Depression in patients with alcohol use disorders: Systematic review and meta-analysis of outcomes for independent and substance-induced disorders

Foulds, James; Adamson, Simon J.; Boden, Joseph M.; Williman, Jonathan; Mulder, Roger

doi:10.1016/j.jad.2015.06.024

Cited by 117 publications

(78 citation statements)

References 62 publications

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“…Furthermore, alcohol is also a contributory factor to other, diseases and injuries. Among the most important disease conditions affected by alcohol consumption are cancers of the oropharynx, esophagus, liver, colon, rectum and the female breast;9 cardiovascular diseases;10 neuropsychiatric disorders (epilepsy, depressive disorders);11 a (not necessarily complete) summary of physical and mental diseases related to alcohol consumption is given in Table 1.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

et al. 2017

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Alcoholic liver disease (ALD) is a leading cause of cirrhosis, liver cancer, and acute and chronic liver failure and as such causes significant morbidity and mortality. While alcohol consumption is slightly decreasing in several European countries, it is rising in others and remains high in many countries around the world. The pathophysiology of ALD is still incompletely understood but relates largely to the direct toxic effects of alcohol and its main intermediate, acetaldehyde. Recently, novel putative mechanisms have been identified in systematic scans covering the entire human genome and raise new hypotheses on previously unknown pathways. The latter also identify host genetic risk factors for significant liver injury, which may help design prognostic risk scores. The diagnosis of ALD is relatively easy with a panel of well-evaluated tests and only rarely requires a liver biopsy. Treatment of ALD is difficult and grounded in abstinence as the pivotal therapeutic goal; once cirrhosis is established, treatment largely resembles that of other etiologies of advanced liver damage. Liver transplantation is a sound option for carefully selected patients with cirrhosis and alcoholic hepatitis because relapse rates are low and prognosis is comparable to other etiologies. Still, many countries are restrictive in allocating donor livers for ALD patients. Overall, few therapeutic options exist for severe ALD. However, there is good evidence of benefit for only corticosteroids in severe alcoholic hepatitis, while most other efforts are of limited efficacy. Considering the immense burden of ALD worldwide, efforts of medical professionals and industry partners to develop targeted therapies in ALF has been disappointingly low.

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Section: Introductionmentioning

confidence: 99%

Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

et al. 2017

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“…This debate is current in the personality field [24]. In contrast, there has already been a more dimensional approach to substance use disorders in the DSM-5, with the previous categorical terms “abuse” and “dependence” being replaced by a unitary construct occurring along a continuum of severity [25]. Without clear markers for cut points in a dimensional system, as is the case in the personality field, the improved validity of this approach is diminished but with a potential loss of utility [26].…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

“…This is particularly relevant for AUD and mood disorders, where heavy drinking is often accompanied by a mood disturbance which resolves as the drinking ceases [25]. Perhaps surprisingly, there is no such tradition of categorizing AUD as primary or secondary to PD, or vice versa, yet plausible arguments could be made for this approach.…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

Personality Disorder and Alcohol Use Disorder: An Overview

Newton‐Howes

Foulds

2018

Psychopathology

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Background: Clinically, personality disorder (PD) commonly coexists with alcohol use disorder (AUD), although within mainstream mental health services both of these mental disorders are routinely overlooked. Despite a rich literature examining the interactions between AUD and personality functioning, personality traits, and PD, there remains conflicting evidence as to the degree of association and impact of one on the other. Methods: A narrative review and a synthesis of the literature were done. Results: The lifetime prevalence of AUD approaches 50% in some PD populations. The rates of PD in AUD populations are less clear but likely similar. Personality influences outcomes in AUD regardless of whether a categorical personality diagnosis or dimensional trait domain approach is taken. There are, however, no good data to inform clinicians on the impact of AUD on the outcomes of PD. Understanding the extent of this impact is complicated by the multiple tools used for diagnosis (of both PD and AUD) and the statistical methods used. Overall, caution is required in interpreting the data due to the quality of the current literature; however, comorbidity between the two disorders is likely significant and the impact of PD on AUD outcomes is sufficient to require consideration. Conclusions: From a research perspective, better agreement on both diagnoses and outcomes is urgently needed to improve the overall quality of the evidence. Clinically, despite the limitations in the literature, it is unacceptable for PD services to ignore AUD and for AUD services not to screen for PD. Both are likely to have an impact on health and functioning and should be considered in routine reviews. A better conceptualization of the putative mechanisms of this interaction, as well as an understanding of the neurobiology and reasons for the impact on treatment outcomes, will help to move the field forward.

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“…It has been attempted in the GBD study 2000 for major depressive disorders [16], but later committees did not see this attempt as convincing enough. Maybe some of the newer research on alcohol and depression [67, 68] will allow for better modelling in future CRAs.…”

Section: Diseases and Causes Of Death Seen As Causally Impacted By Almentioning

confidence: 99%

A narrative review of alcohol consumption as a risk factor for global burden of disease

Rehm

Imtiaz

2016

Subst Abuse Treat Prev Policy

139

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Since the original Comparative Risk Assessment (CRA) for alcohol consumption as part of the Global Burden of Disease Study for 1990, there had been regular updates of CRAs for alcohol from the World Health Organization and/or the Institute for Health Metrics and Evaluation. These studies have become more and more refined with respect to establishing causality between dimensions of alcohol consumption and different disease and mortality (cause of death) outcomes, refining risk relations, and improving the methodology for estimating exposure and alcohol-attributable burden. The present review will give an overview on the main results of the CRAs with respect to alcohol consumption as a risk factor, sketch out new trends and developments, and draw implications for future research and policy.

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Depression in patients with alcohol use disorders: Systematic review and meta-analysis of outcomes for independent and substance-induced disorders

Cited by 117 publications

References 62 publications

Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

Personality Disorder and Alcohol Use Disorder: An Overview

A narrative review of alcohol consumption as a risk factor for global burden of disease

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