Diagnosis of anxiety and depressive states in alcohol dependence: agreement between clinical assessment and patient self-assessment

High-quality diagnostics of anxiety and depression is essential for adequate planning and implementation of interventions, prevention of relapse at the stages of remission formation in alcohol dependence. The aim of the study: to study the correspondence / inconsistency of self-assessment and clinical assessment of anxiety and depression in patients, and to analyze possible causes of discrepancies in assessments. Study material: 56 male patients with a diagnosis of F10.2; subgroups of "consistency of assessments", "predominance of self-assessment score", and "predominance of clinical assessment score" were identified, separately for anxiety and depression. A comparative intergroup analysis of characterological features and coping style of patients with different ratios of assessments was carried out. The results of the study reveal a high prevalence of discrepancies in assessments, more often in the direction of predominance of clinical assessment over self-assessment. A comparatively lower clinical assessment of symptoms is revealed in relation to patients with an exacerbation of characterological traits: individualism, pessimism, rigidity, as well as maladaptive coping (despair reactions and pessimistic forecasting in stressful situations). A comparatively higher clinical assessment was revealed in relation to patients with low values of these indicators and a more adaptive stress-coping. Conclusion: when assessing emotional disorders in patients with alcohol dependence, which are involved in the formation, maintenance and recurrence of this disorder, it is advisable to use the "dual diagnostics" system (self-assessment scales and clinical assessment by a doctor). It is necessary to compare and analyze the results and reasons for the discrepancy in assessments. This will increase the level of the intervention’s personalization by more accurately identifying the leading symptoms in the patient's condition at the stages of remission.

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