Depressive symptoms in alcohol dependence- a cross-sectional study
Keywords:Alcohol dependence, Depression, Prevalence, Sociodemographic factors
Background: Patients with alcohol dependence often suffer from comorbid psychiatric illnesses like depression which may influence treatment and outcomes. Sociodemographic factors may potentially influence depressive symptoms in patients with alcohol dependence. Aims: To study the prevalence of depressive symptoms in patients with alcohol dependence and to identify sociodemographic factors affecting this association. Methods: Patients with alcohol dependence above 18 years of age were included. The diagnosis was made by ICD-10 diagnostic criteria. The severity of alcohol dependence was rated with the severity of the alcohol dependence questionnaire (SADQ) and depression with the Hamilton depression rating scale (HAM-D). Sociodemographic data were recorded in each patient. Statistical analysis was done using independent t-tests, Chi-square tests, one-way analysis of variance (ANOVA) and Pearson’s correlation analysis. Results: The mean SADQ Score was 21.5±8.6 (range, 9-48). The severity of alcohol dependence was mild in 15(25%), moderate in 40(66.7%) and severe in 5(8.3%), respectively. The mean Hamilton depression rating scale score was 7.8±3.9(range, 3-17). The prevalence of depression in our study was 38.3%. Out of these, 17(28.3%) had mild and 6 (10%) had moderate depression. There was a positive and significant correlation between SADQ scores and depression scores (Pearson’s correlation coefficient, r=0.494, P=0.001). Patients who were unemployed (ANOVA, P=0.046, separated (ANOVA, P=0.002), and joint family (ANOVA, P=0.039) had significantly higher depression scores.Conclusion: In conclusion, sociodemographic factors like unemployment, marital separation and living in joint families may significantly influence the association between alcohol dependence and depression.
Agabio R, Trogu E, Pani PP. Antidepressants for the treatment of people with co-occurring depression and alcohol dependence. Cochrane Database Syst Rev. 2018 24;4:CD008581.
Li J, Wang H, Li M, Shen Q, Li X, Rong X, Peng Y. Efficacy of pharmacotherapeutics for patients comorbid with alcohol use disorders and depressive symptoms-A bayesian network meta-analysis. CNS Neurosci Ther. 2020; 26:1185-1197.
World Health Organization. Global status report on alcohol and health. 2018.
World Health Organization. Depression and other common mental disorders. Global Health Estimates. 2017.
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3: e442.
Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005; 62:1097-106.
Li J, Wang H, Li M, Shen Q, Li X, Zhang Y et al. Effect of alcohol use disorders and alcohol intake on the risk of subsequent depressive symptoms: A systemic review and meta-analysis of cohort studies. Addiction 2020;115:1224-1243.
Carton L, Pignon B, Baguet A, et al. Influence of comorbid alcohol use disorders on the clinical patterns of major depressive disorder: a general population?based study. Drug Alcohol Depend. 2018; 187:40?47.
Fergusson DM, Boden JM, Horwood LJ. Tests of causal links between alcohol abuse or dependence and major depression. Arch Gen Psychiatry. 2009; 66:260?266.
Hawton K, Casanas ICC, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord. 2013; 147:17?28.
Halikas JA, Herzog MA, Mirassou MM, Lyttle MD. Psychiatric diagnosis among female alcoholics. In: Galanter G, editor. Currents in Alcoholism. Vol. 8. New York, NY, USA: Grune & Stratton; 1981. pp. 281–291.
Ndetei DM, Khasakhala L, Maru H, Pizzo M, Mutiso V, Ongecha-FA et al. Clinical epidemiology in patients admitted at Mathari Psychiatric Hospital, Nairobi, Kenya. Soc Psychiatry Psychiatr Epidemiol. 2008; 43:736-42.
Flensborg-Madsen T, Mortensen EL, Knop J, Becker U, Sher L, Grønbaek M. Comorbidity and temporal ordering of alcohol use disorders and other psychiatric disorders: results from a Danish register-based study. Compr Psychiatry. 2009; 50:307-14.
Baker AL, Kavanagh DJ, Kay-Lambkin FJ, Hunt SA, Lewin TJ, Carr VJ, et al. Randomized controlled trial of cognitive-behavioural therapy for coexisting depression and alcohol problems: short-term outcome. Addiction. 2010 Jan;105(1):87-99
Cornelius JR, Bukstein OG, Birmaher B, Salloum IM, Lynch K, Pollock NK, et al. Fluoxetine in adolescents with major depression and an alcohol use disorder: an open-label trial. Addict Behav. 2001 Sep-Oct;26(5):735-9.
Ravikanth, T., Sultan, S. The prevalence of psychiatric comorbidity and its relationship to the severity of alcohol dependence in the population of rural south India. Middle East Curr Psychiatry 2020;27: 1.
Stockwell T, Murphy D, Hodgson R. The severity of alcohol dependence questionnaire: its use, reliability, and validity. Br J Addict. 1983;78(2):145-55.
Hamilton M A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960; 23:56-62.
Boden JM, Fergusson DM. Alcohol and depression. Addiction. 2011; 106:906–14.
Lai HM, Cleary M, Sitharthan T, Hunt GE. Prevalence of comorbid substance use, anxiety, and mood disorders in epidemiological surveys, 1990–2014: a systematic review and meta-analysis. Drug Alcohol Depend. 2015; 154:1–13.
Kuria MW, Ndetei DM, Obot IS, Khasakhala LI, Bagaka BM, Mbugua MN, et al. The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence. ISRN Psychiatry. 2012; 2012:482802
McHugh RK, Weiss RD. Alcohol Use Disorder and Depressive Disorders. Alcohol Res. 2019;40: arcr. v40.1.01.
Luitel NP, Baron EC, Kohrt BA, Komproe IH, Jordans MJD. Prevalence and correlates of depression and alcohol use disorder among adults attending primary health care services in Nepal: a cross sectional study. BMC Health Serv Res. 2018;18(1):215.
Luitel NP, Jordans MJ, Sapkota RP, Tol WA, Kohrt BA, Thapa SB, et al. Conflict and mental health: a cross-sectional epidemiological study in Nepal. Soc Psychiatry Psychiatr Epidemiol. 2013; 48:183-93.
Wang J, El-Guebaly N. Sociodemographic Factors Associated with Comorbid Major Depressive Episodes and Alcohol Dependence in the General Population. The Canadian Journal of Psychiatry. 2004;49(1):37-44.
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