title: Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment.
abstract: BACKGROUND
  Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized that co-morbid anxiety disorders would be particularly predictive for early relapse, but not late relapse.
  
  
  METHODS
  In a prospective design, male alcohol dependent patients (n=189) were recruited from an inpatient detoxification clinic. Psychiatric diagnoses and personality traits were assessed using the Mini International Neuropsychiatric Interview for psychiatric disorders and the Temperament and Character Inventory. The addiction severity index was used to assess addiction severity and follow-up.
  
  
  RESULTS
  One year after detoxification, 81 patients (53%) relapsed and nine patients (7%) were deceased, due to alcohol related causes. Co-morbid anxiety disorder, marital status, addiction severity, in particular legal problems, and harm avoidance predicted relapse. Anxiety disorders specifically predicted early relapse.
  
  
  CONCLUSIONS
  Alcohol dependence is a severe mental disorder, with high relapse rates and high mortality. Alcohol dependent patients with co-morbid anxiety disorders are particularly prone to relapse during the first three months of treatment. These patients may therefore require additional medical and psychological attention.
authors.affiliation: Radboud Medical Centre Nijmegen, Department of Psychiatry, 966, PO Box 9101, Reinier Postlaan 10, 6500 HB, Nijmegen, The Netherlands; Nijmegen Institute for Science Practitioners in Addiction (NISPA). Electronic address: a.f.a.schellekens@psy.umcn.nl.
authors.forename: A F A
authors.initials: AF
authors.lastname: Schellekens
authors.affiliation: Nijmegen Institute for Science Practitioners in Addiction (NISPA).
authors.forename: C A J
authors.initials: CA
authors.lastname: de Jong
authors.affiliation: Radboud Medical Centre Nijmegen, Department of Psychiatry, 966, PO Box 9101, Reinier Postlaan 10, 6500 HB, Nijmegen, The Netherlands.
authors.forename: J K
authors.initials: JK
authors.lastname: Buitelaar
authors.affiliation: Department of Cognitive Neuroscience, University Medical Centre.
authors.forename: R J
authors.initials: RJ
authors.lastname: Verkes
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D001008:Anxiety Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D002605:Character; D015897:Comorbidity; D006801:Humans; D008658:Inactivation, Metabolic; D007297:Inpatients; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires; D013694:Temperament; D013997:Time Factors
keywords: Anxiety; Mortality; Substance use disorders; Temperament and character inventory; Treatment