ALCOHOL DEPENDENCE AND PHOBIAS - CLINICAL DESCRIPTION AND RELEVANCE

Of 102 alcoholics admitted to an alcoholism treatment unit one third (33) were clinically rated as having disabling agoraphobia and/or social phobia, and a further third (37) as having less disabling phobic symptoms of either or both kinds. Questionnaires and self-report symptom scales were used to validate the clinical ratings. Alcohol problem screening tests and consumption levels confirmed the severity of alcohol dependence. In a group of 44 phobic alcoholics who reported physical dependence, the onset of phobic symptoms preceded the onset of alcohol-related problems and physical dependence significantly more frequently than the converse. The prevalence of agoraphobia and soial phobia in alcoholics is discussed in relation to prevalence data in affective and normal populations, together with their implications for the aetiology of phobias and alcohol dependence, and for screening and assessment of phobic alcoholics, preventative counselling, treatment approaches and prognosis.