Alcoholism and Depression

Abstract

Alcoholism and depressive disorders co-occur far more commonly than would be expected. The great prevalence of depression in alcoholics constitutes an important clinical issue, because alcoholic subjects with a coexisting depression exhibit heavier alcohol abuse, severer physical damage and greater liability to both psychotropic drug abuse and overdose behaviour than non-depressive alcoholics. The former also experience more frequent and severer relapses and are at greater risk of suicide. The nature of the relationship between alcohol dependence and depressive disorders is of considerable theoretical significance. Three possible non-mutually exclusive types of association are discussed: (1) the ingestion of alcohol may be an attempt at self-medication of depressive symptoms; (2) depression and alcohol abuse may, independently of each other, be attributable to an underlying, possibly genetic, factor; (3) depression may be a result of alcoholism: either induced by heavy alcohol consumption, as a consequence of alcohol withdrawal or as a psychoreactive phenomenon. Clinical guidelines for pharmaco- and psychotherapy of depression in patients suffering from alcoholism are outlined.

Age of onset and temporal sequencing of lifetime DSM-IV alcohol use disorders relative to comorbid mood and anxiety disorders

“…In the literature, several mechanisms have been offered as to how a primary AUD could potentially lead to the development of a subsequent MAD. For example: a) alcohol intoxication or withdrawal may cause acute, substance-induced psychological symptoms; b) long-term alcohol use may cause changes in brain physiology leading to the psychological sequelae; or c) alcohol intoxication may limit the repertoire of coping strategies to stressful situations, leading to feelings of helplessness, inadequacy, negative affect and anxiety (Baving and Olbrich, 1996;Lehman et al, 1989).…”

“…On the contrary, if anything, the phobias may have had some influence in contributing to or causing the AUD. In this regard, self-medication hypotheses have been offered in the literature to explain the path by which psychological distress may lead to the onset of problem drinking (Baving and Olbrich, 1996;Lehman et al, 1989). It is plausible that a subset of the primary phobic individuals may have "self-medicated" with alcohol to reduce their fear-based symptoms, ultimately leading to the development of subsequent AUDs.…”

Development of a questionnaire for measurement of vision-related quality of life

“…It was commented, however, that the effect may have been due to the negative influence of the psychological distress associated with poor vision (which is adequately represented in the VQOL and VCM1) on concentration and memorising. No patient reported lacking energy or being dependent on substances (e.g., alcohol) as a result of visual impairment; however, alcoholism (and lethargy) may be associated with depression, 66 which is addressed in the VQOL and VCM1. One interviewee mentioned difficulty sleeping, but attributed this problem to anxiety (which is represented in the VQOL and VCM1).…”

Helplessness in the Tail Suspension Test Is Associated with an Increase in Ethanol Intake and Its Rewarding Effect in Female Mice

“…However, it is difficult to determine whether depression represents a primary factor of predisposition to drug abuse or is secondary to drug abuse. Various subjective symptoms, including anxiety, anhedonia, depression, and drug craving, are common to withdrawal from all major drugs of abuse, especially alcohol (Baving and Olbrich, 1996;O'Brien, 1996), suggesting that depression could be, at least in part, a consequence of drug abuse. However, whether a preexisting depression in humans may increase the liability to subsequent drug-seeking behavior is still an open question.…”