Course and severity of substance abuse among patients with comorbid major depression.

The authors assessed the course and severity of substance-related disorder (SRD) among patients with comorbid major depressive disorder (MDD) by means of both retrospective and concurrent data. A total of 642 patients were assessed. Data on course included lifetime use, age at first use, years of use, use in the last year; periods of abstinence, and current diagnosis. Data on severity included two measures of SRD-associated problems, substance abuse vs. dependence, self-help activities, and number of substances being abused. SRD-MDD patients tended to manifest lower levels of cannabis, opiate, and cocaine use, and more SRD-only patients were abusing three or more substances. Men with SRD-MDD demonstrated longer mean durations of abstinence compared with men with SRD-only, whereas SRD-MDD women demonstrated shorter mean durations of abstinence, compared with women with SRD-only. MDD-SRD patients showed slightly less substance abuse, but SRD severity was comparable with SRD-only patients.