Body mass index and craving predict 24-month hospital readmissions of alcohol-dependent in-patients following withdrawal

Objective: Addictive alcohol drinking, craving, and overeating share common etiopathological mechanisms. We investigated whether body mass index (BMI) and craving predict outcome of alcohol-dependent in-patients. Method: The prospective study included 101 male and 72 female early-abstinent alcohol-dependent in-patients. Craving was quantified by Obsessive-Compulsive Drinking Scale (OCDS) scores. We documented alcohol-related readmissions over 24 months. Results: In males, a higher BMI was associated with alcohol-related hospital readmission (median 26.1 vs. 23.1 kg/m(2), P = .007) and correlated with more (rho = 0.286, P = .004) and earlier readmissions (rho = -0.256, P = .010). These associations were stronger in the subgroup of active smokers (n = 79; median 25.9 vs. 22.3 kg/m(2), P = .005; rho = 0.350, P = .002; rho = -0.340, P = .002). BMI did not significantly predict outcome in females. Males with at least one readmission reported higher OCDS scores than those without (OCDS-total, OCDS-obsessive, OCDS-compulsive, P < .040), and the OCDS scores correlated with more readmissions (males: OCDS-total, OCDS-obsessive, OCDS-compulsive, rho > 0.244, P < .014; females: OCDS-compulsive, rho = 0.341, P = .003) and fewer days to first readmission (males: OCDS-total, OCDS-compulsive, rho < -0.195, P < .050; females: OCDS-compulsive, rho = -0.335, P = .004). The OCDS scores explained 9 to 19% of the relationship between BMI and outcome in males. Conclusion: BMI and craving are easily accessible outcome predictors of alcohol-related readmission following in-patient withdrawal treatment. They might be used to individualize relapse prevention in the future.