Comorbidity between major depression and alcohol use disorder from adolescence to adulthood.
BACKGROUND
Limited information exists regarding the long-term development of comorbidity between Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD; abuse/dependence). Using a representative prospective study, we examine multiple aspects pertaining to MDD+AUD comorbidity, with a focus on the relation between disorders across periods (adolescence, early adulthood, adulthood) and cumulative impairments by age 30.


METHODS
816 participants were diagnostically interviewed at ages 16, 17, 24, and 30.


RESULTS
Rates of comorbid MDD+AUD were low in adolescence (2%), but increased in early adulthood (11%) and adulthood (7%). Rates of cumulative comorbidity were elevated (21%). Most individuals with a history of MDD or AUD had the other disorder, except for women with MDD. Prospectively, adolescent AUD predicted early adult MDD, while early adult MDD predicted adult AUD. Compared to pure disorders, MDD+AUD was associated with higher risk of alcohol dependence, suicide attempt, lower global functioning, and life dissatisfaction.


CONCLUSIONS
Lifetime rates of comorbid MDD+AUD were considerably higher than in cross-sectional studies. Comorbidity was partly explained by bidirectional and developmentally-specific associations and predicted selected rather than generalized impairments. Clinically, our findings emphasize the need to always carefully assess comorbidity in patients with MDD or AUD, taking into account concurrency and developmental timing.
Université de Montréal, Québec, Canada; School Environment Research Group (SERG), Québec, Canada. Electronic address: frederic.nault-briere@umontreal.ca.
Frédéric N
FN
Brière
Oregon Research Institute, OR, USA.
Paul
P
Rohde
Oregon Research Institute, OR, USA.
John R
JR
Seeley
Stony Brook University, NY, USA.
Daniel
D
Klein
Oregon Research Institute, OR, USA.
Peter M
PM
Lewinsohn
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult