Subtypes of major depression in substance dependence

  1. Mark J. Niciu1,
  2. Grace Chan1,
  3. Joel Gelernter2,
  4. Albert J. Arias1,
  5. Kara Douglas1,
  6. Roger Weiss3,
  7. Raymond F. Anton4,
  8. Lindsay Farrer5,
  9. Joseph F. Cubells6,
  10. Henry R. Kranzler1,7,*

Article first published online: 4 AUG 2009

DOI: 10.1111/j.1360-0443.2009.02672.x

Issue

Addiction

Addiction

Volume 104, Issue 10, pages 1700–1709, October 2009

Additional Information

How to Cite

Niciu, M. J., Chan, G., Gelernter, J., Arias, A. J., Douglas, K., Weiss, R., Anton, R. F., Farrer, L., Cubells, J. F. and Kranzler, H. R. (2009), Subtypes of major depression in substance dependence. Addiction, 104: 1700–1709. doi: 10.1111/j.1360-0443.2009.02672.x

Author Information

  1. 1

    Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA,

  2. 2

    Departments of Psychiatry, Genetics, and Neurobiology, Yale University School of Medicine, New Haven, CT and VA CT Healthcare Center, West Haven, CT USA,

  3. 3

    Department of Psychiatry, Harvard Medical School, Boston, MA, and McLean Hospital, Belmont, MA, USA,

  4. 4

    Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,

  5. 5

    Departments of Medicine (Genetics Program), Neurology, Genetics and Genomics, Epidemiology, and Biostatistics, Boston University Schools of Medicine and Public Health, Boston, MA, USA,

  6. 6

    Departments of Human Genetics and Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA and

  7. 7

    Department of Genetics and Developmental Biology, University of Connecticut School of Medicine, Farmington, CT, USA

*Henry R. Kranzler, Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-2103, USA. E-mail: kranzler@psychiatry.uchc.edu

Publication History

  1. Issue published online: 8 SEP 2009
  2. Article first published online: 4 AUG 2009
  3. Submitted 11 August 2008; initial review completed 5 December 2008; final version accepted 27 April 2009

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Keywords:

  • Attempted suicide;
  • anxiety disorders;
  • independent depression;
  • major depressive episode;
  • mood disorder;
  • substance dependence;
  • substance-induced depression

ABSTRACT

Aims  This study evaluated features that differentiate subtypes of major depressive episode (MDE) in the context of substance dependence (SD).

Design  Secondary data analysis using pooled data from family-based and case–control genetic studies of SD.

Setting  Community recruitment through academic medical centers.

Participants  A total of 1929 unrelated subjects with alcohol and/or drug dependence.

Measurements  Demographics, diagnostic criteria for psychiatric and substance use disorders and related clinical features were obtained using the Semi-Structured Assessment for Drug Dependence and Alcoholism. We compared four groups: no life-time MDE (no MDE), independent MDE only (I-MDE), substance-induced MDE only (SI-MDE) and both types of MDE.

Findings  Psychiatric measures were better predictors of MDE subtype than substance-related or socio-demographic ones. Subjects with both types of MDE reported more life-time depressive symptoms and comorbid anxiety disorders and were more likely to have attempted suicide than subjects with I-MDE or SI-MDE. Subjects with both types of MDE, like those with I-MDE, were also more likely than subjects with SI-MDE to be alcohol-dependent only than either drug-dependent only or both alcohol- and drug-dependent.

Conclusions  SD individuals with both types of MDE have greater psychiatric severity than those with I-MDE only or SI-MDE only. These and other features that distinguish among the MDE subtypes have important diagnostic and potential therapeutic implications.

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