Angeline Nguyen, Michael Mirbaba, Farrah Khaleghi and John Tsuang
Anxiety and alcohol use disorders (AUD) are highly comorbid and prevalent in the United States, yet optimal ways to diagnose and treat these co-occurring conditions have not been fully elucidated due to their inter-related features that create difficulties in determining causality of symptomatology. For instance, many clinicians struggle to distinguish whether or not recurrent withdrawal symptoms in AUD is causing anxiety, or anxiety is causing one to self-medicate with alcohol use. This complex set of the interactions between anxiety disorders and AUD has been associated with worsened outcomes for AUD and lower treatment retention in patients with co-morbid anxiety disorders. Given this, treatment of these co-morbid conditions must be thoughtfully planned and comprehensive to improve outcomes. It is critical that clinicians consider sequential, parallel, or integrated treatment modalities with respect to timing and deliverance of treatment. In this article, we will present a case study illustrating the multidimensional elements of co-morbid anxiety and AUD, and examine the current evidence regarding optimal treatment plans for patients with these dually-diagnosed conditions.
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