SummaryA 12 year follow‐up study was carried out on a sample of 146 patients treated in hospital for neurosis. 10 per cent of these patients were found to show evidence of alcohol or drug abuse at follow‐up. These tended to be patients with worse social adjustment at the time of admission to hospital and they tended to have a much worse outcome at follow‐up than the rest of the ex‐neurotic patients. Severely neurotic patients are considered to be “at risk” for development of dependence and abuse. From studying individual case histories the progression from neurosis to dependence is d