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Evaluating depression in alcoholics.

C A Dackis, M S Gold, A L Pottash

    Psychiatry Research
    |February 1, 1986
    PubMed
    Summary
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    Untreated depression in alcoholics often resolves after two weeks of sobriety. This suggests many cases may be alcohol-induced, improving without medication.

    Area of Science:

    • Psychiatry
    • Addiction Medicine
    • Neuroscience

    Background:

    • Untreated depression is common in individuals with alcohol use disorder.
    • Differentiating major depressive illness from alcohol-induced depression is clinically significant.
    • The impact of sobriety on depressive symptoms in alcoholics requires further investigation.

    Purpose of the Study:

    • To evaluate the persistence of untreated depression in severely depressed alcohol-dependent individuals.
    • To determine the impact of a short period of sobriety on depressive symptoms.
    • To inform treatment guidelines regarding the timing of psychopharmacotherapy for depression in alcohol use disorder.

    Main Methods:

    • A cohort of 49 severely depressed individuals with alcohol use disorder was studied.

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  • Patients maintained sobriety for a minimum of two weeks.
  • Depressive symptoms were assessed using the Research Diagnostic Criteria for major depression.

    • Main Results:

    • Following two weeks of sobriety, 80% of patients no longer met the criteria for major depression.
    • Symptomatic improvement occurred without the use of antidepressant medications.
    • These findings suggest spontaneous remission of depressive symptoms with sustained abstinence.

    Conclusions:

    • A two-week period of sobriety is recommended before initiating antidepressant pharmacotherapy in alcohol-dependent individuals.
    • Many severe depressive syndromes in actively drinking or recently sober alcoholics may be alcohol-induced organic affective syndromes.
    • These alcohol-induced syndromes appear to remit spontaneously with abstinence, unlike primary major depressive illness.