Differences in help seeking rates after brief intervention for alcohol use disorders in general practice patients with and without comorbid anxiety or depressive disorders

Abstract

To examine, if the utilization of help for problematic drinking after brief intervention (BI) differs between general practice (GP) patients with and without comorbid depression or anxiety disorders. Longitudinal data of 374 GP patients, who met the diagnostic criteria of alcohol dependence or abuse according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and criteria of at-risk drinking or binge drinking, were drawn from a randomized controlled BI study. Participants were randomly allocated to either a control or one of two intervention groups, receiving a series of alcohol related BI. Of the sample, 88 participants were diagnosed with comorbid anxiety and/or depressive disorders. At 12-months follow-up, differences in utilization of formal help for drinking problems were assessed between comorbid and non-comorbid individuals. BI were significantly related to an increase in utilization of formal help in non-comorbid patients (chi(2 )= 4.54; df = 1; p < 0.05) but not in comorbid individuals (chi(2 )= 0.40; df = 1; p = 0.60). In a logistic regression analysis, comorbidity [odds ratio (OR) = 1.81; 95% confidence interval (CI) = 1.14-2.88; p = 0.01) and previous help seeking (OR = 15.98; CI = 6.10-41.85; p < 0.001) were found to be positive predictors for utilization of formal help. BIs do not seem to significantly support help-seeking in the comorbid. As comorbid anxiety and depression constitute a positive predictor for help-seeking, individuals with problematic drinking and comorbid anxiety or depressive disorders might benefit from more specialized support exceeding the low level of BI.