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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Psychiatric disorders occur more often among alcoholics than among the general population. The psychiatric disorders that alcoholics most frequently experience include mood disorders (e.g., depression), anxiety disorders, and antisocial personality disorder. The evaluation of psychiatric symptoms in alcoholic patients is complicated by the multiple relationships that exist among heavy drinking, psychiatric symptoms, and personality factors. For example, alcoholics with co-occurring depression may be at greater risk of psychosocial problems, relapse, and suicide. Conversely, heavy drinking may produce or worsen symptoms of depression or anxiety. Although clinical experience provides general guidance for treating these patients, further research is needed to develop effective psychosocial and pharmacological therapies aimed at specific combinations of psychiatric and addictive disorders.
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PMID:Diagnosis and treatment of alcohol-dependent patients with comorbid psychiatric disorders. 1089 Aug 9

Several behavioral/psychological/psychiatric traits/disorders have been associated with increased initiation of smoking, nicotine dependence, and decreased cessation. Although much research has focused on psychiatric disorders, subclinical syndromes (e.g., minor depression and heavy drinking) probably influence smoking initiation and cessation more because they are so much more prevalent. In prospective studies, comorbidity predicts smoking and smoking predicts comorbidity. Preliminary evidence suggests several plausible mechanisms by which this two-way linkage could occur. In addition, other variables (e.g., genetics) could account for the comorbidity/smoking association. What we need to know: how strong and consistent are comorbidity/smoking associations? Is the association of smoking and comorbidity increasing over time? Are the hypothesized mechanisms for the association valid? Can treating comorbidity improve smoking cessation outcomes? Would applying the concept of comorbidity to psychosocial conditions (e.g., poverty) be helpful?
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PMID:Comorbidity and smoking. 1176 73

The objective of this study was to investigate the effect of persistent alcohol consumption on the risks of major and minor depression. A retrospective cohort study design was used. The data was derived from a large scale longitudinal national health study (Canadian National Population Health Survey). Depression status was evaluated by using the Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. Subjects who did not have major depression at baseline were classified into groups according to the persistence of alcohol consumption during the follow-up period. The incidence of major depression in each group was calculated in men and in women separately and were stratified by age. The same procedures were repeated for minor depression. Women who reported having 5+ drinks on one occasion at least once a month were at an elevated risk of major depression. The same pattern was not observed among men in this analysis. However, no difference was found between the groups in terms of the incidence of minor depression. Frequent heavy alcohol use may be a causal factor for major depression among women. Reducing the frequency and quantities of alcohol consumption may offer an opportunity for prevention of major depression among women.
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PMID:Prospective study of frequent heavy alcohol use and the risk of major depression in the Canadian general population. 1181 52

The study aimed to ascertain the outcome of adolescent onset eating disorders in a representative cohort of females. The design was a seven wave cohort study conducted over 6 years. 982 female participants from a total sample of 2032 secondary school students initially aged 14-15 years at 44 schools in the state of Victoria Australia. Branched questionnaires (BET) were used for assessing symptoms of eating disorder. A partial syndrome was defined where a subject met two DSM-IV criteria for either anorexia or bulimia nervosa. The revised Clinical Interview Schedule (CIS-R) was used for assessing depression and anxiety, and self-report frequency of use and retrospective diaries for substance use. The mean point prevalence of eating disorders in females between 15-18 years at the partial syndrome level was 2.4 % (1.8-31). At follow-up at the age of 20 years the point prevalence was 3 % (1.9-4.1). In all 8.8 % reported an eating disorder across the six year study period. Eleven percent of those with eating disorder in the teens had persisting disorder at follow-up. In contrast, close to 50 % had high levels of depression and anxiety, a finding that was particularly marked for those with the partial syndrome of bulimia nervosa during the teens. The bulimia group tended to report a higher level of heavy alcohol use at follow-up. Eating disorders at the partial syndrome level are common in young women but most teenage syndromes are brief and self-limiting. The findings are consistent with the partial syndrome of bulimia nervosa being viewed as a variant of affective disorder with different associated behaviours at particular developmental points.
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PMID:The outcome of adolescent eating disorders: findings from the Victorian Adolescent Health Cohort Study. 1256 12

