Motivation to change and factors influencing motivation in alcohol dependence syndrome in a tertiary care hospital

CONTEXT Motivation plays an important role in the treatment of alcohol dependence syndrome (ADS) by influencing the patient to seek and comply with treatment as well as make successful long term changes. AIM The aim of this study is to study the motivation for change in inpatients with ADS. SETTINGS AND DESIGN One hundred consecutive patients admitted for the treatment of ADS in a medical college hospital were evaluated. MATERIALS AND METHODS The International Classification of Disease 10th Revision - AM symptom checklist for mental disorders screener and appropriate modules were used to establish ADS. The assessment of motivation was done using the University of Rhode Island Change Assessment scale at baseline and after 2 weeks of admission. The Severity of Alcohol Dependence Questionnaire and Kuppuswamy's scale for socioeconomic status were used. STATISTICAL ANALYSIS Paired and unpaired t-test, Fisher's exact test, and Wilcoxon signed-rank test were used to analyze data. RESULTS The assessment of motivation showed 60% of patients in precontemplation (PC) stage at baseline, compared to 34% of the patients in PC, 57% in contemplation, and 9% in action stage after 2 weeks of inpatient stay. A highly significant change was seen in the levels of motivation toward contemplation and action stage after 2 weeks of inpatient stay (Z = 5.745, P < 0.001). Motivation to change had a significant association with complications of alcohol use, medical comorbidity, onset and severity of alcohol dependence, socioeconomic status, religion, and mode of referral. CONCLUSIONS The study concludes that certain patients with ADS may have low pretreatment levels of motivation, with significant improvement in the motivation levels after a short duration of inpatient treatment.