Clinical-Dynamical Features of Alcohol Use Disorder and Mood Disorders Considering the Chronology of Their Comorbidity Formation

Abstract

Background. The comorbid course of Mood Disorders (MD) and Alcohol Use Disorder (AUD) is a problem actively discussed by national and foreign researchers. Scientists pay close attention to clinical and pathodynamic polymorphism of symptoms in their works. Objective of the study: to compare the Clinical-Dynamical characteristics of AUD and MD, taking into account the formation chronology of their comorbidity, in a clinical sample of the specialized psychiatric hospital. Patients and methods: the study enrolled 56 patients under treatment in Department of Affective Disorders or Addictive Disorders of Mental Health Research Institute Clinics with a comorbid diagnosis of AUD (F10.2 according to ICD-10) and MD (F31–F34.1 according to ICD10). The Clinical-Dynamic, Psychometric and Statistical Methods were used in work. Results: according to statistical analysis in the case of the primary onset of AUD a relatively later formation of the comorbidity was shown (p = 0.001, Mann–Whitney test) and a higher frequency of Dysthymia as a Secondary MD (p = 0.043, chi-square test). Inspite of relatively shorter Duration of the Disease (p = 0.001, Mann–Whitney test), Secondary AUD characterized by rapid evolution of clinical and dynamic traits: the Alcohol Tolerance and Duration of Withdrawal Symptoms are comparable to the Primary AUD (p = 0.739, Mann–Whitney test; p = 0.359, Mann–Whitney test), and slightly shorter Duration of Light Gaps (p = 0.087, Mann–Whitney test) and Heavy Drinking Days (p = 0.034, Mann–Whitney test). A Psychometric study of the severity of symptoms of Depression, Anxiety and Craving for alcohol in the dynamics of psychopharmacotherapy demonstrate their comparability both at the beginning of treatment and by the 28th day of therapy (p > 0.05, Mann–Whitney test). Thereby, AUD developed in the background of a formed MD characterized by a prognostically unfavorable course of Disease.