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Anxiety and depression among patients with alcohol dependence: co-morbid or substance-related problems?

Published online by Cambridge University Press:  10 July 2017

C. Gallagher ,
Z. Radmall ,
C. O’Gara  and
T. Burke
C. Gallagher*
Affiliation:
Department of Psychology, Saint John of God Hospital, Stillorgan, Co. Dublin, Ireland Department of Psychology, Saint John of God Menni Services, Islandbridge, Dublin, Ireland School of Psychology, University College Dublin, Dublin, Ireland
Z. Radmall
Affiliation:
Department of Psychology, Saint John of God Hospital, Stillorgan, Co. Dublin, Ireland
C. O’Gara
Affiliation:
Addictions Unit, Saint John of God Hospital, Stillorgan, Co. Dublin, Ireland School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
T. Burke
Affiliation:
School of Psychology, University College Dublin, Dublin, Ireland School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin, Ireland
*
*Address for correspondence: Dr C. Gallagher, Department of Psychology, Saint John of God Hospital, Stillorgan, A94 FH92 Co. Dublin, Ireland. (Email: [email protected])
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Abstract

Objectives

There are conflicting reports on the levels of anxiety and depression in individuals with alcohol problems and whether these conditions are substance-related or independent of the alcohol problem. The aim of this study was to characterise rates of co-morbid psychiatric symptoms among a group of individuals commencing treatment for alcohol dependence, and to examine the stability of these symptoms following treatment of the alcohol problem.

Methods

Symptoms of anxiety and depression were examined in a group of individuals (n=93) undergoing residential treatment for alcohol dependence. Symptoms were measured at treatment entry and again at treatment completion using the Beck Anxiety Inventory and the Beck Depression Inventory – II.

Results

High levels of anxiety and depressive symptoms were reported at treatment entry, but on completion of treatment (28 days later) the majority of participants were no longer reporting symptoms suggestive of a possible co-morbid condition.

Conclusions

The significant change in rates of reported symptoms following completion of treatment suggests that a large proportion of symptoms reported at treatment entry were substance related. Diagnosing co-morbid conditions is best left until after a period of abstinence during which the alcohol problem has been treated. Assessing for co-morbidity at time of treatment seeking is likely to result in inappropriate co-morbid diagnoses being made and inappropriate or unnecessary treatments being prescribed for such individuals.

Keywords

Alcohol co-morbidityalcohol-induced disordersalcohol-related disorders, anxietydepression
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 35 , Issue 2 , June 2018 , pp. 121 - 126
Copyright
© College of Psychiatrists of Ireland 2017 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Babor, TF, Higgins-Biddle, JC, Saunders, JB, Monteiro, MG (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care Settings, 2nd edn. WHO: Geneva.Google Scholar
Beck, AT, Epstein, N, Brown, G, Steer, RA (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893–897.Google Scholar
Beck, AT, Steer, RA (1990). Beck Anxiety Inventory. Psychological Corporation: San Antonio, TX.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1996). Beck Depression Inventory – II. Psychological Corporation: San Antonio, TX.Google Scholar
Dent, HR, Salkovskis, PM (1986). Clinical measures of depression, anxiety and obsessionality in nonclinical populations. Behaviour Research and Therapy 24, 689–691.CrossRefGoogle Scholar
Di Sclafani, V, Finn, P, Fein, G (2008). Treatment-naive active alcoholics have greater psychiatric comorbidity than normal controls but less than treated abstinent alcoholics. Drug and Alcohol Dependence 98, 115–122.CrossRefGoogle ScholarPubMed
Fein, G, Di Sclafani, V, Finn, P, Scheiner, DL (2007). Sub-diagnostic psychiatric comorbidity in alcoholics. Drug and Alcohol Dependence 87, 139–145.CrossRefGoogle ScholarPubMed
Gossop, M, Marsden, J, Stewart, D (2006). Remission of psychiatric symptoms among drug misusers after drug dependence treatment. Journal of Nervous and Mental Disorders 194, 826–832.Google Scholar
Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Dufour, MC, Compton, W, Pickering, RP, Kaplan, K (2006). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Research and Health 29, 107–120.Google Scholar
Grant, BF, Stinson, FS, Hasin, DS, Dawson, DA, Chou, SP, Dufour, MC, Compton, W, Pickering, RP, Kaplan, K (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 807–816.Google Scholar
McCrady, BS (2006). Alcohol and other substance-use problems. In The Handbook of Adult Clinical Psychology: An Evidence-based Practice Approach (ed. A. Carr and M. McNulty), pp. 766–840. Routledge: Hove, England.Google Scholar
O’Connell, D, Beyser, E (2002). Managing the Dually Diagnosed Patient: Current Issues and Clinical Approaches. Haworth Press: New York.Google Scholar
The Psychological Corporation (2001). WTAR: Wechsler Test of Adult Reading. Psychological Corporation: San Antonio, TX.Google Scholar
Ramirez, J (2002). Chemical addictions and anxiety disorders: when adaptive mechanisms go awry. In Managing the Dually Diagnosed Patient: Current Issues and Clinical Approaches (ed. D. O’Connell and E. Beyser), pp 239–286. Haworth Press: New York.Google Scholar
Reeve, BW (2002). A guide to the assessment of psychiatric symptoms in the addictions treatment setting. In Managing the dually diagnosed patient: Current Issues and Clinical Approaches (ed. D. O’Connell and E. Beyser), pp 189–211. Haworth Press: New York.Google Scholar
Rosenthal, RN, Westreich, L (1999). Treatment of persons with dual diagnoses of substance-use disorder and other psychological problems. In Addictions: A Comprehensive Guidebook (ed. B. S. McCrady and E. E. Epstein), pp 439–476. Oxford University Press: London.Google Scholar
Rush, AJ, First, MB, Blacker, D (2008). Handbook of Psychiatric Measures, 2nd edn. American Psychiatric Publishing: London.Google Scholar
Seignourel, PJ, Green, C, Schmitz, JM (2008). Factor structure and diagnostic efficiency of the BDI-II in treatment-seeking substance users. Drug and Alcohol Dependence 93, 271–278.Google Scholar
World Health Organisation (2001). The World Health Report. WHO: Geneva.Google Scholar