Komorbidität von Depression und Alkoholabhängigkeit

M. Soyka; M. Lieb

doi:10.1055/s-0038-1626188

Nervenheilkunde, Table of Contents

Nervenheilkunde 2004; 23(01): 13-20
DOI: 10.1055/s-0038-1626188

Original- und Übersichtsarbeiten - Original and Review Articles

Schattauer GmbH

Komorbidität von Depression und Alkoholabhängigkeit

Klinische und neurobiologische AspekteComorbidity of depressive syndroms and alcoholismClinical and neurobiological aspects

M. Soyka

¹Psychiatrische Klinik und Poliklinik der Ludwig-Maximilians-Universität München

,

M. Lieb

¹Psychiatrische Klinik und Poliklinik der Ludwig-Maximilians-Universität München

› Author Affiliations

Abstract

Zusammenfassung

Die Komorbidität von depressiven Syndromen und Alkoholabhängigkeit wurde in den letzten Jahren zunehmend Gegenstand der Forschung. Nach chronologischen Gesichtspunkten wird unterschieden zwischen primären und sekundären, nach ätiologischen zwischen abhängigen und unabhängigen depressiven Syndromen. Die unterschiedlichen Ergebnisse, die hinsichtlich der Komorbidität in klinischen Studien ermittelt wurden, erklären sich vor allem durch die Verwendung unterschiedlicher Diagnosesysteme, die Auswahl der untersuchten Stichproben und den Zeitpunkt der Untersuchung. So waren im Entzug depressive Symptome deutlich häufiger. Auch auf geschlechtsspezifische Unterschiede wurde eingegangen. Dabei fanden sich depressive Störungen bei Frauen deutlich öfter. Die validesten Ergebnisse hinsichtlich der Prävalenz einer Komorbidität wurden durch epidemiologische Untersuchungen erzielt. Der vorliegende Beitrag stellt daneben neuere biologische und genetische Erkenntnisse über den Zusammenhang zwischen Depressivität und Alkoholabhängigkeit dar und diskutiert prognostische und therapeutische Implikationen.

Summary

The comorbidity of depressive syndroms and alcoholism was investigated in recent years increasingly. It is differentiated according to chronological aspects between primary and secondary depressive syndromes, according to etiologic aspects between dependent and independent ones. The different outcomes regarding comorbidity are explained by the use of diverse diagnostic classification systems, the selection of the sample and the time of testing. Withdrawal increased number and intensity of depressive symptoms. Sex differences were explained. Depressive disorders are to be found at women more often. Most valid results as to prevalence of comorbidity were produced by epidemiological surveys. Recent biological and genetic findings about the connection between depression and alcohol dependency are described. Prognostic and therapeutic implications are discussed.

