31st January 2024

Differential diagnosis

The table below summarises some of the psychiatric disorders that can develop due to/alongside heavy alcohol use:

Condition	Summary
Anxiety	Specific subtypes often seen in those with alcohol dependency are PTSD, social anxiety and panic disorder. Alcohol-induced presentations tend to have more acute onset and resolution without intervention other than abstinence. Those with independent presentations may find symptoms developed before heavy alcohol intake or persistent even with sobriety.
Depression	This can occur as a direct result of alcohol only or, for some, prior to/alongside heavy alcohol use. Compared to those with independent presentations of depression, alcohol-induced depression may be less associated with a family history of depression and suicidal ideation.
Personality disorders	There is evidence that people with alcohol dependence are more likely to also have a comorbid personality disorder.
Bipolar	It can be difficult to distinguish independent presentations of bipolar disorder with alcohol-induced presentations, because of the effect of alcohol on mood and the similarities between the behaviours exhibited, e.g., pursuing pleasurable activities despite negative associated consequences.
Psychosis	As described on page 5, alcohol-induced psychosis can also be termed alcohol hallucinosis.

Source: Adapted from: Shivani R, Goldsmith RJ, Anthenelli RM. Alcoholism and psychiatric disorders: Diagnostic challenges [Internet]. Alcohol Research & Health. National Institute on Alcohol Abuse and Alcoholism; 2002 [cited 2022Dec3]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683829/

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