Alcoholism and affective disorder: Clinical course of depressive Symptoms

ArticleinAmerican Journal of Psychiatry 152(1):45-52 · February 1995with10 Reads
Impact Factor: 12.30 · DOI: 10.1176/ajp.152.1.45 · Source: PubMed

This study compared the severity of and the change in depressive symptoms among men with alcohol dependence, affective disorder, or both disorders during 4 weeks of inpatient treatment. After their primary and secondary psychiatric disorders were defined with the use of criteria based on chronology of symptoms, 54 unmedicated men entering treatment for alcohol dependence or affective disorder were assessed for 4 consecutive weeks with the Hamilton Depression Rating Scale. The findings indicate that the rate of remission of depressive symptoms was consistent with the primary diagnosis. Depressive symptoms remitted more rapidly among the men with primary alcoholism than among those with primary affective disorder. However, a minimum of 3 weeks of abstinence from alcohol appeared to be necessary to consistently differentiate the groups with dual diagnoses on the basis of their current depressive symptoms. Alcohol dependence occurring in conjunction with primary affective disorder did not intensify presenting depressive symptoms or retard the resolution of such symptoms. Diagnoses of alcohol dependence and affective disorder based on symptom chronology appear to have prognostic significance with respect to remission of depressive symptoms in men with both diagnoses. Depressive symptoms of dysphoric mood, dysfunctional cognitions, vegetative symptoms, and anxiety/agitation showed different rates and levels of remission across the primary diagnostic groups.

