title: Alcohol-dependent patients with comorbid phobic disorders: a comparison between comorbid patients, pure alcohol-dependent and pure phobic patients.
abstract: 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?
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry and Institute for Extramural Medicine, VU University Medical Centre, Amsterdam, The Netherlands. a.schade@ggzba.nl
authors.forename: Annemiek
authors.initials: A
authors.lastname: Schadé
authors.forename: Loes A
authors.initials: LA
authors.lastname: Marquenie
authors.forename: Anton J L M
authors.initials: AJ
authors.lastname: Van Balkom
authors.forename: Maarten W J
authors.initials: MW
authors.lastname: Koeter
authors.forename: Edwin
authors.initials: E
authors.lastname: De Beurs
authors.forename: Wim
authors.initials: W
authors.lastname: Van Den Brink
authors.forename: Richard
authors.initials: R
authors.lastname: Van Dyck
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry) / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000453:epidemiology* / Q000523:psychology