Generalized anxiety disorder is under-recognized in clinical practice in patients with alcohol dependence in France

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Alcohol (Fayetteville, N.Y.) (Impact Factor: 2.01). 10/2012; 47(1). DOI: 10.1016/j.alcohol.2012.08.008
Source: PubMed


Generalized Anxiety Disorder (GAD) is a frequent disabling disorder that often occurs with alcohol dependence. However comorbidity between substance use disorders and psychiatric disorders is often under-diagnosed. This study tried to evaluate an under-recognition of GAD by clinicians in alcoholic inpatients. Two groups of alcohol-dependent inpatients, hospitalized in the same non-academic psychiatric hospital in France, were included. The first group (Group 1) (n = 205) was included retrospectively within all patients hospitalized for alcohol dependence from may to November 2007. A record review was performed to determine the number of GAD (and other psychiatric disorders) diagnosis which was reported on these files by the clinicians. The second group (Group 2) (n = 199) was included prospectively from May to November 2008. GAD diagnosis was screened with the Worry and Anxiety Questionnaire and then confirmed with the Mini International Neurodiagnostic Interview. The two groups were similar in terms of social and demographic variables. GAD prevalence rate was significantly higher in Group 2 (30.7% with Confidence Interval [0.242; 0.371]) than in Group 1 (2.4% with Confidence Interval [0.003; 0.045]). This study confirms our hypothesis of an under-recognition of GAD by clinicians in alcohol dependant inpatients. It also confirms the high prevalence rate of comorbidity between alcohol dependence and GAD.

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    • "As for anxiety, men who are substance users have greater anxiety on average than men who were not users. The relationship between substance use and anxiety is known (Cardoso-Moreno & Tomás-Aragonés, 2013; Charriau et al., 2013; Córdova & García, 2011). Men who are substance users scored statistically significantly higher on both state anxiety and trait anxiety than nonusers. "
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    • "The association of alcohol drinking patterns and anxiety disorders is well recognized. Evidence indicates that anxiety disorders may cause and aggravate alcohol intake and vice versa (Smail et al. 1984; Himle and Hill 1991; Lotufo-Neto and Gentil 1994; Allan 1995; Kessler et al. 1997; Kushner et al. 2000; Singh et al. 2005; Charriau et al. 2012). The relationship of phobic disorders, especially social anxiety, and alcohol consumption has been emphasized (Morris et al. 2005; Blumenthal et al. 2010; Schneier et al. 2010; Buckner and Matthews 2012). "
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