The study used the methodology of randomly allocating case vignettes to a sample of British consultant psychiatrists to assess the influence of a past diagnosis of alcohol dependence on present treatment attitudes. The case vignettes either did or did not include the previous diagnosis of alcohol dependence and the sex of the 'case' was also randomized. Psychiatrists receiving the vignette with the diagnosis of alcohol dependence were more likely to rate the patient as difficult, annoying, less in need of admission, uncomplaint, having a poor prognosis and more likely to be discharged from follow-up. There was minimal sex difference. Psychiatrist with a special interest in addictions regarded people with a past diagnosis of alcohol dependence as less difficult to manage than their non-specialist colleagues. The implications for education and treatment are discussed.