The purpose of this study was to examine the latent structure of neuropsychological abilities of drug-abusing patients. Four factors were identified in an exploratory factor analysis (N = 329) and a subsequent confirmatory factor analysis (N = 258): Executive Functioning, Verbal Ability, Memory, and Speed, Education, years of regular alcohol use, number of substance use dependence disorders, percentage of days of heavy drinking in the previous year, depression, familial alcoholism, premorbid level of cognitive functioning, liver functioning, and previous head injuries were identified as risk factors to these latent abilities.
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PMID:The neuropsychological test performance of drug-abusing patients: an examination of latent cognitive abilities and associated risk factors. 1262 42

The harmful effects of heavy alcohol use are well-documented and wide-ranging. Heavy drinking may cause or exacerbate cardiovascular disorders. The author suggests that effects of heavy alcohol consumption on the cardiovascular system may be mediated in part by the influence of alcohol-induced depression on the immune system. This hypothesis is based on the following data: (1) alcohol misuse may cause or exacerbate depression; (2) depressive disorders are associated with increased incidence, morbidity, and mortality of cardiovascular disorders; (3) the immune system may mediate effects of depressive disorders on the cardiovascular system. Further studies are needed to clarify the etiopathogenesis of alcohol-related disorders and develop new treatment modalities.
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PMID:Effects of heavy alcohol consumption on the cardiovascular system may be mediated in part by the influence of alcohol-induced depression on the immune system. 1271 Sep 6

Early studies report very high rates of "alcohol abuse" and alcoholism among lesbians. However, serious methodological problems, including nonrepresentative samples that were often recruited in lesbian or gay lesbian bars, limit the validity of findings from these studies. In this article, I briefly review the literature on lesbians' use of alcohol and present findings from a recent study conducted in Chicago (USA). This study recruited a race- and age-diverse sample of lesbians and a demographically matched group of heterosexual women. Rates of "heavy" alcohol use and alcohol-use-related problems among lesbians were much lower in this study than in early studies. However, lesbians were more likely than their heterosexual counterparts to be in recovery and to have been in treatment for alcohol-use-related problems. Further, high rates of childhood sexual abuse, depression, and suicidal ideation reported by lesbians suggest that at least some groups may be at heightened risk for "heavy" drinking and drinking-related problems. Nevertheless, results of this and other studies suggest that reports of heavy drinking and drinking-related problems among lesbians may have been inflated in earlier studies, or that heavy drinking and drinking-related problems may have declined among lesbians.
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PMID:Lesbians' drinking patterns: beyond the data. 1458 76

Previous studies in recently detoxified dependent alcoholics have shown severely disturbed sleep and impaired quality of life. Although this association has been found to predict short-term relapse to heavy drinking, no sequential studies have been conducted to monitor significant changes in sleep quality and quality of life in abstaining alcoholics. Fifty-seven inpatients at a voluntary sector 12-Step alcohol detoxification unit in South London were administered a series of questionnaires assessing sleep (Pittsburgh Sleep Quality Index, PSQI), Quality of Life (Euro-Qol) and Depression and Anxiety (Hospital Anxiety and Depression Scales, HADS). Questionnaires were administered at baseline and for 12 weeks at monthly intervals. At baseline, PSQI scores showed that 52 of the 57 participants suffered from impaired sleep. The scores, however, did not correlate significantly with any of the other measurements. All except two participants acknowledged impaired Quality of Life in at least one area. With respect to the follow-up measurements 23 (40%) participants completed the study. Quality of life and depression scores improved significantly over a 12-week period but sleep and anxiety scores did not. At 12 weeks the mean PSQI score was still above the cut-off point for 'sleep caseness'. Quality of life and depression show a significant improvement over a 3-month period of abstinence, although at this point the subjects are still experiencing difficulties with sleep and anxiety. This information could help in the planning of future rehabilitation and treatment programmes.
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PMID:Sequential studies of sleep disturbance and quality of life in abstaining alcoholics. 1469 Aug 82

