Aim: This cohort study examined how predictors of alcohol dependence treatment outcomes work together over time by comparing pretreatment and posttreatment predictors. Methods: A sample of 274 alcohol-dependent patients was recruited and assessed at baseline, 6 months after treatment initiation (end of the active intervention phase), and 18 months after treatment initiation (end of the 12-month research follow-up phase). At each assessment point, the participants completed a battery of standardized tests [European Addiction Severity Index (EuropASI), Obsessive Compulsive Drinking Scale (OCDS), Alcohol Timeline Followback (TLFB), Fagerström, and International Personality Disorder Examination (IPDE)] that measured symptom severity and consequences; biological markers of alcohol consumption were also tested at each assessment point. A sequential strategy with univariate and multivariate analyses was used to identify how pretreatment and posttreatment predictors influence outcomes up to 1 year after treatment. Results: Pretreatment variables had less predictive power than posttreatment ones. OCDS scores and biological markers of alcohol consumption were the most significant variables for the prediction of posttreatment outcomes. Prior pharmacotherapy treatment and relapse prevention interventions were also associated with posttreatment outcomes. Conclusions: The findings highlight the positive impact of pharmacotherapy during the first 6 months after treatment initiation and of relapse prevention during the first year after treatment and how posttreatment predictors are more important than pretreatment predictors.

Moos RH, Moos BS: Long-term influence of duration and intensity of treatment on previously untreated individuals with alcohol use disorders. Addiction 2003;98:325-337.
Bischof G, Rumpf H-J, Hapke U, Meyer C, John U: Types of natural recovery from alcohol dependence: a cluster analytical approach. Addiction 2003;98:1737-1746.
Bischof G, Rumpf H-J, Meyer C, Hapke U, John U: Stability of subtypes of natural recovery from alcohol dependence after two years. Addiction 2007;102:904-908.
Dawson DA, Grant BF, Stinson FS, Chou PS, Huang B, Ruan WJ: Recovery from DSM-IV alcohol dependence: United States, 2001-2002. Addiction 2005;100:281-292.
Dawson DA, Stinson FS, Chou PS, Grant BF: Three-year changes in adult risk drinking behavior in relation to the course of alcohol - use disorders. J Stud Alcohol Drugs 2008;69:866-877.
McLellan AT, Alterman AI, Metzger DS, Grissom GR, Woody GE, Luborsky L, O'Brain CP: Similarity of outcome predictors across opiate, cocaine, and alcohol treatments: role of treatment services. J Consult Clin Psychol 1994;62:1141-1158.
Moos RH, Moos BS: Treated and untreated alcohol-use disorders course and predictors of remission and relapse. Eval Rev 2007;31:564-584.
Vaillant GE: A 60-year follow-up of alcoholic men. Addiction 2003;98:1043-1051.
Penick EC, Knop J, Nickel EJ, Jensen P, Manzardo AM, Lykke-Mortensen E, Gabrielli WF: Do premorbid predictors of alcohol dependence also predict the failure to recover from alcoholism? J Stud Alcohol Drugs 2010;71:685-694.
Bottlender M, Soyka M: Outpatient alcoholism treatment: predictors of outcome after 3 years. Drug Alcohol Depend 2005;80:83-89.
Bottlender M, Soyka M: Efficacy of an intensive outpatient rehabilitation program in alcoholism: predictors of outcome 6 months after treatment. Eur Addict Res 2005;11:132-137.
Donovan DM, Anton RF, Miller WR, Longabaugh R, Hosking JD, Youngblood M: Combined pharmacotherapies and behavioural interventions for alcohol dependence (the COMBINE study): examination of posttreatment drinking outcomes. J Stud Alcohol Drugs 2008;69:5-13.
Durazzo TC, Gazdzinsky S, Yeh PH, Meyerhoff D: Combined neuroimaging, neurocognitive and psychiatric factors to predict alcohol consumption following treatment for alcohol dependence. Alcohol Alcohol 2008;43:683-691.
Falk D, Wang XQ, Liu L, Fertig J, Mattson M, Ryan M: Percentage of subjects with no heavy drinking days: evaluation as an efficacy endpoint for alcohol clinical trials. Alcohol Clin Exp Res 2010;34:2022-2034.
Laffaye Ch, McKellar JD, Ilgen MA, Moos RH: Predictors of 4-year outcome of community residential treatment for patients with substance use disorders. Addiction 2008;103:671-680.
Moos RH, Moos BS: Rates and predictors of relapse after natural and treated remissions from alcohol use disorders. Addiction 2006;101:211-222.
Moos RH, Moos BS, Timko CH: Gender, treatment and self-help in remission from alcohol use disorders. Clin Med Res 2006;4:163-174.
Soyka M, Helten C, Schmidt P: OCDS craving predict 24-month outcome in alcoholic outpatients. Am J Addict 2010;19:264-269.
Finney WF, Moyer A, Swearingen CE: Outcome variables and their assessment in alcohol treatment studies: 1968-1998. Alcohol Clin Exp Res 2003;27:1671-1679.
Swearingen CE, Moyer A, Finney WF: Alcoholism treatment outcome studies, 1970-1998 an expanded look at the nature of the research. Addict Behav 2003;28:415-436.
Yates WR, Booth BM, Reed DA, Brown K, Masterson BJ: Descriptive and predictive validity of a high-risk alcoholism relapse model. J Stud Alcohol 1993;54:645-651.
Tiffany ST, Friedman L, Greenfield SF, Hasin DS, Jackson R: Beyond drug use: a systematic consideration of other outcomes in evaluations of treatments for substance use disorders. Addiction 2012;107:709-718.
Babor TF, Steinberg K, Anton R, Del Boca KF: Talk is cheap: measuring drinking outcomes in clinical trials. J Stud Alcohol 2000;61:55-63.
Del Boca FK, Noll JA: Truth or consequences: the validity of self-report data in health services research on addictions. Addiction 2000;95:347-360.
Donovan DM, Bigelow GE, Brigham GS, Carroll KM, Cohen AJ, Gardin JG, Hamilton JA, Huestis MA, Hughes JR, Lindblad R, Marlatt GA, Preston KL, Selzer JA, Somoza EC, Wakim PG, Wells EA: Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials. Addiction 2012;107:694-708.
Kokkevi A, Hartgers C: European adaptation of a multidimensional assessment instrument for drug and alcohol dependence. Eur Addict Res 1995;1:208-210.
Sobell LC, Sobell MB: Alcohol Timeline Followback User's Manual. Toronto, Addiction Research Foundation, 1995.
Flórez G, Saiz PA, García-Portilla P, Alvarez S, Nogueiras L, Bobes J: Topiramate for the treatment of alcohol dependence: comparison with naltrexone. Eur Addict Res 2011;17:29-36.
Flórez G, Saiz PA, García-Portilla P, Alvarez S, Nogueiras L, Bobes J: Amisulpride for the treatment of alcohol dependence (in Spanish). Adicciones 2011;23:149-156.
Anton RF, Moak DH, Latham P: The obsessive compulsive drinking scale: a self-rated instrument for the quantification of thoughts about alcohol and drinking behavior. Alcoholism Clin Exp Res 1995;19:92-99.
Fagerström KO: Measuring degrees of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav 1978;3:235-241.
Loranger AW, Sartorius N, Andreoli P, Berger P, Buchheim P, Channabasavanna SM, Coid B, Dahl A, Diekstra RF, Ferguson B: The International Personality Disorder Examination - the World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration international pilot study of personality disorders. Arch Gen Psychiatry 1994;51:215-224.
Allen JP, Litten RZ, Strid N, Sillanaukee P: The role of biomarkers in alcoholism medication trials. Alcoholism Clin Exp Res 2001;25:1119-1125.
Wiegand P, Pell R, Comas E: Simultaneous variable selection and outlier detection using a robust genetic algorithm. Chem Int Lab Syst 2009;98:108-114.
Holland JM: Adaptation in natural and artificial systems. Ann Arbor, University of Michigan Press, 1975.
Cadima J, Cerdeira JO, Minhoto M: Computational aspects of algorithms for variable selection in the context of principal components. Comput Stat Data Anal 2004;47:225-236.
R Development Core Team: R: a Language and Environment for Statistical Computing. Vienna, R Foundation for Statistical Computing, 2011.
Ghavami R, Najafi A, Sajadi M, Djannaty FJ: Genetic algorithm as a variable selection procedure for the simulation of 13C nuclear magnetic resonance spectra of flavonoid derivatives using multiple linear regression. J Mol Graph Model 2008;27:105-115.
Mantzaris D, Anastassopoulos G, Adamopoulos A: Genetic algorithm pruning of probabilistic neural networks in medical disease estimation. Neural Netw 2011;24:831-835.
Friedman J: Multivariate adaptive regression splines. Ann Stat 1991;19:1-67.
Sekulic S, Kowalski BR: MARS: a tutorial. J Chemom 1992;6:199-216.
Guzmán D, De Cos Juez FJ, Sánchez F, Richard M, Laura Y: Deformable mirror model for open-loop adaptive optics using multivariate adaptive regression splines. Opt Express 2010;18:6492-6505.
Garcia PJ, Sánchez F, De Cos Juez FJ, Alonso JR: Study of cyanotoxins presence from experimental cyanobacteria concentrations using a new data mining methodology based on multivariate adaptive regression splines in Trasona reservoir (Northern Spain). J Hazard Mater 2011;195:414-421.
Witkiewitz K: Predictors of heavy drinking during and following treatment. Psychol Addict Behav 2011;25:426-438.
Whitworth AB, Fischer F, Lesch OM, Nimmerrichter A, Oberbauer H, Platz T, Potgieter A, Walter H, Fleischhacker WW: Comparison of acamprosate and placebo in long-term treatment of alcohol dependence. Lancet 1996;347:1438-1442.
Hendershot ChS, Witkiewitz K, George WH, Marlatt GA: Relapse prevention for addictive behaviors. Subst Abuse Treat Prev Policy 2011;6:17.
Tiet QQ, Ilgen MA, Byrnes HF, Harris AHS, Finney JW: Treatment setting and baseline substance use severity interact to predict patients' outcomes. Addiction 2007;102:432-440.
Babor TF, Del Boca FK: Treatment Matching on Alcoholism. Cambridge, Cambridge University Press, 2003.
Sobell LC, Ellingstad TP, Sobell MB: Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions. Addiction 2000;95:749-764.
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