This diagnosis should only be used when anxiety symptoms are thought to be related to the direct physiological effects of alcohol. The symptomatology may involve anxiety, panic attacks, and phobias. Both alcohol-induced anxiety disorders and mood disorders can develop during intoxication, withdrawal, or up to 4 weeks after cessation of alcohol consumption. During intoxication or withdrawal, the diagnosis should only be given when the symptomatology clearly exceeds what would be expected from anxiety or depressive symptoms during a regular intoxication or withdrawal episode.
Anxiety disorders are among the most common groups of psychiatric disorders in the general population, with prevalence rates of up to 25 per cent. (6) In clinical studies between 20 and 70 per cent of patients with alcoholism also suffer from anxiety disorders. (7) On the other hand, between 20 and 45 per cent of patients with anxiety disorders also have histories of alcoholism.(8) However, it has been argued that the comorbidity figures are overestimated, because in some of the studies the focus was on drinking patterns rather than on alcohol dependence or they describe anxiety symptoms rather than disorders according to diagnostic criteria. (9) Family studies analysing the comorbidity of alcoholism and anxiety disorders might be a means of clarifying this controversy. For instance, in the Yale study the presence of anxiety disorders in the probands slightly increased the risk for alcohol dependence in their relatives, whereas alcohol dependence in the proband did not increase their relative's risk for anxiety disorders. (10) Similarly, Maier et al.(11) demonstrated an increased risk of alcoholism in probands with panic disorders, but not the reverse. Kendler et al.,(12) in a study of female twins, found evidence that common genetic factors may underlie both alcoholism and panic disorder.
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