From the neurobiological basis of comorbid alcohol dependence and depression to psychological treatment strategies: bridging the knowledge gap

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The prevalence of affective disorders in alcohol addiction is estimated to around 23% and the presence of alcohol dependence increases the risk for depression by a factor of almost 5. Suffering from a comorbid depression substantially deteriorates the prognosis of alcohol dependent patients. Despite these tremendous implications for prevention, treatment and disease progression, the mechanisms underlying this comorbidity are not well understood. Although there is significant knowledge of the environmental and neurobiological factors involved in depression and alcohol addiction, only a few studies have tried to translate these empirical findings for a better understanding and treatment of comorbid patients. Furthermore, some of the neurobiological signatures of addiction and depression show even contrary characteristics. While alcohol patients seem to have increased brain reward system responsivity, depressed patients show a reduced sensitivity of the system. While depression is characterized by increased default mode network connectivity, reduced connectivity has been described for alcohol addiction. The proposed project aims to integrate previous research about the reward circuit and brain connectivity associated with alcohol dependence and depression to achieve a better understanding of neural mechanisms characterizing their comorbidity. By means of diverse experimental paradigms allowing a comprehensive characterization of reward and default mode network activity and connectivity and by comparing depressed and addicted patients with comorbid patients, we are planning to identify distinct and common mechanisms underlying the comorbidity of alcohol addiction and depression. In addition, the neurobiological results will be used to test whether a brief psychotherapeutic intervention program is satiable to positively influence the identified neural pathomechanisms.