The impact of comorbid anxiety and depression on alcohol treatment outcomes

Aims This study examines the impact of comorbid Diagnostic and Statistical Manual version IV (DSM-IV) anxiety and/or depression on out-patient treatment for alcohol problems. Design A prospective correlational design. Participants and settings Seventy-one clients seeking alcohol out-patient treatment at two treatment sites were interviewed at commencement of a treatment episode for alcohol problems and reinterviewed using the same measures 3 months later. Comorbid DSM-IV anxiety and/or depression were measured by the Composite International Diagnostic Interview (CIDI), a comprehensive interview developed by the World Health Organization to assess current and life-time prevalence of mental disorders. Outcome measures included standardized measures of disability [the short form (SF)-12 Mental Health Summary Score and the number of days taken out of role] and the average amount of alcohol consumed. Clients were also asked to rate their satisfaction with the services received. Findings Participants with comorbid DSM-IV anxiety and/or depressive disorders were more disabled and drank more heavily than those without these comorbid disorders at entry to treatment. At 3-month follow-up both groups of participants (i.e. those with and without DSM-IV comorbid anxiety and/or depression) were significantly less disabled and also drank significantly less alcohol on an average drinking occasion than at baseline. Despite this, the comorbid group remained more disabled and drank more heavily than the noncomorbid group at follow-up. Conclusions Further research is needed to determine the most appropriate model of care for alcohol treatment seekers with comorbid DSM-IV anxiety and/or depression.