Discriminating between substance-induced and independent depressive episodes in alcohol dependent patients.
OBJECTIVE
The purpose of this study is to examine the accuracy with which the depressive episodes of alcoholics undergoing treatment are classified as substance-induced depression (SID) or independent major depressive disorder (MDD).


METHODS
Participants were 95 patients (64 men) undergoing partial hospital treatment for alcohol dependence. Affective disorders were assessed at baseline and 6 weeks, 3 months, 6 months and 12 months later.


RESULTS
Over one quarter of the depressive episodes originally diagnosed as SID were reclassified as MDD during the 1-year follow-up, due to a continuation of the depressive episode despite a period of prolonged abstinence from alcohol and drugs. Both history of MDD and lower levels of alcohol dependence were associated with diagnostic change from SID to MDD.


CONCLUSIONS
These findings support the diagnostic complexity of these two types of depressive disorders and point to clinical features that may differentiate them.
Ramsey
Susan E
SE
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island 02903, USA. Susan_Ramsey@Brown.edu
Kahler
Christopher W
CW
Read
Jennifer P
JP
Stuart
Gregory L
GL
Brown
Richard A
RA
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D016009:Chi-Square Distribution; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology / Q000706:statistics & numerical data; D016002:Discriminant Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology