Drug and Alcohol Dependence 100 (2009) 173–177 Contents lists available at ScienceDirect Drug and Alcohol Dependence journal homepage: www.elsevier.com/locate/drugalcdep Short communication Alcohol use disorders in patients with obsessive–compulsive disorder: The importance of appropriate dual-diagnosis André F. Gentil a,∗ , Maria Alice de Mathis a , Ricardo C. Torresan b , Juliana B. Diniz a , Pedro Alvarenga a , Maria Conceic ¸ ão do Rosário a,c , Aristides V. Cordioli d , Albina R. Torres b , Euripedes C. Miguel a a Department & Institute of Psychiatry, Clinical Hospital, University of São Paulo Medical School, São Paulo, R. Dr. Ovidio Pires de Campos, 485, 3 ◦ andar, CEAPESQ, sala 7, CEP 05403-010, São Paulo, SP, Brazil b Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, Botucatu, Av. Rio Branco, 936, 18618–970, Botucatu, SP, Brazil c Department of Psychiatry, Federal University of São Paulo Medical School, São Paulo, Rua Botucatu, 740, 3 o andar, 04023-900 - Sao Paulo, SP, Brazil d Department of Psychiatry, Federal University of Rio Grande do Sul Medical School, Porto Alegre, Rua Ramiro Barcelos, 2350, 4 ◦ andar, 90035-003 - Porto Alegre, RS, Brazil article info Article history: Received 22 July 2008 Received in revised form 18 September 2008 Accepted 20 September 2008 Available online 11 November 2008 Keywords: Obsessive–compulsive disorder Alcohol use disorders Alcohol abuse Alcohol dependence Comorbidity Clinical sample abstract Objective: To evaluate the prevalence and clinical associated factors of alcohol use disorders (AUD) comor- bidity in a large clinical sample of patients with obsessive–compulsive disorder (OCD). Methods: A cross-sectional study including 630 DSM-IV OCD patients from seven Brazilian university services, comparing patients with and without AUD comorbidity. The instruments of assessment used were a demographic and clinical questionnaire including evaluation of suicidal thoughts and acts and psychiatric treatment, the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), the Yale- Brown Obsessive–Compulsive Scale, the Dimensional Yale-Brown Obsessive–Compulsive Scale, the Brown Assessment of Beliefs Scale, the Beck Depression and Anxiety Inventories and the Clinical Global Impres- sion Scale. Current or past alcohol and other psychoactive substances use, abuse and dependence were assessed using the SCID-I (section E) and corroborated by medical and familial history questionnaires. Results: Forty-seven patients (7.5%) presented AUD comorbidity. Compared to OCD patients without this comorbidity they were more likely to be men, to have received previous psychiatric treatment, to present lifetime suicidal thoughts and attempts and to have higher scores in the hoarding dimension. They also presented higher comorbidity with generalized anxiety and somatization disorders, and compulsive sex- ual behavior. Substance use was related to the appearance of the first O.C. symptoms and symptom amelioration. Conclusions: Although uncommon among OCD treatment seeking samples, AUD comorbidity has specific clinical features, such as increased risk for suicidality, which deserve special attention from mental health professionals. Future studies focused on the development of specific interventions for these patients are warranted. © 2008 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Obsessive–compulsive disorder (OCD) and alcohol use disorders (AUD) are leading causes of long-term disability. It is estimated that within the next 20 years OCD will be among the top 10 causes of years lived with disability and that AUD will be one of the three leading risk factors for disease burden worldwide (World Health Organization [WHO], 2004; Lopez et al., 2006; WHO, 2006). ∗ Corresponding author at: R. Dr. Ovidio Pires de Campos, 485, 3 ◦ andar, CEAPESQ, sala 7, CEP 05403-010, São Paulo, SP, Brazil. Tel.: +55 11 3069 6972; fax: +55 11 3069 7895. E-mail addresses: afgentil@gmail.com, afgentil@terra.com.br (A.F. Gentil). There is evidence that OCD favors a higher incidence of alcohol dependence among drinkers (Torres et al., 2006) and the presence of obsessive–compulsive symptoms (OCS) has been commonly reported among alcohol dependent patients (Suzuki et al., 2002; Lima et al., 2005). The development of the Obsessive–Compulsive Drinking Scale (Anton et al., 1996) clearly indicates the existence of common characteristics between OCD and AUD. Research on the co-existence of AUD and OCD in clinical samples has received only modest attention. It is likely that a signifi- cant number of mental health practitioners systematically fail to diagnose this co-occurrence and provide appropriate treatment (McKeehan and Martin, 2002). Considering the burden caused by AUD and OCD in the lives of patients and their families, it is impor- tant to study this association in a large sample of subjects. 0376-8716/$ – see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.drugalcdep.2008.09.010