A study of prevalence and comorbidity of depression in alcohol dependence.

Depressive symptoms are wide spread in alcohol abusing patients of all ages and are much more common than diagnosable depressive disorder. Studies have reported that depression diagnosed in the current episode of alcoholism remits after two weeks of abstinence and detoxification from alcohol. Despite the high prevalence of depression in alcohol dependent individuals, the nature of the relationship between depressive disorder and alcohol abuse have been difficult to define. The present work was undertaken with the aim to study the prevalence and comorbidity of major depression in alcohol dependence. The sample comprised of 34 (32 males and 2 females) DSM-IV alcohol dependent patients admitted in the Psychiatry ward of T.U. Teaching Hospital, Kathmandu during one year study period. Diagnosis of major depressive episode was made according to DSMIV criteria. Severity of dependence on alcohol was assessed with the Severity of Alcohol Dependence Questionnaire and severity of depressive symptoms was rated on Hamilton Rating Scale for Depression. Repeat assessment was done on day 14. A high prevalence of major depression (41.7%) was found for the episode of drinking which led to hospitalization. However, within a few days of detoxification from alcohol, only few of them had depressive symptoms amounting to major depression (17.64%). There was no significant correlation between severity of alcohol dependence and depression. The findings suggest that the nature of depression found in those patients with alcohol dependence needs further exploration. It appears that clinicians exercise appropriate judgement in not prescribing antidepressant treatments for symptoms which may change within days, providing that alcohol is not consumed.