Using structured interviews, the Epidemiologic Catchment Area (ECA) studies found that nearly 40 percent of people with an alcohol disorder also fulfilled criteria for a psychiatric disorder. Among people with other drug disorders, more than half reported symptoms of a psychiatric disorder (Regier et al., 1990).
The most common psychiatric diagnoses among patients with an AOD disorder are anxiety and mood disorders. Among those with a mood disorder, a significant proportion has major depression. Mood disorders may be more prevalent among patients using methadone and heroin than among other drug users. In an addiction treatment setting, the proportion of patients diagnosed with major depression is lower than in a mental health setting.
The prevalence rates of mood disorders in the general population can be estimated from the results of the ECA studies (Regier et al., 1988; Robins et al., 1988). These studies indicate that:
- The lifetime prevalence rates for any mood disorder ranged from 6.1 to 9.5 percent in the ECA study of New Haven, Baltimore, and St. Louis.
- The lifetime prevalence rates for major depressive episode ranged from 3.7 to 6.7 percent.
- The lifetime prevalence rates for dysthymia ranged from 2.1 to 3.8 percent.
- The lifetime prevalence rates for manic episode ranged from 0.6 to 1.1 percent.
Some studies demonstrate that the prevalence of mood and anxiety disorders is no greater among alcohol or other drug (AOD) abusers than in the general population. Other studies show elevated rates of these disorders among people with AOD disorders. Many patients receiving treatment for addiction appear depressed, but only a small percent receive a formal diagnosis of major depression as a concurrent illness.
During the first months of sobriety, many AOD abusers may exhibit symptoms of depression that fade over time and that are related to acute withdrawal. Thus, depressive symptoms during withdrawal and early recovery may result from AOD disorders, not an underlying depression. A period of time should elapse before depression is diagnosed.
Among women with an AOD disorder, the prevalence of mood disorders may be high. The prevalence rate for depression among alcoholic women is greater than the rate among men. Counselors should be reminded that women in both addiction and nonaddiction treatment settings are more likely than men to be clinically depressed.
In addition to women, other populations require special consideration. Native Americans, patients with HIV, patients maintained on methadone, and elderly people may all have a higher risk for depression. The elderly may be the group at highest risk for combined mood disorder and AOD problems. Episodes of mood disturbance generally increase in frequency with age. Elderly people with concurrent mood and AOD disorders tend to have more mood episodes as they get older even when their AOD use is controlled.
Ries, R. (2007). Mood Disorders and Alcohol/Drug Use. Psych Central. Retrieved on August 27, 2014, from http://psychcentral.com/lib/mood-disorders-and-alcoholdrug-use/0001151
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
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