Polysubstance dependent alcoholics (PSA) show a high risk of relapse. Decision-making deficits might be predictive of relapse so that high-risk relapse PSA are easily identified and novel more effective treatment interventions can be found.

To evaluate the effect of decision-making as measured by neurocognitive measures like the Iowa Gambling Task (IGT) and the Delay Discounting Task (DDT) on short-term relapse in PSA. The possible confounding effects of personality disorders (PD) are also examined.

Forty-one PSA following an inpatient addiction treatment were questioned about their substance use. After two weeks of stable abstinence they performed self-report questionnaires (Barratt Impulsiveness Scale - Sensitivity to Punishment and Sensitivity to Reward Questionnaires) and neurocognitive measures of decision-making (DDT - IGT). Thirty-seven PSA were retrieved three months after treatment completion and questioned about their current substance use. Thirty-one healthy controls (HC) were also asked to perform the self-report questionnaires and neurocognitive measures.

All PSA showed decision-making deficits in comparison to the HC. Abstinence was associated with better IGT performances, an older age at onset, and a greater likelihood of a cluster C PD.

IGT performances but not DDT performances are associated with short-term relapse in PSA. It is assumed that the processes involved in the DDT are more important to the initiation of the addiction while the processes involved in the IGT are more important to the maintenance of and the relapse in the addiction.