{'fraction_non_alphanumeric': 0.026371308016877638, 'fraction_numerical': 0.015822784810126583, 'mean_word_length': 4.989473684210527, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
A STUDY OF FACTORS CONTRIBUTING RELAPSE IN ALCOHOL DEPENDENCE AND INTRA GROUP COMPARISON FOR FACTORS INFLUENCING DELAY IN TREATMENT SEEKING AFTER RELAPSE

CONTEXT: 
Alcoholism is one of the major health related problems in India. It is characterized by much significant psychological, physiological and social dysfunctions which were associated with excessive and persistent use of alcohol. The most important challenging aspect in assessing the outcome of treatment and the rate of relapse will be the lack of clarity regarding the relapse definition. One study states than relapse following treatment reaches 75% in first 3 – 6 months period. Many studies found that adults with alcohol related problems postpone their treatment and they underutilize the resources. It is very much important to understand the barriers to treatment by people with alcohol dependence. 
AIM OF THE STUDY: To study various factors contributing relapse in alcohol dependence and intra- group comparison for factors influencing delay in treatment seeking after relapse. 
OBJECTIVES: 
1. To study various psychosocial factors contributing relapse in alcohol dependence subjects. 
2. To compare those factors in contributing early relapse. 
3. To study various factors influencing delay in treatment seeking among relapsed patients. 
4. To compare those factors among early and late treatment seekers. 
DESIGN : Cross sectional study. 
SETTING : This study conducted at the Institute of Mental Health, a tertiary care centre in Tamilnadu. 
STUDY POPULATION: 100 subjects of alcohol dependence who relapsed into drinking behavior after de-addiction treatment were selected. 
SCALES USED: Semi structured proforma, Severity of Alcohol Dependence Scale, Alcohol Relapse Risk Scale, Duke’s Social Support and stress Scale. 
RESULTS: 49% people presented for the treatment in 6 – 12 months delay. 84% presented for the treatment within a year. 16% presented only after 1year. 75% report social influence especially other social networks as reason for the delay. 56% report psychological influence especially not decided to stop drinking yet as a factor for their delay. 20% and 40% report situational influence and access barriers for the delay in treatment. 
CONCLUSIONS: The following were the first 3 reasons for relapse elicited in our sample- Family problems (57%), Peer pressure (39%), Craving (19%). While delaying treatment after relapse, only 27% reported within 3 months of relapse, nearly half of the people report by 3 – 6 months. Nearly 50% delay their treatment for more than 6 months after relapse. Person related factors like doubting the need for treatment, public stigma were the important factors delaying the treatment rather than treatment related factors. Those who seek treatment within 6 months of relapse have more social support and less stress.