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Because psychiatric illnesses and problematic alcohol use frequently co-occur and heavy alcohol use can exacerbate depression and anxiety, mental health clinicians should perform alcohol-use screenings. The aim of this study was to determine if psychiatric patients would be accepting of their mental health clinician screening them for heavy alcohol use. Using a written survey, patients rated their levels of agreement with 9 statements regarding opinions about alcohol screening by their mental-health providers. They also completed the Alcohol Use Disorders Identification Test-C (AUDIT-C), a screening instrument for heavy alcohol use. One hundred fifty-four patients were surveyed in 2 psychiatric outpatient clinics. Nearly 40% screened positively for heavy alcohol use on the AUDIT-C. Nearly 8 out of 10 psychiatric patients were in favor of being screened for alcohol use by either self-report or biomarkers, independent of AUDIT-C status and gender. Thus, mental health clinicians should not be deterred from alcohol screening by perceived negative attitudes from patients. (Contains 1 figure and 1 table.)

Social anxiety disorder--an excessive fear of social situations, such as eating or speaking in public--affects 2 to 13 percent of the U.S. population. About one-fifth of patients with social anxiety [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2008.12.011 Byline: Sarah W. Book, Suzanne E. Thomas, Jared P. Dempsey, Patrick K. Randall, Carrie L. Randall Keywords: Social anxiety; Substance-related disorders; Alcoholism; Alcoholics Anonymous; Patient participation; Client participation Abstract: Individuals with social anxiety have difficulty participating in group settings. Although it makes intuitive sense that social anxiety could present a challenge in addiction treatment settings, which often involve small groups and encouragement to participate in self-help groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), to our knowledge no study has yet assessed the impact of shyness on the treatment experience. Assessment surveys were given to 110 individuals seeking intensive outpatient substance abuse treatment at three community treatment programs. Established cut-offs for presence of clinically-significant social anxiety indicated a prevalence of 37%. Controlling for depression and worry, social anxiety was a unique predictor of endorsement that shyness interfered with willingness to talk to a therapist, speak up in group therapy, attend AA/NA, and ask somebody to be a sponsor. Socially anxious substance abusers were 4-8 times more likely to endorse that shyness interfered with addiction treatment activities. These findings have clinical and research implications. Author Affiliation: Charleston Alcohol Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, 4 North, MSC 861, Charleston, SC 29425, United States

Social anxiety is a very common disorder and is especially common among individuals with substance abuse or dependence (substance use disorders [SUDs]). Several epidemiologic surveys have estimated the prevalence of [...]

The article discusses accumulated research and clinical focus on comorbid anxiety and substance use disorders, which has provided important insights into the prevalence, development and maintenance patters, clinical impact, and treatment considerations for these intertwined psychiatric problems. Anxiety and substance use disorders are among the most frequent psychiatric problems in the U.S., with lifetime rates of 28.8% and 14.6%, respectively. Critical components of the treatment include psychotherapy and pharmacotherapy.

Objectives: Psychiatric comorbidity likely complicates the treatment of alcoholism. Studies of alcoholics with and without co-occurring anxiety disorders suggest that the presence of an anxiety disorder can significantly impact alcoholism treatment efficacy and can increase subsequent alcohol relapse rates. The objective of this study was to estimate the long-term relapse rates and costs associated with treating an alcoholic with an anxiety disorder. Methods: We have used a Markov model to create a virtual clinical trial to predict and compare long-term outcomes in alcoholics with and without a co-occurring anxiety disorder. We have also incorporated the subsequent associated costs of the two subject groups. Results: In our model, at the end of live years, 34% of our hypothetical group of 100 alcoholics with an ameliorated anxiety disorder remained abstinent compared to only 8% of the 100 alcoholics with an untreated anxiety disorder. Furthermore, the costs associated with these relapses are greater for the untreated group, after factoring in the costs of anxiety treatment in the treated group, even if only 50% of the anxiety treated group gets amelioration of their anxiety disorder. Conclusion: Our results suggest that addressing co-occurring anxiety disorders in an alcohol treatment setting may have a dramatic impact on alcohol relapse and its associated costs. [ABSTRACT FROM AUTHOR]

The article discusses the diagnosis and treatment of substance abuse and social anxiety disorders. According to the findings of epidemiologic surveys, the prevalence of social anxiety disorder in the general population was estimated between 3 to 13 percent. Neurotransmitter dopamine is one potential neurobiological link between the anxiety disorder and substance dependence. It also suggests approaches to treating both disorders.

Objectives: Alcohol consumption affects sleep both in healthy populations and in patients with alcohol use disorder (AUD). However, sleep has typically not been considered within AUD pharmacotherapy trials. We used data from a completed gabapentin clinical treatment trial to explore the medication's effect on patient-rated insomnia measured by a standard insomnia rating (Insomnia Severity Index [ISI]) and whether this influenced gabapentin's effects on alcohol consumption., Methods: This study included 90 individuals with current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition AUD criteria reporting current or past alcohol withdrawal. Participants were assigned to placebo or gabapentin (up to 1200 mg/day) for a 16-week randomized controlled trial with percent heavy drinking days (PHDD) and percent abstinent days (PDA) as outcomes. Utilizing mixed-effects models, this study assessed medication effects on ISI over the trial. We then examined the interaction of baseline ISI and medication on drinking. Finally, given our previous finding of alcohol withdrawal influencing gabapentin efficacy, we added change in ISI as a potential "moderator" of the interaction of medication effects and alcohol withdrawal on drinking., Results: Sleep (ISI) improved more in those treated with gabapentin (60.6% reduction) compared with placebo (37.8% reduction; P = 0.013). Higher baseline ISI predicted drinking in gabapentin-treated individuals (lower PHDD [ P = 0.026] and higher (PDA [ P = 0.047]). ISI was an independent predictor of PHDD decrease and PDA increase ( P < 0.001; P = 0.002), but this did not significantly moderate gabapentin's effectiveness., Conclusions: Although gabapentin positively impacts both alcohol use and sleep, its effect on drinking is not fully dependent on sleep improvement, implying a direct biological mechanism on alcohol use., Competing Interests: In the past 3 years, Dr Anton has been a consultant for: Alkermes, Beam Therapeutics, Denovo, Dicerna, Foxo Bioscience, Imbrium, Kinnov Therapeutics, Laboratorio Farmaceutico C.T., Otsuka, Pear Therapeutics, Sobrera, Sophrozyne Pharma, and Phi Life Sciences. In the past 36 months, the Alcohol Trial Initiative (ACTIVE), of which Dr Anton is a member and chair, was supported by Alkermes, Pear Therapeutics, Dicerna, Ethypharm, Indivior, Kinnov Therapeutics, and Otsuka. Dr Prisciandaro has been a consultant for Labortorio Farmaceutico C.T. The other authors report no conflicts of interest., (Copyright © 2024 American Society of Addiction Medicine.)