Alcohol-dependent patients with comorbid phobic disorders: a comparison between comorbid patients, pure alcohol-dependent and pure phobic patients.
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.
Schadé
Annemiek
A
Department of Psychiatry and Institute for Extramural Medicine, VU University Medical Centre, Amsterdam, The Netherlands. a.schade@ggzba.nl
Marquenie
Loes A
LA
Van Balkom
Anton J L M
AJ
Koeter
Maarten W J
MW
De Beurs
Edwin
E
Van Den Brink
Wim
W
Van Dyck
Richard
R
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