Course and Outcome of Depressive Disorders among Patients with Alcohol Dependence

Abstract

Abstract Introduction: Alcohol dependence is likely to influence treatment processes and outcomes in depressive patients. This co-occurrence of alcohol use disorder (AUD) and depressive disorder has been previously associated with greater severity and a worse prognosis for both entities. However, there is a dearth of Indian studies on this issue. Objective: To examine the course and outcome among alcohol-dependent/nondependent depressive patients. Materials and Methods: Semistructured pro forma for demographic details, International Classification of Diseases 10 Diagnostic Criteria for Research criteria for diagnosis, and Hamilton Depression Rating Scale (HAM-D) for severity of depression were administered to 124 persons at baseline, 6 weeks, and 3 months. Results: The differences between the groups’ HAM-D scores were found to be statistically significant at all time points (i.e., at baseline, 6 weeks, and 3 months) (P < 0.001), with overall worst scores among patients with bipolar depression with alcohol dependence (Group IA) (P < 0.05 at all follow-up points), indicative of slower remission of depression and poorer course in these patients. Among patients of unipolar depression, those with alcohol dependence scored worse on the HAM-D scale at 3 months of follow-up indicative of worse outcomes in the long term. Conclusions: Patients with mood disorder and AUD were found to have worse outcome on follow-up as compared to those without. Furthermore, bipolar patients with AUD were found to have the worse depression at the end of follow-up thus indicating a poorer outcome in the long term. However, future studies should incorporate study of associated factors and how it contributes to worse outcomes.