A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence.
We conducted a survey on abstinence in patients with alcohol dependence 1 year after completion of an RCT comparing HRV-biofeedback in addition to inpatient rehabilitation treatment alone (controls). Abstinence rates were compared and analysed for association with demographic data as well as psychometric and autonomic cardiac assessment before and after completion of the biofeedback training using bivariate and multivariate regression analyses.
Out of 48 patients who participated in the RCT, 27 patients (9 females, ages 42.9 ± 8.6, mean ± SD) completed our one-year follow-up. When including in the analysis only patients who completed follow-up, the rate of abstinence tended to be higher in patients who underwent HRV-biofeedback 1 year earlier compared to those who received rehabilitative treatment alone (66.7% vs 50%, p = ns). This non-significant trend was also observed in the intention-to-treat analysis where patients who did not participate in the follow-up were assumed to have relapsed (46,7% biofeedback vs. 33.3% controls, p = ns). Neither cardiac autonomic function nor psychometric variables were associated with abstinence 1 year after HRV-biofeedback.
Our follow-up study provide a first indication of possible increase in long-term abstinence after HRV-biofeedback for alcohol dependence in addition to rehabilitation.
The original randomized controlled trial was registered in the German Clinical Trials Register (DRKS00004618). This one-year follow-up survey has not been registered.
World Health Organization. Global status report on alcohol and health-2014. Geneva: World Health Organization; 2014. http://www.who.int/substance_abuse/publications/global_alcohol_report/en/.
McKay JT, Foltz C, Stephens RC, Leahy PJ, Crowley EM, Kissin W. Predictors of alcohol and crack cocaine use outcomes over a 3-year follow up in treatment seekers. J Subst Abus Treat. 2005;28(Suppl 1):S73–82. CrossRef
Schneekloth T, Biernacka J, Hall-Flavin D, et al. Alcohol craving as a predictor of relapse. Am J Addict. 2012;21:20–6. CrossRef
German Society for Addiction Research and Therapy (Deutsche Gesellschaft für Suchtforschung und -therapie, DG-Sucht). Documentation standards III for the evaluation of treatment of addicts (Dokumentationsstandards III für die evaluation der Behandlung von Abhängigen). Sucht. 2001;47(2):3–94. [German]
Devinsky O, Morrell MJ, Vogt BA. Contributions of anterior cingulate cortex to behavior. Brain. 1993;118:279–306. CrossRef
- Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up
Ana Isabel Penzlin
Ben Min-Woo Illigens
- BioMed Central