Alcohol abuse is the third leading preventable cause of death in the United States. Because binge and heavy drinking increase the risk for cirrhosis, cancer, heart disease, stroke, injury, and depression, public health efforts have focused on reducing these patterns of alcohol use. The Council of State and Territorial Epidemiologists, the Association of State and Territorial Chronic Disease Program Directors, and CDC developed Indicators for Chronic Disease Surveillance, which provides a standard set of measures for alcohol surveillance. The New Hampshire Department of Health and Human Services used these measures to facilitate statewide trend analysis of alcohol use among adolescents and adults. This report summarizes the results of that analysis, which indicated that, in 2003, a total of 30.6% of adolescents reported binge drinking. In 2001, a total of 15.8% of adults reported binge drinking, and 6.3% reported heavy drinking. Interventions are needed to prevent adolescent drinking and to reduce excessive alcohol use among adults.
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PMID:Alcohol use among adolescents and adults--New Hampshire, 1991-2003. 1500 78

Over the last 20 years, the role of adjuvant pharmacotherapy in optimising outcome in rehabilitation programmes for alcohol-dependent patients has become increasingly evident. New avenues for rational drug treatment have arisen from better understanding of the neurobiological substrates of alcohol dependence, including adaptive changes in amino acid neurotransmitter systems, stimulation of dopamine and opioid peptide systems, and, possibly, changes in serotonergic activity. Disulfiram, naltrexone and acamprosate are currently the only treatments approved for the management of alcohol dependence. However, there is still no unequivocal evidence from randomised controlled clinical trials that disulfiram improves abstinence rates over the long term. Aversive therapy with disulfiram is not without risk for certain patients, and should be closely supervised. Both naltrexone and acamprosate improve outcome in rehabilitation of alcohol-dependent patients, but seem to act on different aspects of drinking pathology. Naltrexone is thought to decrease relapse to heavy drinking by attenuating the rewarding effects of alcohol. However, data from the naltrexone clinical trial programme are somewhat inconsistent, with several large studies being negative. Acamprosate is believed to maintain abstinence by blocking the negative craving that alcohol-dependent patients experience in the absence of alcohol. The clinical development programme has involved a large number of patients and studies, of which the vast majority have shown a beneficial effect of acamprosate on increasing abstinence rates. Both drugs are generally well tolerated; nausea is reported by around 10% of patients treated with naltrexone, while the most frequent adverse effect reported with acamprosate is diarrhoea. Another opioid receptor antagonist, nalmefene, has shown promising activity in pilot studies, and may have a similar profile to naltrexone. Data from studies of SSRIs in alcohol dependence are somewhat heterogeneous, but it appears that these drugs may indirectly improve outcome by treating underlying depression rather than affecting drinking behaviour per se. Similarly, the anxiolytic buspirone may act by ameliorating underlying psychiatric pathology. Dopaminergic neuroleptics, benzodiazepines and antimanic drugs have not yet demonstrated evidence of activity in large controlled clinical trials. Trials with drugs acting at serotonin receptors have yielded disappointing results, with the possible exception of ondansetron. Because the biological basis of alcohol dependence appears to be multifactorial, the future of management of alcoholism may be combination therapy, using drugs acting on different neuronal pathways, such as acamprosate and naltrexone. Pharmacotherapy should be used in association with appropriate psychosocial support and specific treatment provided for any underlying psychiatric comorbidities.
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PMID:Pharmacotherapy of alcohol dependence: a review of the clinical data. 1518 19


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