MANAGEMENT OF CO-MORBID ANXIETY AND ALCOHOL DISORDERS - PARALLEL TREATMENT OF DISORDERS

Co-morbid alcohol-related disorders and anxiety disorders have been fo und to occur in alcohol treatment populations, anxiety treatment popul ations and the general community. People suffering from co-occurring a lcohol-related and anxiety disorders are more prone to relapse to alco hol abuse, and more likely to re-enter the treatment system for either disorder than sufferers of either disorder without a co-morbid disord er. To review the current state of the management of this disorder, ev idence of the prevalence of this co-morbid condition in clinical and c ommunity populations is examined, then the theoretical mechanisms that might explain this connection are reviewed. A comparison of the few t reatment studies of co-morbid alcohol and anxiety disorders shows a li mited number of pharmacological treatment trials and no psychotherapy outcome trials. This review shows that it is no longer sustainable to conceptualize co-morbidity of alcohol and anxiety disorders as a unita ry concept, i.e. lumping alcohol-related and anxiety disorders as one global condition, but as separate distinct combinations of particular anxiety disorders, e.g. alcohol dependence and panic disorder, alcohol dependence and generalized anxiety disorder. The recommended treatmen t approach, supported by the evidence, is to offer separate and parall el therapy fbr the alcohol-related and anxiety disorder, until empiric al evidence from treatment outcome studies suggest otherwise. There is an urgent need to conduct treatment outcome research for the subtypes of co-morbid alcohol and anxiety disorders.