Psychiatric disorders such as anxiety, depression, and bipolar disorder are common in patients who have alcohol dependence. Because of the similarities in symptoms of psychiatric disorders and those caused by alcohol dependence, differential diagnosis is often difficult, and therefore, one or both disorders may be left undiagnosed and untreated, resulting in poor outcomes. Furthermore, for those with co-occurring mental and addictive disorders, mental health treatment is also complicated by increased rates of nonadherence to medications and other treatments. This review covers the prevalence of co-occurring alcohol dependence and psychiatric disorders, problems associated with co-occurrence, and practical models for addressing alcohol dependence and relapse prevention by clinicians who treat mental disorders. In particular, an integrated treatment approach in which biological, psychological, and social support components are brought together to treat both disorders simultaneously into a single program is described as an effective strategy for treating patients with co-occurring alcohol dependence and psychiatric disorders.
Division of Addictions, Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, WA.
Received July 24, 2006; accepted after revision September 19, 2006.
Sources of support: Forest Laboratories, Inc, Janssen L.P., Bristol-Myers Squibb Company, Pfizer Inc, and Eli Lilly and Company.
Address correspondence and reprint requests to Richard K. Ries, MD, Division of Addictions, Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center 359911, 326 9th Avenue, Seattle, WA 98104. E-mail: firstname.lastname@example.org.