title: Depression and social phobia secondary to alcohol dependence.
abstract: BACKGROUND
  According to the self-medication hypothesis, individuals with depression and anxiety disorders use alcohol to control their symptoms and subsequently become dependent. Conversely, alcohol dependence disorder (ADD) can cause or exacerbate psychiatric disorders. This study analyzed the characteristics of depression and social phobia secondary to ADD. (1) What is their functional impact? (2) Are they independent or associated conditions? (3) Do they completely remit in abstinent individuals? (4) Is the remission of one disorder associated with the remission of the other disorder?
  
  
  METHODS
  Sixty-four inpatients with ADD were evaluated with depression and anxiety disorder scales upon admission to hospital and after 5 weeks of detoxification.
  
  
  RESULTS
  Baseline comparisons differentiated patients with a Hamilton Rating Scale for Depression (HDRS) score > 35 (n = 50; 78%) from those with an HDRS score < or = 35 by higher levels of generalized anxiety and lower global functioning. Patients with generalized social phobia [Leibowitz Social Anxiety Scale (LSAS) score > 60: n = 20; 31.2%] were not distinguishable from those with an LSAS score < or = 60 by depressive and anxiety disorder symptoms. In postdetoxification assessment, patients who remitted from depression (HDRS score < 7: n = 35; 54.6%) had a lower generalized anxiety and marginally higher levels of hypochondriasis compared to nonremitter subjects (HDRS score > or = 7). Patients who remitted from social phobia (LSAS score < 30: n = 32; 50%) did not significantly differ from nonremitter subjects in depressive and anxiety disorder symptoms. Generalized anxiety (Hamilton Rating Scale for Anxiety) and hypochondriasis (Whiteley Index) were the significant predictors of global functioning (Global Assessment Scale).
  
  
  CONCLUSIONS
  Depression and social phobia secondary to ADD are independent conditions that do not completely remit after cessation of drinking. Specific treatments are needed to reduce residual depressive and anxiety symptoms in abstinent alcoholics.
authors.affiliation: Institute of Psychiatry, University of Bologna, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Olgiati
authors.forename: Ioannis
authors.initials: I
authors.lastname: Liappas
authors.forename: Petros
authors.initials: P
authors.lastname: Malitas
authors.forename: Christina
authors.initials: C
authors.lastname: Piperi
authors.forename: Antonis
authors.initials: A
authors.lastname: Politis
authors.forename: Elias O
authors.initials: EO
authors.lastname: Tzavellas
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Zisaki
authors.forename: Barbara
authors.initials: B
authors.lastname: Ferrari
authors.forename: Diana
authors.initials: D
authors.lastname: De Ronchi
authors.forename: Anastasios
authors.initials: A
authors.lastname: Kalofoutis
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000523:psychology*; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010698:Phobic Disorders / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012044:Regression Analysis