    • "Binge drinking is a common correlate of road accidents, and after a previous suicide attempt, depression is the next highest risk factor for youth suicide [1] . Heavy alcohol use, including binge drinking, plays a role in both the development and progression of mental disorders, particularly depression [6]. Treatment access and retention of young people in traditional treatments is poor "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Depression and binge drinking behaviours are common clinical problems, which cause substantial functional, economic and health impacts. These conditions peak in young adulthood, and commonly co-occur. Comorbid depression and binge drinking are undertreated in young people, who are reluctant to seek help via traditional pathways to care. The iTreAD project (internet Treatment for Alcohol and Depression) aims to provide and evaluate internet-delivered monitoring and treatment programs for young people with depression and binge drinking concerns. Methods: Three hundred sixty nine participants will be recruited to the trial, and will be aged 18-30 years will be eligible for the study if they report current symptoms of depression (score 5 or more on the depression subscale of the Depression Anxiety Stress Scale) and concurrent binge drinking practices (5 or more standard drinks at least twice in the prior month). Following screening and online baseline assessment, participants are randomised to: (a) online monthly self-assessments, (b) online monthly self-assessments + 12-months of access to a 4 week online automated cognitive behaviour therapy program for binge drinking and depression (DEAL); or (c) online monthly assessment + DEAL + 12-months of access to a social networking site (Breathing Space). Independent, blind follow-up assessments occur at 26, 39, 52 and 64-weeks post-baseline. Discussion: The iTreAD project is the first randomised controlled trial combining online cognitive behaviour therapy, social networking and online monitoring for young people reporting concerns with depression and binge drinking. These treatments represent low-cost, wide-reach youth-appropriate treatment, which will have significantly public health implications for service design, delivery and health policy for this important age group. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12614000310662 . Date registered 24 March 2014.
    Full-text · Article · Oct 2015 · BMC Public Health
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    • "Of note, low doses of ethanol were found to be associated with antidepressant-like effects in Porsolt`s swim test on mice [23]. We can recall a few primary depressive ethanol-dependents [24], who reported in their early untreated history from`feelingfrom`feeling better´, notably improved mood, more energy and better concentration (ADE?), after a few glasses of beer or wine, initially persisting over a few days before decaying. Assuming to better cope with their depression the frequency of ethanol-intake had been increased over time resulting in a tolerance towards their`feelingtheir`feeling better´. "
    [Show abstract] [Hide abstract] ABSTRACT: Ketamine is an old drug of abuse showing currently a new wave in its spread. Also,ketaminès therapeutic quality is currently under strong observation, especially in terms of its value in the treatment of depression and suicidality. Its a potential revolution in understanding the mechanisms of antidepressant treatment that single and repeated therapeutic administrations of sub-anesthetic ketamine doses are associated with a rapid and robust but transient antidepressant after-effect (ADE) in patients with treatment resistant major depression. There is increasing evidence that this ADE might result primarily fromketaminès feature of being a non-competitive antagonist of glutamatergic N-methyl-D-aspartate (NMDA)-receptors embedded in synaptic membranes of neuronal cortico-limbic networks promoting an extracellular glutamate surge, thereby mediating changes in synaptic and cellular plasticity via local glutamate non-NMDA-receptors. Here, we focus on a couple of striking clinical and biological overlaps with ketamine and ethanol being a non-competitive antagonist of NMDA-receptors, too. Among them, a good portion is currently assumed to be specifically involved in both, the mechanisms of ADE (in the case of ketamine) and the development of addiction (in the case of ethanol). These overlaps are mainly addressed here in more detail, what may draw the reader in terms of the treatment of mood disorders to both, the possibility of a progressing transfer from ADE to addiction when repeatedly using therapeutic ketamine pulses, and on the other hand, a hypothesized therapeutic antidepressant windowóf modest and cautious ethanol use in depressives, who are (still?) not addicted to ethanol. Of course, more frequent and intense use of ethanol or ketamine would prepare the brain to tolerance and dependence possibly using the same pathways.
    Full-text · Article · Apr 2015
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    • "Alternatively, these negative associations may suggest that Brazilians who are frequent heavy drinkers or frequent drinkers do not suffer from depressive symptoms. These speculations do not support causal theories for the association between heavy drinking or alcohol use/abuse and depressive symptoms in the short-term [8]. These findings could lead an erroneous perception that heavy alcohol drinking does not cause depressive symptoms and to permissive alcohol use in the Brazilian population. "
    [Show abstract] [Hide abstract] ABSTRACT: Background The associations between depressive symptoms and alcohol-related disorders, drinking patterns and other characteristics of alcohol use are important public health issues worldwide. This study aims to study these associations in an upper middle-income country, Brazil, and search for related socio-demographic correlations in men and women. Methods A cross-sectional study was conducted between November 2005 and April 2006. The sample of 3,007 participants, selected using a multistage probabilistic sampling method, represents the Brazilian population aged 14 and older. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and alcohol dependence was assessed using the Composite International Diagnostic Interview. Associations assessed using bi-variate analysis were tested using Rao-Scott measures. Gender specific multinomial logistic regression models were developed. Results Among the participants with alcohol dependence, 46% had depressive symptoms (17.2% mild/moderate and 28.8% major/severe; p < 0.01); 35.8% (p = 0.08) of those with alcohol abuse and 23.9% (p < 0.01) of those with a binge-drinking pattern also had depressive symptoms. Alcohol abstainers and infrequent drinkers had the highest prevalence of major/severe depressive symptoms, whereas frequent heavy drinkers had the lowest prevalence of major/severe depressive symptoms. In women, alcohol dependence and the presence of one or more problems related to alcohol consumption were associated with higher risks of major/severe depressive symptoms. Among men, alcohol dependence and being ≥45 years old were associated with higher risks of major/severe depressive symptoms. Conclusions In Brazil, the prevalence of depressive symptoms is strongly related to alcohol dependence; the strongest association was between major/severe depressive symptoms and alcohol dependence in women. This survey supports the possible association of biopsychosocial distress, alcohol consumption and the prevalence of depressive symptoms in Brazil. Investing in education, social programs, and care for those with alcohol dependence and major/severe depressive symptoms, especially for such women, and the development of alcohol prevention policies may be components of a strategic plan to reduce the prevalence of depression and alcohol problems in Brazil. Such a plan may also promote the socio-economic development of Brazil and other middle-income countries.
    Full-text · Article · Jul 2014 · Substance Abuse Treatment Prevention and Policy
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