Abstract
Although alcohol misuse is a major cause of morbidity and mortality and an important health care burden, the Quality of Life (QoL) of alcohol misusing subjects has been little studied to date. For example, only 5 out of 442 accepted abstracts at a recent international QoL conference concerned alcohol-dependent subjects. This paper reviews the ongoing and published work in the area focusing upon QoL characteristics of alcohol-dependent subjects, the link between QoL comorbidity and alcoholism, QoL alcohol dependency and social environment, changes in QoL status as a result of abstinence, minimal or controlled drinking, QoL as a predictor of relapse to heavy drinking and the importance of using a QoL measure when assessing treatment outcomes together with some of the present difficulties with existing measures. The main conclusions from the review were that the QoL of alcohol-dependent subjects is very poor but improved as a result of abstinence, controlled or minimal drinking. The important factors in the QoL of alcohol-dependent subjects are psychiatric comorbidity, social environment and disturbed sleep.
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Testa M, Simonson D. Assessment of Quality of Life outcomes. N Engl J Med 1996; 334: 835±840.
Donovan D, Mattson M. Alcoholism treatment matching research: methodological and clinical issues, In: Donovan D, Mattson M (Eds). Alcoholism Treat-ment Matching Research: methodological and clinical approaches. J Stud Alcohol Suppl 1994; 12: 138±148.
Project MATCH Research Group. Project MATCH: Rationale and methods for a multi site clinical research trial matching patients to alcoholism treatment. Alco-hol Clin Exp Res 1993; 17: 1130±1145.
Longabaugh R, Mattson R, Connors G, Cooney N. Quality of Life as an outcome variable in Alcoholism Treatment Research. J Stud Alcohol Suppl 1994; 55: 119±129.
National Institute of Health. Quality of Life Assess-ment. Practice, Problems, and Promise. Proceedings of a Workshop. Bethsada Md. 1990.
Muldoon M, Barger S, Flory J, Manuck S. What are quality of life measurements measuring? Brit Med J 1998; 316: 542±545.
Little J. Chronic pancreatitis: the results of protocol management. Aust-N-Z J Surg 1983; 53: 403±409.
Kiviluoto T, Schroder T, Lempinen M. Total pancre-atectomy for chronic pancreatitis. Surg-Gynecol-Obstet 1985; 160: 223±227.
Orozco H, Guevara L, Uribe M, et al. Survival and quality of life after selective portasystemic shunts. Am J Surg 1981; 141: 183±186.
Haring R. Interdisciplinary management of portal hy-pertension: status of portosystemic shunt operations. Zentralbl Chir 1995; 120: 95±102.
Van Theil, Kumar S, Gavaler J, Tarter R. E.ect of liver transplantation on the hypothalamic-pituitary-gonadal axis of chronic alcoholic men with advanced liver dis-ease. Alcohol Clin Exp Res 1990; 14: 478±481.
Shaw B (Jnr). Liver transplantation. Current Opin Gen Surg 1993; 239±248.
Knechtle S, Fleming M, Barry K, et al. Liver trans-plantation in alcoholics: assessment of psychological health and work activity. Transplant Proc 1993; 25: 1916±1918.
Kleber G, Ansari H, Sauerbruch T. Prophylaxis of ®rst variceal bleeding. Baillieres Clin Gastroentrol 1992; 6: 563±580.
Gaa'l C, Freebairn. Ear-acupuncture relaxation therapy in alcoholics. Report on a follow-up survey. Med-J-Aust 1979; 2: 179±180.
Turner B, Bennet V, Hernadez H. The bene®cial side of moderate alcohol use. John Hopkins Med J 1981; 148: 55±63.
Abramson R. A dying patient: the question of eutha-nasia.Int J Psychiatry Med 1975; 6: 431±454.
Hume F, Summer®eld D. After the war in Nicaragua: a psychosocial study of war-wounded ex-combatants. Med War 1994; 10: 4±25.
Foster JH, Marshall EJ, Hooper R, Peters TJ. Quality of Life measures in alcohol dependent subjects and changes with abstinence and continued heavy drinking. Addict Biol 1998; 3: 321±332.
Foster JH, Marshall EJ, Peters TJ. Predictors of Re-lapse to heavy drinking in alcohol dependent subjects following alcohol detoxi®cation ± the role of quality of life measures, ethnicity, social class, cigarette and drug use. Addict Biol 1998; 3: 333±343.
