Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Research Report Eur Addict Res 2007;13:109–115 DOI: 10.1159/000097941 Anxiety Disorders: Treatable regardless of the Severity of Comorbid Alcohol Dependence Annemiek Schadé a Loes A. Marquenie a Anton J.L.M. van Balkom a Maarten W.J. Koeter b Edwin de Beurs c Richard van Dyck a Wim van den Brink b a Department of Psychiatry and Institute for Extramural Medicine, VU University Medical Centre, GGZ-Buitenamstel, Amsterdam, b Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Addiction Research, Amsterdam, and c Leiden University Medical Centre, Leiden, The Netherlands comorbid alcohol dependence did not influence the benefi- cial effect of CBT on the anxiety disorder. Psychological dis- tress (SCL-90), neuroticism (NEO N), conscientiousness (NEO C), gender, employment and age of onset of alcohol depen- dence showed some predictive value. Conclusions: Alco- hol-dependent males with a comorbid anxiety disorder seem to benefit most from CBT if their alcohol dependence started after age 25, if they are employed and if their gen- eral psychopathology is less severe. The most important conclusion, however, is that even severely alcohol-depen- dent patients with an anxiety disorder can benefit from psy- chotherapy for their anxiety disorder. Copyright © 2007 S. Karger AG, Basel Introduction Until recently it was common practice to select only ‘pure’ patient samples for randomized controlled trials (RCTs) to measure the efficacy of a certain treatment. However, the selection of pure patient samples has been criticized on account of their limited generalizability. Clinical and epidemiological research has shown that co- morbidity with psychiatric disorders is the rule rather than the exception [1–3] . Anxiety disorders have fre- Key Words Anxiety disorder, treatment  Alcohol dependence  Cognitive behavioral therapy Abstract Aims: Clinical and epidemiological research has shown that comorbidity is the rule rather than exception in the case of psychiatric disorders. Cognitive behavioral therapy (CBT) has been clearly demonstrated to be effective in treating anxiety and avoidance symptoms in patient samples of so- cial phobia and agoraphobia without comorbid alcohol use disorders. It has recently been shown that treatment of co- morbid anxiety disorders in alcohol-dependent patients can also be very successful. The purpose of the present study was to find predictors of treatment success for comorbid anxiety disorders in alcohol-dependent patients. Methods: The study was conducted in a sample of 34 completers with a double diagnosis of alcohol dependence and agoraphobia or social phobia who received CBT for their comorbid anxi- ety disorder in a 32-week randomized controlled trial com- paring alcohol and CBT anxiety disorder treatment with al- cohol treatment alone. In the current report, treatment success was defined as a clinically significant change (recov- ery) on the anxiety discomfort scale. Results: The severity of E u r o pea n Addi cti o n c R e e s ar h Annemiek Schadé Department of Psychiatry and Institute for Extramural Medicine VU University Medical Centre, Oldenaller 1 NL–1081 HJ Amsterdam (The Netherlands) Tel. +31 20 7884 666, E-Mail a.schade@ggzba.nl © 2007 S. Karger AG, Basel 1022–6877/07/0132–0109$23.50/0 Accessible online at: www.karger.com/ear