Harmen Beurmanjer

15 General Introduction 1 study consisted of semi-structured interview, which explored illness perception and treatment needs in 20 treatment-seeking patients with GUD. The analysis was based on the principles of Grounded Theory by two interviewers and an independent researcher. In Chapter 4 the relationship between cognitive performance, coma’s, GUD and relapse rates will be discussed. In this prospective cohort study a consecutive series of patients with GUD (n=137) admitted for detoxification were recruited at six addiction care facilities in the Netherlands. The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairments before and after detoxification. Follow-up duration for the assessment of relapse in GHB use was three months. Part 2: Pharmacological treatment interventions for patients with GHB use disorder. Chapter 5 compares two detoxification methods for patients with GUD. In this multicentre non-randomised comparison of two treatments-as-usual, patients with GUD received benzodiazepine tapering or pharmaceutical GHB tapering (matched sample). Withdrawal was assessed using the Subjective and Objective Withdrawal Scales, craving was assessed with a Visual Analogue Scale, and adverse events were systematically recorded. Chapter 6 focusses on the potential effectiveness of baclofen to prevent relapse in GHB use, after detoxification. This out-patient, multicentre, open-label, non-randomized, controlled trial in patients with GUD (n = 107) Treatment as usual (TAU) was compared with TAU plus baclofen 45-60 mg/day for 3 months. Outcome measures were rates of lapse (any use) and relapse (using GHB on average once a week or more), based on self-report. Side effects were monitored with a baclofen side-effects questionnaire. Chapter 7 Summarizes the key findings of this thesis, its scientific and clinical relevance, the limitations of the present studies, and the recommendations for future research.