The aim of this study was to evaluate the change of psychological distress measured by the symptom checklist in alcohol dependent inpatients during treatment and at follow-up. In addition, psychological distress as a predictive variable for abstinence or relapse during a 1-year follow-up was investigated. In a sample of 314 alcohol-dependent inpatients, we found a statistically significant reduction of psychological distress during therapy. Comparison of patients within 1-year follow-up showed a significant reduction of psychological distress only for the later abstinent subgroup. Later abstinent patients were significantly less distressed at the end of therapy and at follow-up. Logistic regression indicated that a higher Global Severity Index (GSI) of psychological distress at the end of therapy increases the relapse risk.