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Clusters of Alcohol Use Disorders Diagnostic Criteria and Predictors of Alcohol Use After Liver Transplantation for Alcoholic Liver Disease

Received April 21, 2006; revised August 3, 2006; accepted August 9, 2006. From The University of Pittsburgh Medical Center and Starzl Transplant Institute, Pittsburgh, PA. Send correspondence and reprint requests to Andrea DiMartini, M.D., Western Psychiatric Institute and Clinic, 3811 O’Hara St., Pittsburgh, PA 15213. e-mail: dimartiniaf{at}upmc.edu
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Establishing the correct alcohol use disorder diagnosis is clinically relevant because several reports of post-transplant alcohol use suggest that a pre-transplant diagnosis of alcohol dependence (rather than abuse) predicts relapse to alcohol use. Numerous combinations of specific symptoms are possible to achieve diagnostic significance. OBJECTIVE: The authors hypothesized that there would be distinct clusters of liver transplant recipients who showed specific combinations of alcohol-related symptoms and that these clusters would be predictive of alcohol-abuse outcome after transplant. METHOD: A group of 120 ALD liver transplant recipients received the Structured Clinical Interview for DSM–IV (SCID) module for alcohol abuse/dependence, and a cluster analysis was performed. RESULTS: Within the clusters of those with alcohol dependence, cluster assignment did not predict those more likely to drink. However, those assigned to the alcohol abuse cluster were significantly less likely to drink than those with alcohol dependence. CONCLUSION: Results therefore suggest that the prognosis regarding continued abstinence posttransplant is much more positive for individuals with a diagnosis of abuse than for those who meet criteria for alcohol dependence.

Key Words: Alcoholism • Liver Transplantation • Outcome Studies

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