Affective and anxiety disorders and alcohol and drug dependence: diagnosis and treatment

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examines the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.