Efficacy of psychosocial interventions in inducing and maintaining alcohol abstinence in patients with chronic liver disease: a systematic review
Open accessAbstract
Background & aims We conducted a systematic review of efficacy of psychosocial interventions in inducing or maintaining alcohol abstinence in patients with chronic liver disease (CLD) and alcohol use disorder (AUD).Methods We performed structured keyword searches in PubMed, PsychINFO, and MEDLINE for original research articles that were published from January 1983 through November 2014 that evaluated the use of psychosocial interventions to induce or maintain alcohol abstinence in patients with CLD and AUD.Results We identified 13 eligible studies that comprised 1945 patients; 5 were randomized controlled trials (RCTs). Delivered therapies included motivational enhancement therapy, cognitive behavioral therapy (CBT), motivational interviewing, supportive therapy, and psychoeducation either alone or in combination in the intervention group and general health education or treatment as usual in the control group. All studies of induction of abstinence (4 RCTs and 6 observational studies) reported an increase in abstinence among participants in the intervention and control groups. Only an integrated therapy that combined CBT and motivational enhancement therapy with comprehensive medical care, delivered during a period of 2 years, produced a significant increase in abstinence (74% increase in intervention group vs 48% increase in control group, P = .02), which was reported in 1 RCT. All studies of maintenance of abstinence (1 RCT and 2 observational studies) observed recidivism in the intervention and control groups. Only an integrated therapy that combined medical care with CBT produced a significantly smaller rate of recidivism (32.7% in integrated CBT group vs 75% in control group, P = .03), which was reported from 1 observational study. However, data were not collected for more than 2 years on outcomes of patients with CLD and AUD.Conclusions In a systematic analysis of studies of interventions to induce or maintain alcohol abstinence in patients with CLD and AUD, integrated combination psychotherapy with CBT, motivational enhancement therapy, and comprehensive medical care increased alcohol abstinence. No psychosocial intervention was successful in maintaining abstinence, but an integrated therapy with CBT and medical care appears to reduce recidivism.
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References 44 · Cited by 179
Research works printed but not linked: 2
- [8]Younossi ZM Mortality risk greater among patients with HCV who drank alcohol moderately, heavily Aliment Pharmacol Ther 2013 37 703 709 23432436
- [39]Miller WR Wilbourne PL Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders Addiction 2002 97 3 265 277 11964100
- Authors
- Khan, A., Tansel, A., White, D. L., Kayani, W. T., Bano, S., Lindsay, J., El-Serag, H. B., & Kanwal, F.
- Affiliations
- Baylor College of Medicine (US)
- Michael E. DeBakey VA Medical Center (US)
- Aga Khan University (PK)
- Corresponding author
- Kanwal, Fasiha
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 14
- Issue
- 2
- Pages
- 191-202.e4
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC4805368
- OpenAlex
- W1110780430
- Cited by
- 179
- References
- 44
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 20 · 2023: 26 · 2022: 22 · 2021: 13 · 2020: 21 · 2019: 18 · 2018: 18 · 2017: 4 · 2016: 6 · 2015: 1
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons-TMC (Texas Medical Center) (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK56338, DK095082, R03DK095082, P30DK056338, T32DK083266)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- psychosocial interventions, alcohol abstinence, chronic liver disease, alcoholism, cognitive behavioral therapy, motivational enhancement therapy, motivational interviewing, psychoeducation, abstinence maintenance, relapse
- MeSH terms
- Psychiatric Rehabilitation, Alcoholism, Behavior Therapy, Humans, Liver Diseases, Treatment Outcome, Alcohol Abstinence
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