Schlüsselwörter

Alkohol - Abhängigkeit - Depression - affektive Störung

Keywords

Alcohol - dependence - depression - affective disorder

Full Text

References

Literatur
1 Schuckit MA. Genetic and clinical implications of alcoholism and affective disorders. Am J Psychiatry 1986; 43 (02) 140-7.
2 Keeler MH, Taylor CI, Killer WC. Are all recently detoxified alcoholics depressed?. Am J Psychiatry 1979; 136: 586-88.
3 Cadoret R, Winokur G. Depression in alcoholism. Ann NY Acad Sci 1974; 233: 34-9.
4 Fowler RC, Lidkow BI, Tanna VL. Alcoholism, depression and life events. J Affective Disord 1980; 02: 127-35.
5 Halikas JA, Herzog MA, Mirasou MM, Lyttle MD. Psychiatric diagnosis among female alcoholics. Curr Alcohol 1981; 08: 283-91.
6 Robins E, Gentry KA, Munoz RA, Marten S. A contrast of the three more common illness with the ten less common in a study and 18 month follow up of 314 psychiatric emergency room patients. Arch Gen Pschiatry 1977; 34: 269-81.
7 Woodruff RA, Guze SB, Clayton PJ, Carr D. Alcoholism and depression. Arch Gen Psychiatry 1973; 97-100.
8 Bromet EJ, Parkinson DK, Curtis EC, Schulberg HC, Blane H, Dunn LO, Phelan J, Dew MA, Schwartzt JE. Epidemiology of depression and alcohol abuse/dependence in a managerial and professional work force. J Occup Med 1990; 32: 989-95.
9 Bronisch Th. Zur Beziehung zwischen Alkoholismus und Depression anhand eines Überblicks über empirische Studien. Fortschr Neurol Psychiatr 1985; 53: 454-68.
10 Ewusi-Mensah I, Saunders JB, Wodak AD, Murray AM, Williams R. Psychiatric morbidity in patients with alcoholic liver disease. Br med J 1983; 287: 1417-19.
11 Weismann MM, Myers IK. Clinical Depression in alcoholism. Am J Psychiatry 1980; 137: 372-3.
12 Kasperowicz-Dabrowiecka et al. Beyond the Winokur concept of depression spectrum disease: which types of alcoholism are related to primary affective illness?. J Affektive Disord 2001; 63: 133-8.
13 Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goldwin FK. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511-18.
14 Kessler RC. et al. Lifetime Co-occurrence of DSM-III-R Alcohol Abuse and Dependence with other psychiatric disorders in the national comorbidity survey. Arch Gen Psychiatry 1997; 54: 313-21.
15 Golding JM, Burnam MA, Benjsamin B, Wells KB. Risk factors for secondary depression among Mexican Americans and non-hispanic whites. J Nerv Ment Dis 1993; 181: 166-75.
16 Schuckit et al. Comparison of induced and independent Major depressive disorders in 2.945 alcoholics. Am J Psychiatry 1997; 154: 948-57.
17 Kandel DB. et al. Comorbidity patterns of substance use dependence and psychiatric syndromes. Drug Alcohol Depend 2001; 64: 233-41.
18 Gilman SE, Abraham HD. A longitudinal study of the order of onset of alcohol dependence and major depression. Drug Alcohol Depend 2001; 63 (03) 277-86.
19 Brook DW, Brook JS, Zhang C. et al. Drug use and the risk of major depressive disorder, alcohol dependency and substance use disorders. Arch Gen Psychiatry 2002; 59: 1039-44.
20 Rae AM. et al. The effect of a history of alcohol dependence in adult major depression. J Affect Disord 2002; 70 (03) 281-90.
21 Clark DB. et al. Physical and sexual abuse, depression and alcohol use disorders in adolescents: onsets and outcomes. Drug Alcohol Depend 2003; 69: 51-60.
22 Kumpulainen K. et al. Depressive Syndroms at the age of 12 years and future heavy alcohol use. Addictive Behaviors 2002; 27: 425-36.
23 Torikka et al. Depression, drinking and substance use among 14-to 16-year-old Finnish adolescents. Nord J Psychiatry 2001; 55 (05) 351-7.
24 Fine EW, Richman SA, Teichmann MX. Depression in female alcoholics. In: Galanter M. (ed). Currents in alcoholism. vol. III. New York, London, Toronto: Grune & Stratton; 1993
25 Zielinski JJ. Psychological test data of depressed, nondepressed and relapsed alcoholics receiving pharmacological aversion. Br J Addict 1979; 74: 174-82.
26 Equi PJ, Jabara RF. Validation of the self-rating depression scale in an alcoholic population. J Clin Psych 1976; 32: 504-7.
27 Hesselbrock MN, Hesselbrock VM, Tennen H, Meyer RE, Workman KL. Methodological consideration in the assessment of depression in alcoholics. J Consult Clin Psychol 1983; 51: 399-405.
28 Weissman MM, Myers JK, Harding PS. Prevalence and psychiatric heterogeneity of alcoholism in a united states urban community. J Stud Alcohol 1980; 41: 672-81.
29 Beck AT, Steer RA, McElroy MG. Self-reported precedence of depression in alcoholism. Drug Alcohol Depend 1982; 10: 185-90.
30 Davidson KM. Diagnosis of depression in alcohol dependence. Br J Psychiatry 1995; 166: 199-204.
31 Liappas J, Paparrigopoulos T, Tzavellas E, Christodoulou G. Impact of alcohol detoxification on anxiety and depressive symptomns. Drug Alcohol Depend 2002; 68 (02) 215-20.
