Follow-up study of anxiety disorder and alcohol dependence in comorbid alcoholism treatment patients.
BACKGROUND
Anxiety disorders are present in a high percentage of alcoholism treatment patients. We tested the prediction that having a comorbid anxiety disorder increases the prospective risk for relapse to drinking after alcoholism treatment. We also explored the prospective associations of specific anxiety syndromes (and depression) with drinking and anxiety outcomes.


METHODS
We assessed the diagnostic status and daily drinking patterns of 82 individuals approximately one week after they entered alcoholism treatment (baseline) and again approximately 120 days later (follow-up) (n=53).


RESULTS
Consistent with study predictions, those with a baseline anxiety disorder (approximately 55%) were significantly more likely than others to meet various definitions of drinking relapse over the course of the follow-up. Regression models showed that baseline social phobia was the single best predictor of a return to any drinking after treatment, whereas panic disorder was the single best predictor of a relapse to alcohol dependence after treatment. Having multiple anxiety disorders (versus any specific anxiety disorder) at the baseline was the strongest predictor of having at least one active ("persistent") anxiety disorder at the follow-up. Cross-sectional analysis at the follow-up showed that anxiety disorder persisted in the absence of a relapse to alcohol dependence far more often than relapse to alcohol dependence occurred in the absence of a persistent anxiety disorder.


CONCLUSIONS
Screening for comorbid anxiety disorder in alcoholism treatment patients is warranted and, where found, should be considered a marker of high relapse risk relative to that of noncomorbid patients. The capacity of specific anxiety treatment to mitigate relapse risk among comorbid patients remains an open question.
Kushner
Matt G
MG
Department of Psychiatry, Fairview Riverside Hospital, University of Minnesota, Minneapolis 55454, USA. kushn001@umn.edu
Abrams
Kenneth
K
Thuras
Paul
P
Hanson
Karen L
KL
Brekke
Marjorie
M
Sletten
Sandra
S
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D012008:Recurrence; D012054:Reinforcement, Psychology; D012307:Risk Factors; D016896:Treatment Outcome