The Impact of Substance Dependence on the Course of Depression

Comorbid depression and substance dependence is very common. The impact of current alcohol and drug dependence on the course of depression, however, has received limited attention. Using data from 8098 noninsitutionalized participants (aged 15–54 years) of a national study on psychiatric disorders, researchers assessed how substance dependence (SD) influences the prevalence of major depression.

• Of 319 subjects with both lifetime substance dependence and major depression, half had remitted SD.
• Past-year depression was significantly more common in the following:

• subjects with current SD than in subjects with remitted SD (odds ratio 2.9)
• subjects with remitted SD than in the total study sample (odds ratio 6.7)

Comments:

Some patients use substances to self-medicate their depressive symptoms. But just as depression adversely affects the course of alcoholism and drug dependence, active substance dependence appears to worsen depression outcomes. Such negative consequences strongly suggest that healthcare providers should assess their patients with depression for comorbid substance dependence and help those affected to stop using alcohol and/or drugs.

Jeffrey H. Samet, MD, MA, MPH

Reference:

Agosti V, Levin FR. The effects of alcohol and drug dependence on the course of depression. Am J Addict. 2006;15(1):71–75.