Harvard Medical School, McLean Hospital, Mailstop #109, 115 Mill Street, Belmont, MA 02478, USA.
Curr Psychiatry Rep. 2012 Dec;14(6):610-8. doi: 10.1007/s11920-012-0314-7.
Alcohol use disorders (AUDs) and depressive illnesses are highly prevalent, frequently co-occur, and are associated with worse outcomes when paired. The assessment and treatment of patients with co-occurring alcohol use disorders and depressive illnesses is wrought with many significant challenges. When it comes to advocating treatment guidelines for this dually-diagnosed population, the data are limited, but, nonetheless, do suggest that an integrated approach to patients presenting with co-occurring AUD and depressive symptoms can be efficacious. In this approach, ongoing evaluation and treatment are provided under one roof according to the evolving needs of each patient. Utilizing antidepressant medications in conjunction with psychosocial therapies may augment overall treatment efficacy; data also suggest that combining and tailoring psychosocial therapies, such as motivational enhancement therapies, cognitive therapies, and twelve-step facilitation may further improve treatment outcomes for patients with co-occurring depressive and alcohol use disorders.
酒精使用障碍(AUDs)和抑郁性疾病的发病率很高,经常同时发生,如果同时发生,其结果会更差。当同时患有酒精使用障碍和抑郁性疾病的患者进行评估和治疗时,会遇到许多重大挑战。在为同时患有这两种疾病的患者制定治疗指南时,数据有限,但仍然表明,对同时出现 AUD 和抑郁症状的患者采用综合方法可能是有效的。在这种方法中,根据每个患者不断变化的需求,在一个屋檐下提供持续的评估和治疗。联合使用抗抑郁药物和心理社会疗法可能会提高整体治疗效果;数据还表明,结合和调整心理社会疗法,如动机增强疗法、认知疗法和十二步促进疗法,可能会进一步改善同时患有抑郁和酒精使用障碍的患者的治疗效果。