title: The effectiveness of anxiety treatment on alcohol-dependent patients with a comorbid phobic disorder: a randomized controlled trial.
abstract: OBJECTIVE
  Evidence has emerged which indicates that the post-treatment relapse rate for alcohol-dependent patients with a comorbid anxiety disorder is higher than for alcohol-dependent patients without a comorbid anxiety disorder. The question raised by this evidence is whether the relapse rate in these dually diagnosed patients could be reduced if they were given additional treatment for the comorbid anxiety disorder. We attempted to answer this question by conducting a trial among patients with a double diagnosis of alcohol dependence and agoraphobia or social phobia.
  
  
  METHODS
  We conducted a 32-week randomized controlled trial among 96 abstinent patients with a primary diagnosis of alcohol dependence and a comorbid anxiety disorder involving agoraphobia or social phobia. The patients were randomly assigned to an intensive psychosocial relapse-prevention program on its own (n = 49) or in combination with an anxiety treatment program comprising cognitive behavioral therapy (CBT) and optional pharmacotherapy consisting of an SSRI (n = 47). The primary outcome measure was the percentage of patients who suffered an alcohol relapse during a 32-week period. The secondary outcome measures were total abstinence, a reduction in the days of heavy drinking, and less severe anxiety symptoms.
  
  
  RESULTS
  Although the additional therapy clearly reduced the anxiety symptoms, it had no significant effect on the alcohol relapse rates.
  
  
  CONCLUSIONS
  Anxiety treatment for alcohol-dependent patients with a comorbid anxiety disorder can alleviate anxiety symptoms, but it has no significant effect on the outcome of alcohol treatment programs.
authors.affiliation: Department of Psychiatry and Institute for Extramural Medicine, 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; D000379:Agoraphobia / Q000150:complications* / Q000523:psychology / Q000628:therapy; D000437:Alcoholism / Q000150:complications* / Q000523:psychology / Q000628:therapy; D001007:Anxiety / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D013695:Temperance; D016896:Treatment Outcome