Influence of comorbid alcohol use disorders on the clinical patterns of major depressive disorder: A general population-based study. (1st June 2018)

• Record Type: Journal Article
• Authors: Carton, Louise; Pignon, Baptiste; Baguet, Alexandre; Benradia, Imane; Roelandt, Jean-Luc; Vaiva, Guillaume; Thomas, Pierre; Amad, Ali; De Timary, Philippe; Naassila, Mickaël; Geoffroy, Pierre A.; Rolland, Benjamin
• Is Part Of: Drug and alcohol dependence. Volume 187(2018)
• Page Start: 40
• Page End: 47
• Publication Date: 2018-06-01
• Subjects: Alcohol use disorder -- Alcohol abuse -- Alcohol dependence -- Major depressive disorder -- Dual diagnosis -- Epidemiology; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2018.02.009
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Major depressive disorder (MDD) with alcohol use disorders (AUDs) group displayed a more severe profile than MDD noAUD group. A gradient of severity was highlighted from alcohol abuse to alcohol dependence. Alcohol abuse and dependence groups exhibited different features. Subjects with alcohol abuse expressed less sadness. Abstract: Background: To compare the symptom patterns of major depressive disorder (MDD) among subjects with MDD and 1) no alcohol use disorder (AUD), 2) alcohol abuse and 3) alcohol dependence, respectively. Methods: In a general population survey of 38, 694 French individuals, MDD and AUDs were assessed using the Mini International Neuropsychiatric Interview 5.0.0 (MINI). A total of 4339 subjects (11.2%) in the sample met the criteria for MDD. Among them, 413 (9.5%) AUD subjects were identified: 138 (3.2%) for alcohol abuse and 275 (6.3%) for alcohol dependence. The associations of each of the ten MDD criteria of the MINI and psychiatric clinical features were compared among the three groups. The relative profiles of 'MDD + AUD' vs. 'MDD alone' were determined using a multivariable stepwise regression model. Results: With the noAUD group as the reference, sadness (OR = 0.46; 95%CI, 0.29–0.74) and anhedonia (OR = 1.66; 95%CI, 1.06–2.73) were only associated with alcohol abuse. Sleep disorders (OR = 2.07; 95%CI, 1.51–2.88), feelings of guilt (OR = 1.41; 95%CI, 1.05–1.90), diminished concentration/indecisiveness (OR = 1.52; 95%CI, 1.12–2.07) and thoughts of death (OR = 1.95; 95%CI 1.49–2.55) were only associated with alcohol dependence. Weight or appetite variations were both associated with alcohol abuse (OR = 1.7; 95%CI, 1.15–2.53) and dependence (OR = 1.41; 95%CI, 1.06–1.88). Bipolar disorder and PTSD were only associated with alcohol dependence. Psychotic features, previous suicide attempts, and panic disorder were more frequent in the MDD-AUD group. Conclusion: MDD-AUD subjects displayed a more severe profile with specific symptomatology and comorbidity profiles compared to MDD-only subjects.