Social adaptation level and its relationship with the main clinico-dynamic and psychological characteristics in the comorbidity of affective disorders and alcohol dependence

Abstract

Alcohol dependence (AD) and mood disorders are not only a serious medical and socio-economic problem for modern society, but also the cause of social adaptation disorders that form even in the early stages of each of these disorders, as well as in case of their comorbidity.Objective: to determine the relationship between the level of subjective assessment of social adaptation and the main clinical, dynamic and psychological characteristics in patients with affective disorders (AFD) with comorbid AD.Patients and methods. The study included 126 patients treated for AFD in the departments of affective or addictive conditions of the clinic of the Research Institute of Mental Health of the Tomsk National Research Medical Center (F31 – F34.1 according to ICD-10; n=83) or AFD comorbid with AD (F10. 2; n=43). The study used clinical-dynamic, psychometric, pathopsychological and statistical methods.Results and discussion. Patients with AFD without comorbidity at admission were characterized by a greater severity of subjective impairment of social adaptation and anhedonia; hypochondriacal, depressive, psychasthenic and schizoid traits predominated in the structure of their personality. At the same time, the condition of patients with AFD and AD comorbidity was objectively assessed as more severe. An inverse correlation was found between the level of subjective assessment of social adaptation and anhedonia in the group of patients with «pure» AFD, and in the group with AFD and AD comorbidity, with the severity of depressive symptoms (due to typical depressive symptoms), as well as with depressive and anxious personality traits of patients.Conclusion. Self-assessment of social adaptation of patients with “pure” AFD depends on the intensity of anhedonia manifestations, and in patients with AFD and AD comorbidity, on depressive symptoms (due to typical depressive symptoms) and on the severity of such psychological characteristics as depression and psychasthenia.