Agnes Massak and Kathryn Graham
Centre for Addiction and Mental Health, London, Ontario Department of Psychology, University of Western Ontario, London, Ontario, Canada
Comorbidity of Depression and Alcohol Use Disorders. Hauppauge, New York: Nova Science Publishers, 2009, 198 pages.

A relationship between depression and alcohol abuse/dependence has been found in both clinical and general population samples, generally focusing on a co-occurrence of the presence of depression and alcohol use disorders. Alcohol use disorders, however, are comprised of more than one dimension. The Institute of Medicine (IOM), for example, recommends that three dimensions be assessed to define an alcohol use disorder: hazardous drinking pattern, dependence symptoms, and harmful consequences from drinking. In these analyses, we examine the relationship between depression and each dimension of alcohol problems as well as the overall relationship between depression and level of alcohol problems. We also assess whether depression is more strongly related to subjective versus objective criteria for alcohol problems. Finally, coping motives have been found to be associated with both alcohol problems and depression. Therefore, we explore the extent that the relationship between depression and alcohol use disorder can be accounted for by coping motives for drinking. A representative sample of 14,063 Canadian men and women participated in a telephone interview about their alcohol use and general well-being. Depression in the last 12 months was measured using the Composite International Diagnostic Interview (CIDI). Alcohol use disorder was measured using the Alcohol Use Disorders Identification Test (AUDIT). Coping motives were measured using the Measure of Drinking Motives. The analyses were conducted separately for males and females. We found that depression was more strongly and more generally related to hazardous drinking pattern for women than for men, with depression associated with usual quantity consumed and frequency of drinking 5 or more drinks for women but only with drinking 5 drinks at least 5 days a week for men. Alcohol dependence symptoms and harmful consequences from drinking were significantly associated with depression for both men and women. Subjective items within each dimension, such as feelings of guilt, were more strongly related to depression than were more objective items, such as morning drinking. Coping motives for drinking were significantly associated with depression in multivariate models including the dimensions of alcohol use disorders, while measures of alcohol use disorders became nonsignificant, except the relationship between depression and harmful consequences which remained significant for women. These results suggest that although the relationship between depression and alcohol problems has been found to be quite robust, this relationship may be largely attributable to the association of coping motives with both alcohol problems and depression.