title: Independent versus substance-induced major depressive disorders in first-admission patients with substance use disorders: an exploratory study.
abstract: BACKGROUND
  Clinical differences between independent and substance-induced (S-I) major depressive disorders (MDDs) in patients with substance use disorders (SUDs) are insufficiently studied.
  
  
  METHODS
  The catchment area sample consisted of 42 SUD patients with independent and/or S-I MDD (bipolar disorders excluded), admitted consecutively to addiction clinics or psychiatry departments (inpatient or outpatient) with no previous treatment history from specialized services. Assessments included the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), the Structured Clinical Interview for DSM-IV, Axis II, Personality Disorders (SCID-II), the Inventory of Depressive Symptoms (IDS), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Symptom Check List, 90 questions, revised (SCL-90-R).
  
  
  RESULTS
  Of the 42 SUD patients, 48% had independent MDD episode(s) only, 24% had S-I MDD episode(s) only, and 28% had both independent and S-I MDD episodes. Insomnia, psychomotor agitation, concentration and decision problems, melancholic features, higher total MDD symptom count, longer time being depressed, higher mean score on the Montgomery-Asberg Depression Rating Scale, and shorter duration of SUDs characterized independent MDDs.
  
  
  CONCLUSIONS
  Small sample size with risk of type II error.
  
  
  CONCLUSIONS
  Independent MDDs were more severe and had different qualities compared with S-I MDDs, suggesting important treatment implications. Longitudinal studies including larger samples and carefully addressing the association between SUD subtypes and MDD subtypes are needed to substantiate our findings.
authors.affiliation: Vestre Viken Hospital Trust, Division of Mental Health and Addiction, Department of Mental Health Research and Development, Lier, Norway. alanga@vestreviken.no
authors.forename: Anne-Marit
authors.initials: AM
authors.lastname: Langås
authors.forename: Ulrik Fredrik
authors.initials: UF
authors.lastname: Malt
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
mesh_terms: D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010343:Patient Admission; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012494:Sampling Studies; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult