ABDUL KHALID, MD., Lecturer, Department of Psychiatry & Mental Health, Institute of Medicine, Kathmandu, Nepal
Indian J Psychiatry. 2000 Oct;42(4):434-8.
Depressive symptoms are wide spread in alcohol abusing patients of all ages and are much more common than diagnosable depressive disorder. Studies have reported that depression diagnosed in the current episode of alcoholism remits after two weeks of abstinence and detoxification from alcohol. Despite the high prevalence of depression in alcohol dependent individuals, the nature of the relationship between depressive disorder and alcohol abuse have been difficult to define. The present work was undertaken with the aim to study the prevalence and comorbidity of major depression in alcohol dependence. The sample comprised of 34 (32 males and 2 females) DSM-IV alcohol dependent patients admitted in the Psychiatry ward of T.U. Teaching Hospital, Kathmandu during one year study period. Diagnosis of major depressive episode was made according to DSMIV criteria. Severity of dependence on alcohol was assessed with the Severity of Alcohol Dependence Questionnaire and severity of depressive symptoms was rated on Hamilton Rating Scale for Depression. Repeat assessment was done on day 14. A high prevalence of major depression (41.7%) was found for the episode of drinking which led to hospitalization. However, within a few days of detoxification from alcohol, only few of them had depressive symptoms amounting to major depression (17.64%). There was no significant correlation between severity of alcohol dependence and depression. The findings suggest that the nature of depression found in those patients with alcohol dependence needs further exploration. It appears that clinicians exercise appropriate judgement in not prescribing antidepressant treatments for symptoms which may change within days, providing that alcohol is not consumed.
抑郁症状在各个年龄段的酗酒患者中广泛存在，而且比可诊断的抑郁障碍更为常见。研究报告称，在两周的戒酒和戒酒后，当前酗酒发作期间诊断出的抑郁症会缓解。尽管酒精依赖个体中抑郁症的患病率很高，但抑郁障碍和酒精滥用之间的关系性质一直难以确定。本研究旨在研究酒精依赖中重度抑郁症的患病率和共病情况。该样本包括 34 名（32 名男性和 2 名女性）符合 DSM-IV 酒精依赖标准的患者，他们在一年的研究期间被收入加德满都 T.U.教学医院的精神科病房。根据 DSM-IV 标准诊断为重度抑郁症发作。酒精依赖的严重程度用酒精依赖严重程度问卷进行评估，抑郁症状的严重程度用汉密尔顿抑郁评定量表进行评定。第 14 天进行重复评估。发现导致住院的饮酒发作中存在重度抑郁症（41.7%）的高患病率。然而，在戒酒几天后，只有少数人有严重的抑郁症状，达到重度抑郁症（17.64%）。酒精依赖的严重程度与抑郁之间没有显著相关性。研究结果表明，在那些患有酒精依赖的患者中发现的抑郁性质需要进一步探索。似乎临床医生在不使用抗抑郁药物治疗可能在几天内改变的症状时会做出适当的判断，只要不饮酒。
