title: Correlates of major depressive disorder with and without comorbid alcohol use disorder nationally in the veterans health administration.
abstract: OBJECTIVE
  This study assesses medical and psychiatric comorbidities, service utilization, and psychotropic medication prescriptions in veterans with comorbid major depressive disorder (MDD) and alcohol use disorder (AUD) relative to veterans with MDD alone.
  
  
  METHODS
  Using cross-sectional administrative data (fiscal year [FY]2012: October 1, 2011-September 30, 2012) from the Veterans Health Administration (VHA), we identified veterans with a diagnosis of current (12-month) MDD nationally (N = 309,374), 18.8% of whom were also diagnosed with current (12-month) AUD. Veterans with both MDD and AUD were compared to those with MDD alone on sociodemographic characteristics, current (12-month) medical and psychiatric disorders, service utilization, and psychotropic prescriptions. We then used logistic regression analyses to calculate odds ratio and 95% confidence interval of characteristics that were independently different between the groups.
  
  
  RESULTS
  Dually diagnosed veterans with MDD and AUD, relative to veterans with MDD alone, had a greater number of comorbid health conditions, such as liver disease, drug use disorders, and bipolar disorder as well as greater likelihood of homelessness and higher service utilization.
  
  
  CONCLUSIONS
  Dually diagnosed veterans with MDD and AUD had more frequent medical and psychiatric comorbidities and more frequently had been homeless. These data suggest the importance of assessing the presence of comorbid medical/psychiatric disorders and potential homelessness in order to provide appropriately comprehensive treatment to dually diagnosed veterans with MDD and AUD and indicate a need to develop more effective treatments for combined disorders.
authors.affiliation: VA New England Mental Illness, Research, Education, and Clinical Center, West Haven, Connecticut.|VA Connecticut Healthcare System, Yale University School of Medicine, West Haven, Connecticut.
authors.forename: Gihyun
authors.initials: G
authors.lastname: Yoon
authors.affiliation: VA New England Mental Illness, Research, Education, and Clinical Center, West Haven, Connecticut.|VA Connecticut Healthcare System, Yale University School of Medicine, West Haven, Connecticut.
authors.forename: Ismene L
authors.initials: IL
authors.lastname: Petrakis
authors.affiliation: VA New England Mental Illness, Research, Education, and Clinical Center, West Haven, Connecticut.|VA Connecticut Healthcare System, Yale University School of Medicine, West Haven, Connecticut.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation; D017831:Diagnosis, Dual (Psychiatry); D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D014481:United States; D014600:Utilization Review; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
chemical_list: D011619:Psychotropic Drugs