Am J Psychiatry 1993; 150:294-301
Copyright © 1993 by American Psychiatric Association
Depressive symptoms and the self-reported use of alcohol, caffeine, and carbohydrates in normal volunteers and four groups of psychiatric outpatients
E Leibenluft, PL Fiero, JJ Bartko, DE Moul and NE Rosenthal
Clinical Psychobiology Branch, NIMH, Bethesda, MD 20892.
OBJECTIVE: The authors examined the relationship between depressive
symptoms and the self-reported use of alcohol, carbohydrates, and caffeine
in normal volunteers and four groups of psychiatric outpatients. METHOD:
Outpatients and normal volunteers were given a questionnaire asking about
their use of each of the three substances in response to each of the 14
depressive symptoms on the Hamilton Rating Scale for Depression. They also
rated how much each substance improved each symptom. Twenty-six normal
volunteers, 35 patients with major depression, 117 patients with seasonal
affective disorder, 16 patients with alcohol dependence, and 24 patients
with comorbid primary depression and secondary alcohol dependence completed
the questionnaire. Test-retest reliability was established. Analysis of
variance and stepwise multivariate discriminant function analyses were used
to determine if diagnostic groups differed in the reported use and effect
of each of the three substances. RESULTS: The responses concerning use and
effect of alcohol of patients with alcohol dependence with or without
depression were indistinguishable from each other. The responses of the
patient groups regarding caffeine and carbohydrate use did not differ from
each other, but all differed significantly from the responses of normal
volunteers. Discriminant function analysis distinguished alcoholics from
nonalcoholics in the relationship between drinking and the symptoms of
anger and anhedonia. CONCLUSIONS: The relationship between symptoms and
substance use varied depending on the substance. Alcoholics without
depression were as likely to report drinking in response to depressive
symptoms as were those who had had depression. Patients of all diagnostic
groups were more likely than normal volunteers to report using caffeine and
carbohydrates in response to depressive symptoms.
