Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-27T21:37:17.263Z Has data issue: false hasContentIssue false

Alcohol Dependence and Phobias: Clinical Description and Relevance

Published online by Cambridge University Press:  29 January 2018

J. A. Mullaney
Affiliation:
St. Nicholas Hospital, Gosforth, Newcastle upon Tyne, NE3 3XT; Newcastle AHA(T)
C. J. Trippett
Affiliation:
Parkwood House, Alcohol and Drug Dependence Unit, St. Nicholas Hospital, Gosforth, Newcastle upon Tyne Received 22 December 1978

Summary

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-telated problems and physical dependence significantly more frequently than the converse.

The prevalence of agoraphobia and social 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.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1979 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agras, S., Sylvester, D. & Oliveau, D. (1969) The epidemiology of common fears and phobias. Comprehensive Psychiatry, 10, 151–6.Google Scholar
Barraclough, B., Bunch, J., Nelson, B. & Sainsbury, P. (1974) A hundred cases of suicide: clinical aspects. British Journal of Psychiatry, 125, 355–73.Google Scholar
Bates, H. D. (1970) Predictive power of the reinforcement survey schedule; near null results. Newsletter of Research in Psychology, 12, 113–6.Google Scholar
Bryant, B., Trower, P., Yardley, K., Urbieta, H., & Letemendia, F. J. (1976) A survey of social inadequacy among psychiatric outpatients. Psychological Medicine, 6, 101–12.Google Scholar
Calef, V. (1967) Alcoholism and ornithophobia in women. Psychoanalytic Quarterly, 36, 584–7.CrossRefGoogle ScholarPubMed
Curlee, J. & Stern, H. (1973) The fear of heights among alcoholics. Bulletin of the Menninger Clinic, 37, 615–23.Google ScholarPubMed
Delhees, K. H. & Cattell, R. B. (1971) A manual for the clinical analysis questionnaire (CAQ). IPAT, 1602 Coronado Drive, Champagne, Illinois USA. Google Scholar
Demaree, R. G. (1972) Fear Survey Schedule in O.K. Buros (ed.). The Seventh Mental Measurements Yearbook, Highland Park, NJ. Gryphon Press.Google Scholar
Derogate, L. R., Lipman, R. S. & Covi, L. S. (1973) SCL-90-R an outpatient psychiatric rating scale: preliminary report. Psycho-pharmacology Bulletin, 9, 13.Google Scholar
Edwards, G., Chandler, J., & Hensman, C. (1972) Drinking in a London suburb. I. Correlates of normal drinking. Quaterly Journal of Studies of Alcohol, Supplement No 6, p 69.CrossRefGoogle Scholar
Edwards, G., Hawker, A., Hensman, C., Peto, J., Williamson, V. (1973) Alcoholics known or unknown to agencies. Epidemiological studies in a London suburb. British Journal of Psychiatry, 123, 169–83.Google Scholar
Errera, P. & Coleman, J. V. (1963) A long-term follow-up study of neurotic patients in a psychiatric clinic. Journal of Nervous and Mental Diseases, 136, 267.Google Scholar
Frazier, S. H. & Carr, A. C. (1967) Phobic reactions. In Comprehensive Textbook of Psychiatry (eds. Freedman, A. M. and Kaplan, H. I.). Baltimore: Williams and Wilkins.Google Scholar
Greer, J. H. (1965) The development of a scale to measure fear. Behaviour Research and Therapy, 3, 4553.CrossRefGoogle Scholar
Hore, B. D. (1971) Factors in alcoholic relapse. British Journal of Addiction, 66, 89.Google ScholarPubMed
Hore, B. D. & Smith, E. (1975) Who goes to alcoholism treatment units? British Journal of Addiction, 70, 263.Google Scholar
Kerr, T. A., Roth, M. & Schapira, K. (1974) Prediction of outcome in anxiety states and depressive illness. British Journal of Psychiatry, 124, 125–33.Google Scholar
Kessel, N. (Chairman) (1978) Report by Advisory Committee on Alcoholism. Department of Health and Social Security, Elephant and Castle, London.Google Scholar
Klein, D. F. & Fink, M. (1962) Psychiatric reaction patterns to imipramine. American Journal of Psychiatry, 119, 432.CrossRefGoogle ScholarPubMed
Lang, P. J. & Lazovik, A. D. (1963) Experimental desensitisation of a phobia. Journal of Abnormal Psychology, 66, 519–25.Google Scholar
Marks, I. M., Birley, J. R. T. & Gelder, M. G. (1966) Modified leucotomy in severe agoraphobia, a controlled serial inquiry. British Journal of Psychiatry, 112, 757–69.CrossRefGoogle ScholarPubMed
Merseyside, Lancashire and Cheshire Council on Alcoholism (1977) Fourteenth Annual Report.Google Scholar
Miller, W. R. (1976) Alcoholism scales and objective assessment methods: a review. Psychological Bulletin, 83, 649–74.Google Scholar
Mullaney, J. A. (1979) MD Thesis (in preparation). University College, Dublin.Google Scholar
Quitkin, F. M. et al (1972) Phobic anxiety syndrome complicated by drug dependence and addiction, a treatable form of drug abuse. Archives of General Psychiatry, 27, 159–62.Google Scholar
Ross, S. M. (1973) Fear reinforcing activities and degree of alcoholism. Quarterly Journal of Studies of Alcohol, 34, 823–8.Google Scholar
Ruff, C. F., Ayres, J. L., Simon, S. E. & Templer, D. I. (1976) The fear of heights among alcoholics: additional data relevant to the Curlee and Stern study. Bulletin of the Menninger Clinic, 40, 162–3.Google Scholar
Schapira, K., Kerr, T. A. & Roth, M. (1970) Phobias and affective illness. British Journal of Psychiatry, 117, 2532.Google Scholar
Schmidt, W. & De Lint, J. (1970) Estimating the prevalence of alcoholism from alcohol consumption and mortality data. Quarterly Journal of Studies of Alcohol, 31, 957–64.CrossRefGoogle ScholarPubMed
Selzer, M. L. (1971) The Michigan alcoholism screening test: the quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 1653–8.CrossRefGoogle ScholarPubMed
Tyrer, P. (1976) Towards rational therapy with monoamine-oxidase inhibitors. British Journal of Psychiatry, 128, 354–60.Google Scholar
Whitlock, P. R., Overall, J. E. & Patrick, J. H. (1971) Personality patterns and alcohol abuse in a state hospital population. Journal of Abnormal Psychology, 78, 916.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Winokur, G., Clayton, P. J. & Reich, T. (1969) Manic Depressive Illness. St. Louis.Google Scholar
Wolpe, J. & Lang, P. J. (1964) A fear survey schedule for use in behaviour therapy. Behaviour Research and Therapy, 2, 2730.Google Scholar
Woodruff, R. H., Guze, S. B. & Clayton, P. J. (1972) Anxiety neurosis among psychiatric outpatients. Comprehensive Psychiatry, 13, 165–70.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.