Evaluating whether certain subtypes of Major Depressive Disorder (MDD) are more strongly associated with Substance Use Disorders (SUDs) may help clarify reasons for MDD-SUD relations. Therefore, this study compared DSM-IV-defined non-atypical/non-melancholic depression (undifferentiated depression; n=365), atypical depression (n=117), melancholic depression (n=245), and atypical-melancholic depression (n=68) in the prevalence of current SUDs, while controlling for relevant demographic and clinical variables. Psychiatric outpatients with a current diagnosis of unipolar MDD were assessed using the Structured Clinical Interview for DSM-IV, supplemented by questions from the Schedule for Affective Disorders and Schizophrenia. Results showed that compared with patients with undifferentiated depression, melancholic patients had higher rates of current nicotine dependence (34% vs. 26%) and drug abuse/dependence (8% vs. 3%), Ps<0.05. These differences were explained by the association between specific melancholic features (marked psychomotor agitation and weight loss/decreased appetite) and nicotine and drug use disorders. Atypical depression, atypical-melancholic depression, and other subtype symptoms were not significantly associated with any SUDs. Although this study is limited by low prevalence of alcohol and drug use disorders, the present findings suggest that different symptomatic expressions of MDD differentially associate with some SUDs.

After eliminating the four somatic criteria from the DSM-IV definition of MDD, a high level of concordance was found between this simpler definition and the original DSM-IV classification. This new definition offers two advantages over the current DSM-IV definition--it is briefer and it is easier to apply with medically ill patients because it is free of somatic symptoms.

Alcohol-impaired driving continues to be a major public health concern, particularly among college students. The current study examined whether sociodemographic, behavioral, and cognitive variables predicted alcohol-impaired driving in a sample of college students. Data were collected via telephone interviews from a random sample of undergraduates, ages 18-25 years old, stratified by sex and class in school. Using hierarchical logistic regression analyses (n = 330), results revealed that higher levels of weekly alcohol use, being age 21 or older, and perceived difficulty in obtaining alternative transportation were associated with a greater likelihood of drinking and driving. In addition, perceived likelihood of drinking and driving-related consequences was associated with a lower likelihood of drinking and driving. Knowledge of the .08% per se and zero tolerance laws did not predict alcohol-impaired driving. Findings are discussed in terms of their implications for college media campaigns designed to reduce alcohol-impaired driving.