Co-occurrence of substance use disorders with anxiety disorders: Epidemiology, psychobiology, clinical features, and treatment

Symptoms of anxiety and anxiety disorders commonly co-occur with substance use disorders (SUDs). The interaction between these disorders is bidirectional: anxiety disorders may contribute to the development of SUDs and modify the presentation and the outcomes of treatment for SUDs; on the other hand, SUDs may modify the manifestation of anxiety disorders. Anxiety symptoms are also accompanied with intoxication or withdrawal symptoms. Studies in clinical samples and community surveys have demonstrated high rates of co-occurrence of anxiety disorders with alcohol and drug use disorders. In National Epidemiologic Survey on Alcohol and Related Conditions, 17.71% of respondents with any 12 month substance use disorder had at least one independent anxiety disorder and 14.96% of respondents with any 12-month anxiety disorder had at least one substance use disorder, during the same 12-month period. Despite the high prevalence rates, anxiety disorders are frequently under-diagnosed in substance abuse settings. However, it is clinically important while the outcome for each type of disorder is worse across clinical and psychosocial domains than for the disorders without comorbidity. Integrated treatment strategies including medications and psychosocial treatment perspectives are needed for co-occurring anxiety and substance disorders to improve outcome. © 2010 Nova Science Publishers, Inc. All rights reserved