The relationship between alcohol dependence and depression.

Alcohol dependence is not a unitary or homogeneous disorder. There is substantial evidence to suggest that in both community and particularly in clinical samples, additional psychopathology is common. Although estimates of additional psychopathology differ according to the samples studied and the instruments used to classify disorders, up to two-thirds of clinical samples of patients with alcohol dependence are likely to have a lifetime diagnosis of another psychiatric disorder. Affective disorder and antisocial personality disorder appear to be the most commonly and consistently reported additional disorders. Women more than men appear to suffer from additional psychopathology, including secondary and primary depression, although this evidence is weakened by there being fewer studies carried out on mixed gender populations. Having an additional psychiatric diagnosis appears to alter the course of alcohol dependence: it may hasten the development of dependence on alcohol and may bring individuals to the attention of treatment agencies more quickly. More recent studies have examined the relationship between alcohol dependence and affective disorder in the current episode. There is consistent evidence to suggest that a diagnosis of depression in the current episode may change to one of alcohol dependence alone, once detoxification or abstinence has been achieved. The prognosis of those who continue to be depressed remains unclear.