Follow-up study of anxiety disorder and alcohol dependence in comorbid alcoholism treatment patients
Follow-up study of anxiety disorder and alcohol dependence in comorbid alcoholism treatment patients
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DOI：
10.1097/01.alc.0000175072.17623.f8
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发表时间：
2005-08-01
影响因子：
3.2
通讯作者：
Sletten, S
中科院分区：
文献类型：
--
作者：
Kushner, MG;Abrams, K;Sletten, S
背景：焦虑症存在于酒精中毒治疗患者的高比例。我们测试了有共病性焦虑症会增加酒精中毒治疗后饮酒复发的预期风险的预测。我们还探讨了特定焦虑综合征（和抑郁）与饮酒和焦虑结果的潜在关联。方法：我们评估了82名患者的诊断状态和日常饮酒模式，这些患者在接受酒精中毒治疗大约一周后（基线），并在大约120天后（随访）再次评估（n = 53）。结果：与研究预测一致，在随访过程中，基线焦虑症患者（约55%）明显比其他人更有可能满足饮酒复发的各种定义。回归模型显示，基线社交恐惧症是治疗后再次饮酒的最佳预测指标，而恐慌症是治疗后酒精依赖复发的最佳预测指标。在基线时患有多种焦虑障碍（与任何特定的焦虑障碍相比）是在随访中至少患有一种活动性（“持续性”）焦虑障碍的最强预测因子。随访时的横断面分析显示，在没有酒精依赖复发的情况下，焦虑症持续存在的几率远高于在没有持续焦虑症的情况下酒精依赖复发的几率。结论：酒精中毒治疗患者的共病焦虑障碍筛查是有必要的，一旦发现，应被视为相对于非共病患者复发风险高的标志。特异性焦虑治疗减轻合并症患者复发风险的能力仍然是一个悬而未决的问题。
Background: Anxiety disorders are present in a high percentage of alcoholism treatment patients. We tested the prediction that having a comorbid anxiety disorder increases the prospective risk for relapse to drinking after alcoholism treatment. We also explored the prospective associations of specific anxiety syndromes (and depression) with drinking and anxiety outcomes.Methods: We assessed the diagnostic status and daily drinking patterns of 82 individuals approximately one week after they entered alcoholism treatment (baseline) and again approximately 120 days later (follow-up) (n = 53).Results: Consistent with study predictions, those with a baseline anxiety disorder (approximately 55%) were significantly more likely than others to meet various definitions of drinking relapse over the course of the follow-up. Regression models showed that baseline social phobia was the single best predictor of a return to any drinking after treatment, whereas panic disorder was the single best predictor of a relapse to alcohol dependence after treatment. Having multiple anxiety disorders (versus any specific anxiety disorder) at the baseline was the strongest predictor of having at least one active ("persistent") anxiety disorder at the follow-up. Cross-sectional analysis at the follow-up showed that anxiety disorder persisted in the absence of a relapse to alcohol dependence far more often than relapse to alcohol dependence occurred in the absence of a persistent anxiety disorder.Conclusions: Screening for comorbid anxiety disorder in alcoholism treatment patients is warranted and, where found, should be considered a marker of high relapse risk relative to that of noncomorbid patients. The capacity of specific anxiety treatment to mitigate relapse risk among comorbid patients remains an open question.