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

酒精成瘾中情感障碍的患病率估计约为23%，酒精依赖的存在使抑郁症的风险增加了近5倍。患有共病抑郁症大大恶化酒精依赖患者的预后。尽管这些对预防、治疗和疾病进展的巨大影响，但这种合并症的潜在机制还没有得到很好的理解。虽然有显着的环境和神经生物学因素参与抑郁症和酒精成瘾的知识，只有少数研究试图翻译这些实证研究结果，以更好地了解和治疗共病患者。此外，成瘾和抑郁的一些神经生物学特征甚至表现出相反的特征。虽然酒精患者似乎增加了大脑奖励系统的反应性，但抑郁症患者显示出系统的敏感性降低。虽然抑郁症的特征是默认模式网络连接增加，但酒精成瘾的连接减少。该项目旨在整合先前关于与酒精依赖和抑郁症相关的奖励回路和大脑连接的研究，以更好地了解其共同发病的神经机制。通过不同的实验范式，允许奖励和默认模式的网络活动和连接的全面表征，并通过比较抑郁症和成瘾患者与共病患者，我们正计划确定不同的和共同的机制，酒精成瘾和抑郁症的共病。此外，神经生物学的结果将被用来测试是否一个简短的心理治疗干预计划是满意的积极影响所确定的神经病理机制。

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.