Abstract
In the past half-century, the incidence of major mood disorders reportedly has risen, and onset age, diminished. Substance-use disorders (SUDs) are commonly comorbid with mood disorders and may influence their course and outcome. Since secular relationships of these disorders remain unknown, we evaluated medical records of 421 patients (233 men, 188 women) at first-lifetime admissions for major depression, mania or mixed bipolar episodes at a public hospital in Italy during 1978-2002, updated diagnoses to DSM-IV criteria, and compared selected factors between subjects with vs. without SUDs, seeking evidence of secular trends in SUDs in association with early mood disorders. SUD was diagnosed in 122 patients (29.0%). SUD risk was greatest in young males. Relative risk (RR) of diagnostic association with SUDs ranked: mixed states (RR 1.80), mania (RR 1.06), depression (RR 0.55). Annual rates of comorbid SUD and mood disorders increased continuously over the 25-yr epoch for all substances (r=0.640, p<0.001). Age at onset of illness and at first hospitalization (averaging 36 yr and 38 yr) were unrelated to year of hospitalization in this relatively brief sampling, but patients with SUD were younger at onset and admission, overall. Clinical Global Impression (CGI) ratings of illness severity at hospitalization and discharge were stable across years. These findings indicate a secular increase of comorbid SUD among first admissions for mood disorder, especially in young males, with a parallel increase in the proportion of bipolar disorder diagnoses over the past quarter of a century.
Highlights
Prevalence of major mood disorders has reportedly increased steadily over the past century (Angst, 1985 ; Klerman and Weissman, 1989)
The 25-yr sampling yielded 539 patients hospitalized for the first time with an episode of a major mood disorder, or 10 % of a total of 5351 patients admitted in the same period ; of candidate subjects, 118 were excluded for not meeting DSM-IV diagnostic criteria on review, leaving a total of n=421 study subjects [233 men (55.3 %) and 188 women (44.7 %)]
We found that substance abuse comorbidity in major affective disorders increased steadily between 1978 and 2002 and in association with younger age at hospitalization (Table 3)
Summary
Prevalence of major mood disorders has reportedly increased steadily over the past century (Angst, 1985 ; Klerman and Weissman, 1989). Evidence for such a secular trend includes higher proportions of hospital admissions for mood disorders during the years 1950–1980 than in 1920–1949 (Angst, 1985). The average age at onset for mood disorders may have decreased (Chengappa et al, 2003 ; Klerman, 1986), in the late 20th century vs before 1940 (Klerman, 1976) This increased prevalence of mood disorders may partly explain increased rates of. The prevalence of mood disorders among persons with substance abuse has averaged y43 % (range 12–74 %) in recent years (Brady et al, 1991 ; Kessler et al, 1996 ; Miller et al, 1989 ; Regier et al, 1990 ; Strakowski and Del Bello, 2000), and is high among adolescents and young adults (Deykin et al, 1992 ; Paton et al, 1977 ; Rabinowitz et al, 1998 ; Strakowski et al, 1993)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: The International Journal of Neuropsychopharmacology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
