The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence

Abstract

The presence of depression in alcohol-dependent persons is likely to influence treatment process and outcomes. Identification of depression is important though not every depressed alcohol-dependent person requires treatment with antidepressants. Understanding the association between depression and alcohol dependence is essential for proper management of alcohol dependence. Objectives. To determine the prevalence of depression among alcohol-dependent persons before and after alcohol detoxification and rehabilitation. Design. Clinical trial with pre-/postmeasurements. Method. The CIDI and WHO-ASSIST were administered to 188 alcohol-dependent persons at intake and after six months. A researcher-designed sociodemographic questionnaire was also administered at intake. Results. The prevalence of depression among alcohol-dependent persons is high (63.8%) with a significant association between depression and the mean AUDIT score. At posttest, depressed participants had a statistically significant craving for alcohol. Conclusion. Alcohol dependence is associated with major depression.

Detection of depression among patients with problematic alcohol use in General Out Patient setting

“…The socio-demographic distribution is similar to the findings of an earlier study in East Africa. 1 The occurrence of clinically significant depression among participants who reported problems with alcohol use in our study was 31.1%. Prior studies have often reported an association with depression with greater risk with increasing use of alcoholic beverage.…”

“…Alcohol use has been postulated by some authors to be a predisposing/causal factor to depression while others are of the view that depression underlies majority of cases of alcohol use disorders. 1,6,7 Till date there is no clear consensus among researchers on the nature of the relationship. Co-occurrence of depression in those with problematic use of alcohol may lead to a pattern of self-medication of depressive symptoms with alcohol, increased rate of relapse after treatment, high utilization of health services and risk of suicide.…”

“…4 The interest is not only due to the challenge of getting an accurate diagnosis but the implications for treatment and long term prognosis. 1,5 A major issue of clinical interest inherent in the co-morbidity is to delineate the predisposing or causal factor among the two disorders. Alcohol use has been postulated by some authors to be a predisposing/causal factor to depression while others are of the view that depression underlies majority of cases of alcohol use disorders.…”

“…[1][2][3] Prevalence estimates of such co-morbidity in various settings ranged between 16-68%. 1 The nature of this dual relationship is of interest to mental health professionals.…”

“…[1][2][3] Prevalence estimates of such co-morbidity in various settings ranged between 16-68%. 1 The nature of this dual relationship is of interest to mental health professionals. 4 The interest is not only due to the challenge of getting an accurate diagnosis but the implications for treatment and long term prognosis.…”