Welsh J, Buchsbaum D, Kaplan C. Quality of Life of alcoholics and non alcoholics: does excessive drinking make a di.erence in an urban setting. Qual Life Res 1993; 2: 335±340.
Chubon R. Development of a Quality of Life rating scale for use in health care evaluation. Eval Health Prof 1987; 10: 1034±1038.
Hunt S, McEwen J. The development of a subjective health indicator. Sociol Health Illn 1980; 2: 231±246.
Stockwell T, Hodgson R, Edwards G, Taylor C, Ran-kin H. The development of a questionnaire to measure severity of alcohol dependence. Br J Addict 1979; 74: 79±87.
Dummond C. The relationship between alcohol de-pendence and alcohol related problems in a clinical population. Br J Addict 1990; 85: 357±366.
Lundberg J, Passik S. Alcohol and cancer: a review for psycho-oncologists. Psycho-oncology 1997; 6: 253±266.
Foster JH, Marshall EJ, Peters TJ. Comparison of the Quality of Life of cancer patients and alcohol de-pendents. Qual Life Res 1997; 6: 646(published abstract).
DeHaes J, van Knippenburg F, and Neijt J. Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptoms Checklist. Br J Cancer 1990; 62: 1034±1038.
Gillet C, Paille F, Wahl D, Aubin H, Pirollet P, Prime T. Outcome of treatment in alcoholic women. Drug Alcohol Depend 1991; 29: 189±194.
Foster JH, Marshall EJ, Peters TJ. The Quality of Life differences between male and female alcohol dependent subjects. Addiction Biology 1998; 3: 357(published abstract).
Beck A, Mendelson M, Mock J. Inventory for measur-ing depression. Arch Gen Psychiatry 1961; 4: 561±571.
Goldberg D. The detection of psychiatric illness by questionnaire (Maudsley Monograph No 2), London: Oxford University Press, 1972.
Braucht G, Reichardt C, Geissler L, Kwiatowski C, Kirby Jr M. E.ective services for homeless substance abusers. J Addict Dis 1995; 14: 87±109.
Brazier J, Harper R, Jones N, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Brit Med J 1992; 305: 160±164.
American Psychiatric Association. Diagnostic and sta-tistical manual of mental disorders, 4th ed. Washington DC: American Psychiatric Association Publications, 1994.
Volk R, Cantor S, Steinbauer J, Cass A. Alcohol use disorders, consumption patterns, and health-related quality of life of primary care patients. Alc Clin Exp Res 1997; 21: 899±905.
McKenna M, Chick J, Buxton M, Howlett H, Patience D, Ritson B. THE SECCAT SURVEY: I. The costs and consequences of alcoholism. Alcohol Alcohol 1996; 31: 565±576.
Patience D, Buxton D, Chick J, Howlett H, McKen-na M, Ritson B. THE SECCAT SURVEY: II. The alcohol related problems questionnaire as a proxy for resource costs and quality of life in alcoholism treat-ment. Alcohol Alcohol 1997; 32: 79±84.
True R, Romeis B, Waterman J, et al. Alcoholism and health related quality of life. Alcohol Clin Exp Res 1997, 21(Suppl): 116A(published abstract).
Daeppen J, Kreig M, Burnard B, Yersin B. Health re-lated quality of life in alcoholic patients measured with the 36-item Short-Form Health Survey. Qual Life Res 1995; 4: 413(published abstract).
Popovic V, Popovic I, Lilic V, Tosic S, Zlatanovic L, Vukic D. Some aspects of Quality of Life of alcoholics. Qual Life Res 1997; 6: 700(published abstract).
Spitzer R, Kroenke K, Linzer M et al. Health-related quality of life in primary care patients with mental disorders. Results from the PRIME±MD study. JAMA 1995; 274: 1511±1517.
Linzer M, Spitzer R, Kroenke K, et al. Gender quality of life and mental disorders in primary care: Results from the PRIME±MD study. Am J Med 1996; 101: 526±533.
Stewart A, Hays R, Ware J. The MOS Short-Form General Health Survey: reliability and validity in a patient population. Med Care 1988; 26: 724±732.
