title: Patterns of alcohol and drug use among depressed older adults seeking outpatient psychiatric services.
abstract: OBJECTIVE
  Alcohol and drug use and related problems may compromise depression treatment, and older adults may be especially at risk for poor outcomes. However, alcohol and drug use among older adults have not been studied in settings in which depression treatment is provided. This study examined the prevalence and clinical and demographic correlates of alcohol and drug use and misuse of prescription drugs among adults with depression seeking outpatient psychiatric care (excluding chemical dependency treatment).
  
  
  METHODS
  The sample included 154 older adults (age 60 years and older who scored ≥10 on the Beck Depression Inventory-II [BDI-II] at intake). Participants also completed alcohol and drug use questions and the Short Michigan Alcohol Screening Test.
  
  
  RESULTS
  Recent alcohol and drug use, heavy episodic drinking, and history of alcohol-related problems were common. Alcohol use in the prior 30 days was reported by 53% of men and 50% of women. Cannabis use in the prior 30 days was reported by 12% of men and 4% of women; and misuse of sedatives in the prior 30 days was reported by 16% of men and 9% of women. In exact logistic regression, higher BDI-II score was associated with cannabis use (odds ratio = 15.8, 95% confidence interval = 2.0-734.0, exactp = 0.003).
  
  
  CONCLUSIONS
  Older adults with depression are likely to present for treatment with a range of concurrent alcohol and drug use patterns, including cannabis use and misuse of prescription medication. Clinicians should evaluate depressed patients for substance use and related problems and consider appropriate interventions.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 94143, USA. dereks@lppi.ucsf.edu
authors.forename: Derek D
authors.initials: DD
authors.lastname: Satre
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Sterling
authors.forename: R Scott
authors.initials: RS
authors.lastname: Mackin
authors.forename: Constance
authors.initials: C
authors.lastname: Weisner
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000553:Ambulatory Care / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology / Q000523:psychology; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D015995:Prevalence; D012495:San Francisco; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires