  4. Bromet EJ, Moos R (1977) Environmental resources and posttreatment functioning of alcoholic patients. J Health Soc Behav 18:326–338Google Scholar
  5. Bromet EJ, Moos R, Bliss F, Wuthmann C (1977) Posttreatment functioning of alcoholic patients: its relation to program participation. J Consult Clin Psychol 45:829–842Google Scholar
  6. Costello RM (1975a) Alcoholism treatment and evaluation. In search of methods. Int J Addict 10:251–275Google Scholar
  7. Costello RM (1975b) Alcoholism treatment and evaluation. In search of methods. II. Collation of two-year follow-up studies. Int J Addict 10:857–867Google Scholar
  8. Costello RM, Biever P, Baillargeon JG (1977) Alcoholism treatment programming: historical trends and modern approaches. Alcohol Clin Exp Res 1:311–318Google Scholar
  9. Emrick CD (1974) A review of psychologically oriented treatment of alcoholism. I. The use and interrelationship of outcome criteria and drinking behavior following treatment. Q J Stud Alcohol 35:523–549Google Scholar
  10. Emrick CD (1975) A review of psychologically oriented treatment of alcoholism. II. The relative effectiveness of different treatment approaches and the effectiveness of treatment versus no treatment. Q J Stud Alcohol 36:88–108Google Scholar
  11. Ewing JA (1977) Matching therapy and patients: the cafeteria plan. Br J Addict 72:13–18Google Scholar
  12. Fahrenberg I, Selg H, Hampel R (1973) Das Freiburger Persönlichkeitsinventar (FPI), 2nd edn. Hogrefe, GöttingenGoogle Scholar
  13. Feuerlein W (1984) Langzeitverläufe bei Alkoholikern. In: Kryspin-Exner K, Schubert H (eds) Langzeittherapie psychiatrischer Erkrankungen. IV. Alpenländisches Psychiatrie-Symposium Seefeld/Tirol 1./2.10.1982. Schattauer, StuttgartGoogle Scholar
  14. Feuerlein W (1987) Die Untersuchung über stationäre Entwöhnungsbehandlung von Alkoholabhängigen als Beitrag zur Optimierung medizinischer Reha-Maßnahmen. In: Kongreßbericht Bundeskongreß Rehabilitation 1987 in Karlsruhe. Bundesarbeitsgemeinschaft für Rehabilitation, Bonn, pp 208–218Google Scholar
  15. Gibbs L, Flanagan I (1977) Prognostic indicators of alcoholism treatment outcome. Int J Addict 12:1097–1141Google Scholar
  16. Glaser FB (1980) Anybody got a match? Treatment research and matching hypothesis. In: Edwards G, Grant M (eds) Alcoholism treatment in transition. Croom Helm, LondonGoogle Scholar
  17. Grawe K (1978) Indikation zur Psychotherapie. In: Pongratz L (ed) Handbuch der Psychologie, vol 8. Hogrefe, GöttingenGoogle Scholar
  18. Henrich G, De Jong R, Mai N (1979) Aspekte des therapeutischen Klimas — Entwicklung eines Fragebogens. Z Klin Psychol 8:41–55Google Scholar
  19. Hoellen BM, Hoellen B (1985) Neue Ergebnisse der Alkoholismustherapie: Ein Überblick. Suchtgefahren 31:402–413Google Scholar
  20. Holmes TH, Rahe RH (1967) The social adjustment rating scale. J Psychosom Res 11:213–218Google Scholar
  21. Keup W (1985) Jahresstatistik 1983 der Fachkrankenhäuser für Suchtkranke (DOSY 83): Katamnesen. In: Ziegler H (ed) Jahrbuch 85 zur Frage der Suchtgefahren. Neuland, HamburgGoogle Scholar
  22. Kissin B, Rosenblatt SM, Machover K (1968) Prognostic factors in alcoholism. Am Psychiatr Assoc Rep 24:22–43Google Scholar
  23. Klein KH (1981) Probleme bei Katamnesen von Alkoholiker-Therapie. Katamnestische Untersuchung in einer Fachklinik für Alkoholabhängige. Thesis, University of Freiburg/BreisgauGoogle Scholar
  24. Koester W, Schneider R, Hachmann E, Mai N (1981) Dokumentation und Evaluation der stationären Behandlung von Alkohol- und Medikamentenabhängigen nach einem verhaltenstherapeutischen Programm. Beschreibung des Dokumentationssystems und Ergebnisse. Suchtgefahren 27:193–206Google Scholar
  25. Krampen G (1986) Zum indikativen Wert handlungstheoretischer Persönlichkeitsvariablen für die Alkoholismusbehandlung. In: Ladewig D (ed) Drogen-Alkohol. Der aktuelle Stand in Behandlung Drogen- und Alkoholabhängiger. ISPA Press, LausanneGoogle Scholar
  26. Küfner H (1984) Zur Prognose des Alkoholismus. Therapiewoche 34:3636–3643Google Scholar
  27. Küfner H, Feuerlein W (1989) In-patient treatment for alcoholism. Springer, Berlin Heidelberg New YorkGoogle Scholar
  28. Küfner H, Feuerlein W, Flohrschütz T (1984) Untersuchungen über stationäre Alkoholismustherapien. Erste Ergebnisse einer Halbjahres-Katamnese. In: Ladewig D (ed) Drogen und Alkohol. Der aktuelle Stand in der Behandlung Drogen-und Alkoholabhängiger. International Symposium, Basel 1983. Karger, Basel, pp 148–186Google Scholar
  29. Küfner H, Feuerlein W, Flohrschütz T (1986) Die stationäre Behandlung von Alkoholabhängigen: Merkmale von Patienten und Behandlungseinrichtungen, katamnestische Ergebnisse. Suchtgefahren 32:1–86Google Scholar
  30. Küfner H, Feuerlein W, Huber M (1988) Die stationäre Behandlung von Alkoholabhängigen: Ergebnisse der 4-Jahreskatamnesen, mögliche Konsequenzen für Indikationsstellung und Behandlung. Suchtgefahren 34:157–271Google Scholar
  31. Matakas F, Berger H, Koester H, Legnaro A (1984) Alkoholismus als Karriere. Springer, Berlin Heidelberg New YorkGoogle Scholar
  32. McLachlan JFC (1974) Therapy strategies, personality orientation recovery from alcoholism. Can J Psychiatry 19:25–30Google Scholar
  33. Miller WR, Hester RK (1980) Treating the problem drinker: Modern approaches. In: Miller WR (ed) The addictive behaviors: treatment of alcoholism, drug abuses, smoking and obesity. Pergamon Press, OxfordGoogle Scholar
  34. Moos RH, Cronkite RC, Finney JW (1982) A conceptual framework for alcoholism treatment evaluation. In: Pattison EM, Kaufmann E (eds) Encyclopedic handbook of alcoholism. Gardner, New YorkGoogle Scholar
  35. Orford J, Edwards G (1977) Alcoholism. Oxford University Press, OxfordGoogle Scholar
  36. Polich JM, Armor DJ, Braiker HB (1980a) The course of alcoholism: four years after treatment. Rand Corporation, Santa Monica, Calif.Google Scholar
  37. Polich JM, Armor DJ, Braiker HB (1980b) Patterns of alcoholism over four years. Q J Stud Alcohol 41:397–416Google Scholar
  38. Scheller R, Klein M (1982) Persönlichkeitspsychologische Determinanten des Therapieerfolgs bei Alkoholabhängigen. Z Differ Diagn Psychol 3:47–54Google Scholar
  39. Smart RG (1976) Spontaneous recovery in alcoholics: a review and analysis of the available research. Drug Alcohol Depend 1:277–285Google Scholar
  40. Smart RG, Gray G (1978) Minimal-, moderate- and long-term treatment for alcoholism. Br J Addict 73:35–38Google Scholar
  41. Smith ML, Glass GV, Miller TJ (1980) The benefits of psychotherapy. Johns Hopkins University Press, BaltimoreGoogle Scholar
  42. Ullrich DR, Muynck R, Ullrich R (1977) Der Unsicherheitsfragebogen. Testmanual. Pfeiffer, MunichGoogle Scholar
  43. Waldow M, Klink M (1986) Rehabilitationsverlauf Alkoholund Medikamentenabhängiger nach stationärer Behandlung. Eine multivariate Globalanalyse katamnestischer Daten. Elwert, MarburgGoogle Scholar
  44. Watzl H (1986) Die Vorhersage des Behandlungserfolgs bei alkoholkranken Frauen — eine empirische Untersuchung. Röttger, MunichGoogle Scholar
  45. Zerssen D von (1976) Beschwerden-Liste. Manual. Beltz, WeinheimGoogle Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • Wilhelm Feuerlein
    • 1
  • Heinrich Küfner
    • 1
  1. 1.Max-Planck-Institut für PsychiatrieMunich 40Federal Republic of Germany

Personalised recommendations