Thomas Paparrigopoulos, Eleftherios Mellos and Ioannis Liappas
Athens University Medical School, 1st Department of Psychiatry, Eginition Hospital, Athens, Greece
Comorbidity of Depression and Alcohol Use Disorders. Hauppauge, New York: Nova Science Publishers, 2009, 198 pages.
Alcohol use disorders are often accompanied by symptoms of other major psychiatric syndromes which may precede, follow, or be concurrent but independent of alcohol misuse. Epidemiological and clinical studies provide evidence that at least two-thirds of alcohol abusing individuals present with clinically significant symptoms of anxiety, sadness, mania-like conditions, other substance use disorders and antisocial behaviours. Affective disorders, including major depression, dysthymia or bipolar disorder, have been shown to be among the most frequent psychiatric disorders that co-occur with alcohol dependence. It is reported that in community samples there is a 2- to 4-fold greater lifetime risk for developing one disorder when the other disorder is present and that this risk is even higher in treatment settings. The co-occurrence of affective and alcohol disorders aggravates the clinical course, treatment outcome, and prognosis for each one of them. Individuals with both disorders have significantly increased rates of alcohol relapse, more severe symptoms, increased suicide risk, poorer treatment compliance and response, severe social and occupational impairment and disability, and consequently higher health services costs. In this context, a growing literature related to the treatment of comorbid depression and alcohol dependence has developed during the last decade, which suggests that antidepressants could be of help in the management of depressed alcoholics.