Relationship of relapse with impulsivity, novelty seeking and craving in male alcohol-dependent inpatients

Introduction and Aims. Aim of this study was to evaluate the relationship of relapse with impulsivity, novelty seeking (NS) and craving during 12 month follow up after inpatient treatment in male alcohol dependents. Design and Methods. Among 156 consecutively admitted male alcohol dependents, 102 were examined by face to face interview 12 months after discharge from hospital. Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), the NS dimension of the Temperament and Character Inventory, the Penn Alcohol Craving Scale (PACS) and Michigan Alcoholism Screening Test at the end of 12 months. Results. Among 102 alcohol-dependent inpatients 61.8% (n = 63) were considered as relapsed to alcohol use during 12 month follow up. Sociodemographic variables did not differ between relapsed and non-relapsed groups. Mean scores of BIS-11 and NS and subscales of these scales were higher in relapsed group than non-relapsed group. BIS-11 and NS and their subscales were positively correlated with each other. PACS was also positively correlated with these scales and their subscales. Only exception was 'exploratory excitability' (NS1) subscale of NS, which did not differ between groups and did not correlate with PACS or BIS-11. Extravagance (NS3) and BIS-11 non-planning impulsiveness (NPI) scores were associated with craving in Stepwise Linear Regression model. Only NS3 showed an association with relapse in the first Forward Wald logistic regression model. When severity of craving was included in the second model, as an independent variable, it was also associated with relapse additional to NS3. Discussion and Conclusions. Both impulsivity and NS seem to be related with craving and relapse. Particularly, NS3 may be related with relapse both directly and indirectly via craving, whereas NPI may be related with relapse only indirectly via craving. Thus severity of craving may be a final pathway to relapse in these relationships of NS3 and NPI with relapse. These findings suggest that impulsivity, NS and craving are important variables to predict outcome and also for the treatment plan. [Evren C, Durkaya M, Evren B, Dalbudak E, Cetin R. Relationship of relapse with impulsivity, novelty seeking and craving in male alcohol-dependent inpatients. Drug Alcohol Rev 2012; 31: 81-90]