[Diagnostic and treatment strategies for depressive disorders in alcohol dependence]

Alcohol dependence is one of most common chronic diseases in Germany. Many alcoholics attribute mental disorders as causative for their elevated alcohol consumption intending to cope with these disorders. Epidemiological studies show that alcoholics have a high lifetime prevalence of psychiatric illnesses, particularly of depressive disorders. The complex relationships between elevated alcohol consumption and depressive symptoms frequently lead to problems in finding the diagnosis and thereafter in planning therapeutic strategies. The indication for drug treatment should be based on the psychopathological findings about 14 days after cessation of drinking, since in many subjects depressive symptomatology abates within the first weeks of abstinence without any treatment. Up to now no specific recommendations can be given because the results of the few published controlled studies showed some discrepancies. Summing up, thus far the efficacy of psychopharmacological drugs in treating alcoholics with depressive disorders have not been investigated sufficiently.