Depressed Patients With Co-Occurring Alcohol Use Disorders

重性抑郁障碍 精神科 酒精使用障碍 萧条(经济学) 冲动性 酗酒 共病 自杀未遂 药物滥用 侵略 临床心理学 重性抑郁发作 医学 心理学 毒物控制 家族史 伤害预防 内科学 心情 医疗急救 生物化学 化学 经济 宏观经济学
作者
Leo Sher,Barbara Stanley,Jill M. Harkavy-Friedman,Juan J. Carballo,Mikkel Arendt,David A. Brent,Dahlia Sperling,Dana Lizardi,J. John Mann,Maria A. Oquendo
出处
期刊:The Journal of Clinical Psychiatry [Physicians Postgraduate Press, Inc.]
卷期号:69 (6): 907-915 被引量:55
标识
DOI:10.4088/jcp.v69n0604
摘要

Alcohol use and depressive disorders are frequently comorbid. Few studies have assessed the impact of comorbid alcohol use disorders (AUDs) on clinical aspects of major depression. We compared depressed subjects with and without co-occurring AUDs with respect to demographic and clinical parameters.505 individuals participated. 318 subjects had DSM-IV major depressive disorder (MDD) without a history of any alcohol or substance abuse/dependence (MDD only), and 187 individuals had MDD and a history of alcohol abuse/dependence (MDD/AUD). Demographic, clinical, and psychiatric history measures of patients in the 2 groups were examined and compared. The study was conducted from January 1990 to June 2005.MDD/AUD patients were younger at their first psychiatric hospitalization (p = .014), their first major depressive episode (p = .041), and their first suicide attempt (p = .001). They reported more previous major depressive episodes (p = .001), suicide attempts (p = .001), and recent life events (p = .001); and had higher lifetime aggression (p < .001), impulsivity (p < .001), and hostility (p < .001) scores. MDD/AUD patients were also more likely to report tobacco smoking (p < .001), a lifetime history of abuse (p = .004), and a history of AUD among first-degree relatives (p < .001) compared to MDD only patients. MDD/AUD individuals also had higher childhood (p < .001), adolescent (p < .001), and adult (p < .001) aggression scores and reported more behavioral problems during their childhood compared to their counterparts. Logistic regression analysis demonstrates that the number of previous depressive episodes, lifetime aggression, and smoking drive the difference between the groups.Our findings suggest that comorbid MDD/AUD may result from worse antecedents and lead to early onset, more comorbidity, and a more severe course of illness.
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