Relation between alcoholism and depression based on a review of empirical studies

Abstract

The article surveys empirical studies on the relation between alcohol addiction and depression. For a better understanding and interpretation of the results of these empirical since the end of the 'sixties, the author presents first of all a brief historical abstract of the development of classification of depressive disorders and of the definition of alcoholism. In this article, the author restricts his comments to studies conducted since the end of the 'sixties, as self-rating scales or observers-rating scales or standardised interviews have been employed from that time for characterising the pattern of signs and symptoms and for diagnosis, and now widely used diagnostic schemas also became available (ICD-8, Feighner's criteria, DSM-II). For further clarification studies on genetic studies in the patients' families and on the premorbid personality of alcoholics and depressives are utilised for assessment. The results of these empirical studies are interpreted from the "diagnostic viewpoint" of the 'eighties (i.e. from the viewpoint of ICD-9 and DSM III). Suggestions for further research approach are given. The survey shows that depressive moods appear with greater frequency in patients with alcohol abuse or alcoholism who are under inpatient or outpatient treatment. However, such depressions are usually not very intensive; they will mostly subside towards the end of the treatment course. "Primary depression" and "secondary depression" are seen with an incidence rate far beyond the value expected if two diseases would merely coincide at random, in patient populations whenever alcoholism is involved. On the other hand, no increased prevalence rate for alcoholism was seen in first-degree relations of patients with "major depression" and "Bipolar I disorder", compared with a random sample of a healthy population and first-degree relations of such a random sample. To date we can say that a considerably increased incidence of alcohol abuse, but not of alcohol addiction, is definitely present in clinical populations of patients with bipolar disorders. However, because of the lack of studies which differentiate by means of operationalised criteria between manias and hypomanias and between alcohol addiction and alcohol abuse, it has not been clarified to the present time whether alcohol abuse found in these studies is mainly linked to manic/hypomanic or depressive phases, or whether the alcohol abuse is independent of these phases.(ABSTRACT TRUNCATED AT 400 WORDS)