Leo Sher, M.D.

Ten years ago, our research paper, “Depressed patients with co-occurring alcohol use disorders: a unique patient population” was published in the Journal of Clinical Psychiatry (1). We compared depressed subjects with and without co-occurring alcohol use disorder with respect to demographic and clinical parameters.

505 individuals were enrolled in the study. 318 subjects who had major depressive disorder without a history of any alcohol or substance abuse/dependence were compared to 187 individuals who had major depressive disorder and a history of alcohol abuse/dependence.

Individuals with major depressive disorder and a history of alcohol abuse/dependence were younger at their first psychiatric hospitalization, their first major depressive episode, and their first suicide attempt. They reported more previous major depressive episodes, suicide attempts, and recent life events; and had higher lifetime aggression, impulsivity, and hostility scores. Patients with major depressive disorder and a history of alcohol abuse/dependence were also more likely to report tobacco smoking, a lifetime history of abuse, and a history of alcohol use disorder among first-degree relatives compared to patients who had major depressive disorder without a history of any alcohol or substance abuse/dependence. Patients with major depressive disorder and a history of alcohol abuse/dependence also had higher childhood, adolescent, and adult aggression scores and reported more behavioral problems during their childhood compared to their counterparts. The percentages of patients with major depressive disorder and a history of alcohol abuse/dependence who began drinking/using drugs before ages 13 and 18 were 8.6% and 48.8%, respectively. Logistic regression analysis demonstrated that the number of previous depressive episodes, lifetime aggression, and smoking drive the difference between the groups.

Our findings suggest that patients with major depressive disorder and a history of alcohol abuse/dependence represent a unique patient population that may need to be studied separately in order to reduce morbidity and mortality in individuals with comorbid major depressive and alcohol use disorders.

Reference

1. Sher L, Stanley BH, Harkavy-Friedman JM, Carballo JJ, Arendt M, Brent DA, Sperling D, Lizardi D, Mann JJ, Oquendo MA. Depressed patients with co-occurring alcohol use disorders: a unique patient population. J Clin Psychiatry 2008; 69(6): 907-15.