Comorbidity Between Major Depression and Alcohol Use Disorder From Adolescence to Adulthood
Article [Accepted Manuscript]
Is part of
Comprehensive psychiatry ; vol. 55, no. 3, pp. 526-533.Abstract(s)
Background—Limited information exists regarding the long-term development of comorbidity
between Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD; abuse/dependence).
Using a representative prospective study, we examine multiple aspects pertaining to MDD+AUD
comorbidity, with a focus on the relation between disorders across periods (adolescence, early
adulthood, adulthood) and cumulative impairments by age 30.
Method—816 participants were diagnostically interviewed at ages 16, 17, 24, and 30.
Results—Rates of comorbid MDD+AUD were low in adolescence (2%), but increased in early
adulthood (10%) and adulthood (7%). Rates of cumulative comorbidity were elevated (21%).
Most individuals with a history of MDD or AUD had the other disorder, except for women with
MDD. Prospectively, adolescent AUD predicted early adult MDD, while early adult MDD
predicted adult AUD. Compared to pure disorders, MDD+AUD was associated with higher risk of
alcohol dependence, suicide attempt, lower global functioning, and life dissatisfaction.
Conclusions—Lifetime rates of comorbid MDD+AUD were considerably higher than in crosssectional
studies. Comorbidity was partly explained by bidirectional and developmentally-specific
associations and predicted selected rather than generalized impairments. Clinically, our findings
emphasize the need to always carefully assess comorbidity in patients with MDD or AUD, taking
into account concurrency and developmental timing.
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