title: Is Specialized Integrated Treatment for Comorbid Anxiety, Depression and Alcohol Dependence Better than Treatment as Usual in a Public Hospital Setting?
abstract: OBJECTIVE
  To assess the effectiveness of a 12 week specialized, integrated intervention for alcohol dependence with comorbid anxiety and/or mood disorder using a randomized design in an outpatient hospital setting.
  
  
  METHODS
  Out of 86 patients meeting the inclusion criteria for alcohol dependence with suspicion of comorbid anxiety and/or depressive disorder, 57 completed a 3-week stabilization period (abstinence or significantly reduced consumption). Of these patients, 37 (65%) met a formal diagnostic assessment of an anxiety and/or depressive disorder and were randomized to either (a) integrated intervention (cognitive behavioural therapy) for alcohol, anxiety and/or depression, or (b) usual counselling care for alcohol problems.
  
  
  RESULTS
  Intention-to-treat analyses revealed a beneficial treatment effect of integrated treatment relative to usual counselling care for the number of days to relapse (χ(2) = 6.42, P < 0.05) and lapse (χ(2) = 10.73, P < 0.01). In addition, there was a significant interaction effect of treatment and time for percentage days of abstinence (P < 0.05). For heavy drinking days, the treatment effect was mediated by changes in DASS anxiety (P < 0.05). There were no significant treatment interaction effects for DASS depression or anxiety symptoms.
  
  
  CONCLUSIONS
  These results provide support for integrated care in improving drinking outcomes for patients with alcohol dependence and comorbid depression/anxiety disorder.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01941693.
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, University of Sydney, Sydney, NSW, Australia kirsten.morley@sydney.edu.au.
authors.forename: K C
authors.initials: KC
authors.lastname: Morley
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Baillie
authors.affiliation: Central Clinical School, University of Sydney, Sydney, NSW, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Leung
authors.affiliation: Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Sannibale
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Teesson
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, University of Sydney, Sydney, NSW, Australia Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
authors.forename: P S
authors.initials: PS
authors.lastname: Haber
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology / Q000628:therapy*; D001007:Anxiety / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003376:Counseling; D003863:Depression / Q000150:complications / Q000628:therapy*; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D016896:Treatment Outcome