Schadé A, Marquenie L A, van Balkom A J L M, Koeter M M J, van den Brink W, van Dyck R
GGZ Buitenamstel, A.J.Ernststraat 887, 1081 HL Amsterdam.
Tijdschr Psychiatr. 2008;50(3):137-48.
There is evidence that the post-treatment relapse rate for alcohol-dependent patients with a comorbid anxiety disorder is higher than for alcohol-dependent patients without this disorder. aim To discover whether the post-treatment relapse rate in alcohol-dependent patients who suffer from both alcohol-dependence and a comorbid anxiety disorder can be lowered by giving them additional treatment specifically for the comorbid anxiety disorder.
A 32-week randomised controlled trial among 96 abstinent patients with a primary diagnosis of alcohol dependence and a comorbid anxiety disorder involving agoraphobia or social phobia. The patients were randomly assigned either to an intensive psychosocial relapse-prevention programme only (n = 49) or to a combined programme in which the aforementioned programme was supplemented by an anxiety treatment programme comprising cognitive behavioural therapy and optional pharmacotherapy in the form of an SSRI (n = 47). The primary outcome measure was the percentage of patients who suffered an alcohol relapse during a 32-week period. The secondary outcome measures were: total abstinence, a reduction in the number of days of heavy drinking and a reduction in anxiety symptoms. results Although the anxiety symptoms in the group receiving cognitive behavioural therapy diminished more than in the group not receiving this therapy, the alcohol relapse rates in the former group were not significantly lower than in the latter group.
Anxiety treatment for alcohol-dependent patients with a comorbid anxiety disorder can alleviate anxiety symptoms but has no significant effect on the outcome of alcohol treatment programmes.
有证据表明,患有共病焦虑症的酒精依赖患者治疗后的复发率高于无此疾病的酒精依赖患者。目的:探究对患有酒精依赖且合并焦虑症的患者,给予专门针对共病焦虑症的额外治疗是否能降低其治疗后的复发率。
对96名初步诊断为酒精依赖且合并广场恐惧症或社交恐惧症的共病焦虑症戒酒患者进行了一项为期32周的随机对照试验。患者被随机分配到仅接受强化心理社会预防复发计划组(n = 49)或联合计划组,在联合计划组中,上述计划辅以包括认知行为疗法和选择性5-羟色胺再摄取抑制剂(SSRI)形式药物治疗的焦虑症治疗计划(n = 47)。主要结局指标是在32周内出现酒精复发的患者百分比。次要结局指标包括:完全戒酒、重度饮酒天数减少以及焦虑症状减轻。结果:尽管接受认知行为疗法组的焦虑症状比未接受该疗法组减轻得更多,但前一组的酒精复发率并不显著低于后一组。
对患有共病焦虑症的酒精依赖患者进行焦虑症治疗可缓解焦虑症状,但对酒精治疗计划的结果无显著影响。