32 Hatsukami D, Pickens RW, Silvikis D. Posttreatment depression in an alcohol and drug abuse population. Am J Psychiatry 1981; 139: 1563-66.
33 Hatsukami D, Pickens RW. Post-treatment depressive symptons and relapse to drug use in different age groups of an alcohol and other drug abuse population. Drug Alcohol Depend 1982; 08: 271-7.
34 Scholz H. Das Ausfallsyndrom nach Unterbrechung der Alkoholabhängigkeit. Fortschr Neurol Psychiatr 1982; 50: 279-96.
35 Hasin DS, Grant BF. Major depression in 6050 drinkers: association with past alcohol dependence. Arch Gen Psychiatry 2002; 59 (09) 794-800.
36 Miguel-Hidalgo JJ. et al. Comparison of prefrontal cell pathology between depression and alcohol dependence. J Psychiatr Res 2003; 37: 411-20.
37 Winterer G. et al. EEG phenotype in alcoholism: increased coherence in the depressive subtype. Act Psychiatr Scand 2003; 108: 51-60.
38 Pietraszek MH. et al. Alcohol induced depression: involvement of serotonin. Alcohol Alcohol 1991; 26: 155-9.
39 Lejoyeux M. Use of serotonin (5-hydroxytryptamine) reuptake inhibitors in the treatment of alcoholism. Alcohol Alcohol 1996; 31 (Suppl.): 69-75.
40 Schmidt K. et al. Psychopathological correlates of reduced dopamine receptor sensitivity in depression, schizophrenia and opiate and alcohol dependence. Pharmacopsychiatry 2001; 34: 66-72.
41 Fu Q, Heath AC, Buchholz KK, Nelson E, Goldberg J, Lyons MJ, True WR, Jacob T, Tsuang MT, Eisen SA. Shared genetic risk of major depression, alcohol dependence and marijuana dependence: contribution of antisocial personality disorder in men. Arch Gen Psychiatry 2002; 59: 1125-32.
42 Kovacs M. et al. A controlled family history study of childhood-onset depressive disorder. Arch Gen Psychiatry 1997; 54: 613-23.
43 Nurnberger JI. et al. Evidence for a Locus on Chromosome 1 that influences vulnerability to alcoholism and affective disorder. Am J Psychiatry 2001; 158: 718-24.
44 Fehr C. et al. The HTBR1G>C receptor polymorphism among patients suffering from alcoholism, major depression, axiety disorders and narcolepsy. Psychiatry Res 2000; 97: 1-10.
45 Kranzler HR. et al. Comorbid psychiatric diagnosis predicts three year outcomes in alcoholics: posttreatment natural history study. J Stud Alcohol 1996; 57: 619-26.
46 Fortney JC. et al. Do patients with alcohol dependence use more services? A comparative analysis with other chronic disorders. Alcohol Clin Exp Res 1999; 23: 127-33.
47 Greenfield SF. et al. The effect of depression on return to drinking: a prospective study. Arch Gen Psychiatry 1998; 55: 259-65.
48 Davidson KM. et al. Comorbid depression and drinking in those with alcohol dependence. Alcohol Alcohol 1998; 33: 482-87.
49 Preuss UW, Schuckit MA, Smith TL, Danko GR, Dasher AC, Hesselbrook MN, Hessel-brook VM, Nurnberger Jr JI. A comparsion of alcohol-induced and independent depression in alcoholics with histories of suicide attempts. J Stud Alcohol 2002; 63 (04) 498-502.
50 Aharanov E. et al. Suicide attempts in substance abusers: effects of major depression in relation to substance use diorders. Am J Psychiatry 2002; 159: 1600-2.
51 Soyka M. Praxisratgeber Alkoholabhängigkeit. Bremen: Uni-Med; 2000: 113-4.
52 McGrath et al. Imipramine treatment of alcoholics with major depression: A placebo controlled clinical trial link. Arch Gen Psych 1996; 53: 232-40.
53 Powell BJ. et al. A double-blind, placebo controlled study of nortriptyline and bromocriptine in male alcoholics subtyped by psychiatric disorder. Alcoholism Clinical and Experimental Research 1995; 19: 462-8.
54 Mason BJ. et al. A double-blind, placebo controlled trial of desipramine for primary alcohol dependence stratified on the presence of absence of major depression. Journal of the American Medical Association 1996; 275: 761-67.
55 Cornelius JR. et al. Fluoxetine in depressed alcoholics: A double blind placebo controlled trial. Arch Gen Psych 1997; 54: 700-5.
56 Cornelius et al. Fluoxetine versus placebo in depressed alcoholics: A one year follow up study. Addictive Behaviors 2000; 24: 307-10.
57 Kranzler HR. et al. Placebo controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am J Psychiatry 1995; 152: 391-97.
58 Roy A. Placebo controlled study of sertraline in depressed recently abstinent alcoholics. Biological psychiatry 1998; 44: 633-37.
59 Cornelius JR. et al. Alcohol and Psychiatric Comorbidity. Recent Dev Alcohol 2003; 16: 361-74.
60 Pettinati HM. et al. The Status of Serotoninselective Pharmacotherapy in the treatment of alcohol dependence. Recent Dev Alcohol 2003; 16: 247-62.
61 Mundle G. et al. AWMF-Behandlungsleitlinie: Akutbehandlung alkoholbezogener Störungen. Sucht 2003; 49 (03) 147-67.