Major depression and comorbid substance use disorders
Major depression and comorbid substance use disorders
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DOI：
10.1097/yco.0b013e3282f32408
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发表时间：
2008-01-01
影响因子：
6.9
通讯作者：
Frazier, Elizabeth
中科院分区：
文献类型：
--
作者：
Davis, Lori;Uezato, Akihito;Frazier, Elizabeth
审查目的：严重抑郁障碍的表现往往因同时出现酒精和非法药物滥用或依赖等物质使用障碍而复杂化。本文综述了近年来对重度抑郁障碍合并物质使用障碍患者的基线特征(包括人口学特征、家族史的影响)、临床特征(如抑郁症状和自杀意念)以及抑郁症治疗结果的系统研究。综述还讨论了文献中引用的可能的解释，即为什么这两种疾病倾向于同时发生，以及这些疾病的并存对治疗的影响。最近的发现近三分之一的严重抑郁障碍患者也有物质使用障碍，这种共病会导致更高的自杀风险和更大的社会和个人损害以及其他精神疾病。虽然用药物治疗重度抑郁障碍和物质使用障碍可能是有效的，但基于物质使用障碍共病的区别治疗效果一直被研究得很少。综述最近研究比较了重度抑郁障碍患者与严重抑郁障碍和物质使用障碍患者的结果，结果表明，与较小的、方法上不那么严格的研究中的旧假设相比，基于共病的差异效应较少。
Purpose of reviewThe presentation of major depressive disorder is often complicated by the co-occurrence of substance use disorders, such as alcohol and illicit drug abuse or dependence. The article reviews the recent systematic research on the distinguishing baseline characteristics including demographic characteristics and the influence of family history, and clinical features such as depressive symptomatology and suicidal ideation, and the outcome of treatment for depression in patients with comorbid major depressive disorder and substance use disorders. The review also addresses the possible explanations cited in the literature as to why these two disorders tend to co-occur and the implications of the comorbiclity of these illnesses on treatment.Recent findingsNearly one-third of patients with major depressive disorder also have substance use disorders, and the comorbidity yields higher risk of suicide and greater social and personal impairment as well as other psychiatric conditions. Although the treatment of comorbid major depressive disorder and substance use disorders with medication is likely effective, the differential treatment effects based on substance use disorder comorbidity have been understudied.SummaryEmerging results of recent studies comparing the outcome of major depressive disorder patients with comorbid major depressive disorder and substance use disorders suggest that there are fewer differential effects based on comorbidity than previously anticipated by older assumptions from smaller, less methodologically rigorous studies.