title: Subtypes of major depression in substance dependence.
abstract: OBJECTIVE
  This study evaluated features that differentiate subtypes of major depressive episode (MDE) in the context of substance dependence (SD). Design  Secondary data analysis using pooled data from family-based and case-control genetic studies of SD.
  
  
  METHODS
  Community recruitment through academic medical centers.
  
  
  METHODS
  A total of 1929 unrelated subjects with alcohol and/or drug dependence.
  
  
  METHODS
  Demographics, diagnostic criteria for psychiatric and substance use disorders and related clinical features were obtained using the Semi-Structured Assessment for Drug Dependence and Alcoholism. We compared four groups: no life-time MDE (no MDE), independent MDE only (I-MDE), substance-induced MDE only (SI-MDE) and both types of MDE.
  
  
  RESULTS
  Psychiatric measures were better predictors of MDE subtype than substance-related or socio-demographic ones. Subjects with both types of MDE reported more life-time depressive symptoms and comorbid anxiety disorders and were more likely to have attempted suicide than subjects with I-MDE or SI-MDE. Subjects with both types of MDE, like those with I-MDE, were also more likely than subjects with SI-MDE to be alcohol-dependent only than either drug-dependent only or both alcohol- and drug-dependent.
  
  
  CONCLUSIONS
  SD individuals with both types of MDE have greater psychiatric severity than those with I-MDE only or SI-MDE only. These and other features that distinguish among the MDE subtypes have important diagnostic and potential therapeutic implications.
authors.affiliation: Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030-2103, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Niciu
authors.forename: Grace
authors.initials: G
authors.lastname: Chan
authors.forename: Joel
authors.initials: J
authors.lastname: Gelernter
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Arias
authors.forename: Kara
authors.initials: K
authors.lastname: Douglas
authors.forename: Roger
authors.initials: R
authors.lastname: Weiss
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Anton
authors.forename: Lindsay
authors.initials: L
authors.lastname: Farrer
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Cubells
authors.forename: Henry R
authors.initials: HR
authors.lastname: Kranzler
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D003865:Major Depressive Disorder / Q000145:classification / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D012008:Recurrence; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
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