Clark D, Kirisci L. Posttraumatic stress disorder, de-pression, alcohol use disorders and quality of life of adolescents. Anxiety 1996; 2: 226±233.
Warshaw M, Fierman E, Pratt L, et al. Quality of life and dissociation in anxiety disorder patients with his-tories of trauma or PTSD. Am J Psychiatry 1993; 150: 1512±1516.
Driessen M, Veltrup C, Weber J, Ulrich J, Wetterling T, Dilling H. Psychiatric comorbidity, suicidal behav-iour and suicidal ideation in alcoholics seeking treat-ment. Addiction 1998; 93: 889±894.
Beattie M, Longabaugh R, Elliot G, Stout R, Fava J, Noel N. E.ect of social environment on alcohol in-volvement and subjective well-being prior to alcoholism treatment. J Stud Alcohol 1993; 54: 283±296.
Humphreys K, Moos R, Cohen C. Social and com-munity resources and long-term recovery from treated and untreated alcoholism.J Stud Alcohol 1997; 58: 231±238.
Hornquist J, Elton M. A prospective longitudinal study of abusers of alcohol granted disability pension. Scand J Soc Med 1983; 11: 91±96.
Hornquist J, Akerlind I. Loneliness correlates in ad-vanced alcohol abusers. II. Clinical and psychological factors. Scand J Soc Med 1987; 15: 225±232.
Rather B, Sherman M. Relationship between alcohol expectancies and length of abstinence among alco-holics anonymous members. Addict Behav 1989; 14: 531±536.
Mann K, Morlock P, Mezger A. Quality of Life and drinking status in alcoholics 6 years after treatment. Qual Life Res 1997; 6: 688(published abstract).
Chaturvedi S, Kirthana R, Desai M. Quality of Life and alcoholism: what aspects are perceived as impor-tant. Qual Life Res 1997; 6: 632(published abstract).
Amodeo M, Kurtz N, Cutter H. Abstinence, reasons for not drinking and life satisfaction. Int J Addict 1992; 27: 707±716.
Crumbaugh J, Raphael M (Snr), Shraeder R. Frankls' will to meaning in a religious order. J Clin Psychol 1970; 26: 206±297.
Bradburn N. The structure of psychological well-being. Chicago: Aldine Press, 1969.
Watson C, Hancock M, Malovrh P, Gearhart L, Raden M. A 48-week natural history follow-up of al-coholics who do and do not engage in limited drinking after treatment. J Nerv Ment Dis 1996; 184: 623±627.
Watson C, Hancock M, Gearhart L, Mendez C, Ma-lovrh P, Raden M. A comparative outcome study of frequent, moderate, occasional and nonattenders of Alcoholics Anonymous. J Clin Psychol1997; 53: 209± 214.
Vitiello M.Sleep, Alcohol and Alcohol Abuse. Addict Biol 1997; 2: 151±159.
Peters TJ and Foster J. Sleep disturbance in alcohol misuse: a predictor of relapse. Alcohol Clin Exp Res 1998; 22(Suppl): 183A.
Fabsitz R, Sholinsky P, Goldberg J. Correlates of sleep problems among men: the Vietnam Era Twin Registry. J Sleep Res 1997; 6: 50±56.
Slevin M, Plant H, Lynch D, Drinkwater J, Gregory WM. Who should measure quality of life the doctor or the patient? Br J Cancer 1988; 57: 109±112.
Pearlman R, Uhlmann R. Patient and physician per-ceptions of patient quality of life across chronic dis-eases. J Gerontol 1988; 43: 25±30.
Rosser RM, Watts VC. The measurement of hospital output. Int J Epidemiol 1972; 1: 361±368.
Torrance GW, Boyle MH, Horwood SP. Application of multiattribute utility theory to measure social preferences for health states. Oper Res 1982; 30: 1043±1069.
Williams A. The economics of coronary artery bypass grafting. Brit Med J 1985; 291: 326±329.
Williams A. The measurement and valuation of health, University of York: Centre for Health Economics, (Discussion Paper 136), 1995.
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Foster, J., Powell, J., Marshall, E. et al. Quality of Life in alcohol-dependent subjects – a review. Qual Life Res 8, 255–261 (1999). https://doi.org/10.1023/A:1008802711478
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DOI: https://doi.org/10.1023/A:1008802711478