Psychiatric Annals

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CME Article 

Anxiety Disorders with Comorbid Substance Use Disorders: Diagnostic and Treatment Considerations

Sudie E. Back, PhD; Kathleen T. Brady, MD, PhD

Abstract

Anxiety disorders, symptoms of anxiety, and substance use disorders (SUDs) commonly co-occur. The interactions between SUDs and anxiety are multifaceted and variable. Symptoms of anxiety often emerge during the course of chronic intoxication and withdrawal from a number of substances. Anxiety disorders are a risk factor for the development of SUDs and may modify the presentation and course of illness for SUDs. Similarly, SUDs may modify the presentation and course of anxiety disorders. In this article, co-occurring SUDs and anxiety disorders will be briefly reviewed, including prevalence, diagnostic issues, and treatment options.

ABOUT THE AUTHORS

Sudie E. Back, PhD; and Kathleen T. Brady, MD, PhD, are with the Clinical Neuroscience Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston.

Address correspondence to: Sudie E. Back, PhD, 67 President Street, PO Box 250861, Charleston, SC 29425; fax: 843-792-0528; or e-mail backs@musc.edu.

Dr. Back and Dr. Brady have disclosed no relevant financial relationships

EDUCATIONAL OBJECTIVES

  1. Understand the prevalence of co-occurring anxiety disorders and substance use disorders.
  2. List the major diagnostic considerations in assessing co-occurring anxiety disorders among individuals with substance use disorders.
  3. Demonstrate awareness of the pharmacologic and psychosocial treatments to date in this area.

Abstract

Anxiety disorders, symptoms of anxiety, and substance use disorders (SUDs) commonly co-occur. The interactions between SUDs and anxiety are multifaceted and variable. Symptoms of anxiety often emerge during the course of chronic intoxication and withdrawal from a number of substances. Anxiety disorders are a risk factor for the development of SUDs and may modify the presentation and course of illness for SUDs. Similarly, SUDs may modify the presentation and course of anxiety disorders. In this article, co-occurring SUDs and anxiety disorders will be briefly reviewed, including prevalence, diagnostic issues, and treatment options.

ABOUT THE AUTHORS

Sudie E. Back, PhD; and Kathleen T. Brady, MD, PhD, are with the Clinical Neuroscience Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston.

Address correspondence to: Sudie E. Back, PhD, 67 President Street, PO Box 250861, Charleston, SC 29425; fax: 843-792-0528; or e-mail backs@musc.edu.

Dr. Back and Dr. Brady have disclosed no relevant financial relationships

EDUCATIONAL OBJECTIVES

  1. Understand the prevalence of co-occurring anxiety disorders and substance use disorders.
  2. List the major diagnostic considerations in assessing co-occurring anxiety disorders among individuals with substance use disorders.
  3. Demonstrate awareness of the pharmacologic and psychosocial treatments to date in this area.

Anxiety disorders, symptoms of anxiety, and substance use disorders (SUDs) commonly co-occur. The interactions between SUDs and anxiety are multifaceted and variable. Symptoms of anxiety often emerge during the course of chronic intoxication and withdrawal from a number of substances. Anxiety disorders are a risk factor for the development of SUDs and may modify the presentation and course of illness for SUDs. Similarly, SUDs may modify the presentation and course of anxiety disorders. In this article, co-occurring SUDs and anxiety disorders will be briefly reviewed, including prevalence, diagnostic issues, and treatment options.

ABOUT THE AUTHORS

Sudie E. Back, PhD; and Kathleen T. Brady, MD, PhD, are with the Clinical Neuroscience Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston.

Address correspondence to: Sudie E. Back, PhD, 67 President Street, PO Box 250861, Charleston, SC 29425; fax: 843-792-0528; or e-mail backs@musc.edu.

Dr. Back and Dr. Brady have disclosed no relevant financial relationships

EDUCATIONAL OBJECTIVES

  1. Understand the prevalence of co-occurring anxiety disorders and substance use disorders.
  2. List the major diagnostic considerations in assessing co-occurring anxiety disorders among individuals with substance use disorders.
  3. Demonstrate awareness of the pharmacologic and psychosocial treatments to date in this area.

10.3928/00485713-20081101-01

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