[Subsyndromal depressive semiology in severe alcoholism].
BACKGROUND
Several investigations have communicated frequent association between alcohol dependence and depression.


METHODS
21 subjects with DSM-IV criteria for alcohol dependence were included in an open label trial for alcohol withdrawal. At inclusion and along the follow-up none of the probands met DSM-IV criteria for mood disorder. Follow-up included a 15-day detoxification period and 195 days of withdrawal program, including treatment with 20 mg/d of fluoxetine. Occurrence of depressive semiology was measured using the Beck Depression Inventory (BDI) on day 15 (after detoxification), day 75 and day 210 (after withdrawal from ethanol of 195 days).


RESULTS
67% of the sample showed a positive basal BDI (after-detoxification-BDI> 9). Global retention rate after 210 days of follow-up was 57%. All patients who dropped out the investigation before completing the protocol showed a basal BDI in the depressive rank (BDI= 10-63), and maintained depressive scores in this instrument until their abandonment.


CONCLUSIONS
Prevalence of <<subsyndromal depressive semiology>> in this population appears to be high. This clinical feature is frequently ignored because most of the patients do not meet standardized diagnostic criteria for mood disorders. Post-detoxification BDI could be used as a predictive factor of therapeutic result in long-term alcohol withdrawal programs. In addition, in our study fluoxetine showed efficacy in maintaining long-term alcohol abstinence.
Huertas
D
D
Servicio de Psiquiatría, Hospital Universitario de Guadalajara, Guadalajara, 19002, España.
Bautista
S
S
Sanjoaquín
A
A
Chamorro
L
L
Gilaberte
I
I
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology*; D002391:Catchment Area, Health; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D013030:Spain; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000523:psychology; D013577:Syndrome
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors