Psychiatric symptoms in alcohol dependence: diagnostic and treatment implications.

Fifty consecutive alcohol dependent inpatient admissions are reported on. They were found to have grief, agoraphobic, paranoid and depressive symptoms secondary to the withdrawal state. These symptoms remitted with detoxification. Absence of anxiety signalled other disorders. Longituding observations aided diagnostic assessment and patient management. The history of the course of symptoms aids diagnoses when obtainable, but detoxification remains essential to discriminate primary from symptomatic or secondary psychiatric symptoms in the alcohol dependent person. Transient psychiatric symptoms may merely be less common forms of withdrawal symptoms and must not be confused with syndromes which attract ongoing drug treatment. This is a highly undesirable situation for those who are at risk of psychotropic drug abuse and overdose behaviour.