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Am J Psychiatry 1995; 152:45-52
Copyright © 1995 by American Psychiatric Association
Alcoholism and affective disorder: clinical course of depressive symptoms
SA Brown, RK Inaba, JC Gillin, MA Schuckit, MA Stewart and MR Irwin
VA Medical Center, San Diego, CA 92161.
OBJECTIVE: This study compared the severity of and the change in depressive
symptoms among men with alcohol dependence, affective disorder, or both
disorders during 4 weeks of inpatient treatment. METHOD: After their
primary and secondary psychiatric disorders were defined with the use of
criteria based on chronology of symptoms, 54 unmedicated men entering
treatment for alcohol dependence or affective disorder were assessed for 4
consecutive weeks with the Hamilton Depression Rating Scale. RESULTS: The
findings indicate that the rate of remission of depressive symptoms was
consistent with the primary diagnosis. Depressive symptoms remitted more
rapidly among the men with primary alcoholism than among those with primary
affective disorder. However, a minimum of 3 weeks of abstinence from
alcohol appeared to be necessary to consistently differentiate the groups
with dual diagnoses on the basis of their current depressive symptoms.
Alcohol dependence occurring in conjunction with primary affective disorder
did not intensify presenting depressive symptoms or retard the resolution
of such symptoms. CONCLUSIONS: Diagnoses of alcohol dependence and
affective disorder based on symptom chronology appear to have prognostic
significance with respect to remission of depressive symptoms in men with
both diagnoses. Depressive symptoms of dysphoric mood, dysfunctional
cognitions, vegetative symptoms, and anxiety/agitation showed different
rates and levels of remission across the primary diagnostic groups.
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