Alcohol & Alcoholism Vol. 39, No. 3, pp. 241-246, 2004
Alcohol & Alcoholism Vol. 39, No. 3 © Medical Council on Alcohol 2004; all rights reserved
ALCOHOL-DEPENDENT PATIENTS WITH COMORBID PHOBIC DISORDERS: A COMPARISON BETWEEN COMORBID PATIENTS, PURE ALCOHOL-DEPENDENT AND PURE PHOBIC PATIENTS
1 Department of Psychiatry and Institute for Extramural Medicine, VU University Medical Centre, Amsterdam and 2 Amsterdam Institute for Addiction Research, Amsterdam Medical Centre, University of Amsterdam, Amsterdam and 3 Leiden University Medical Centre, Leiden, The Netherlands
* Author to whom correspondence should be addressed at: VU University Medical Centre, GGZBA, Lassusstraat 2, 1075 GV Amsterdam, Netherlands. Tel.: +00 31 20 573 6600; E-mail: a.schade{at}ggzba.nl
(Received 13 October 2003; first review notified 9 December 2003; in revised form 16 December 2003; accepted 21 December 2003)
Background: Patients with a double diagnosis of alcohol dependence and phobic disorders are a common phenomenon in both alcohol and anxiety disorder clinics. If we are to provide optimum treatment we need to know more about the clinical characteristics of this group of comorbid patients. Objective: To answer the following questions. (1) What are the clinical characteristics of treatment-seeking alcohol-dependent patients with a comorbid phobic disorder? (2) Are alcohol dependence and other clinical characteristics of comorbid patients different from those of ‘pure’ alcohol-dependent patients? (3) Are the anxiety symptoms and other clinical characteristics of comorbid patients different from those of ‘pure’ phobic patients? Method: Three groups of treatment-seeking patients were compared on demographic and clinical characteristics: alcohol dependent patients with a comorbid phobic disorder (n = 110), alcohol-dependent patients (n = 148) and patients with social phobia or agoraphobia (n = 106). In order to diagnose the comorbid disorders validly, the assessment took place at least 6 weeks after detoxification. Results: Comorbid patients have high scores on depressive symptoms and general psychopathology: 25% of patients have a current and 52% a lifetime depressive disorder. The majority have no partner and are unemployed, they have a high incidence of other substance use (benzodiazepine, cocaine, cannabis) and a substantial proportion of comorbid patients have been emotionally, physically and sexually abused. They do not have a more severe, or different type of alcohol dependence or anxiety disorder than ‘pure’ alcohol-dependent patients and phobic patients respectively. Conclusion: Comorbid patients constitute a complex part of the treatment-seeking population in alcohol clinics and psychiatric hospitals. These findings should be taken into account when diagnosing and treating alcohol-dependent patients with a comorbid phobic disorder.