Influence of Comorbidity of Depressive Disorders with Alcohol Dependence on the Main Clinical and Dynamic Characteristics of Depression and the Manifestations of Aggressiveness

Background: the comorbidity of depressive disorders (DD) and alcohol dependence (AD) negatively affects the clinical and dynamic characteristics of depressive disorders, as well as the manifestations of aggressiveness in these patients. The aim was to evaluate the impact of comorbidity of DD and AD on the main clinical and dynamic characteristics of DD and the manifestations of aggressiveness. Patients and Methods: 182 patients were selected in the departments of affective and addictive states of Mental Health Research Institute, Tomsk National Research Medical Center. The study group was divided into a group of patients according to the ICD-10 classification (n = 132) with DD (F32–33, F34.1) and group of patients (n = 50) with DD comorbid with AD (F3 + F10). In the F3 group, women predominated (82.6%), and in the F3 + F10 group, men predominated (68,0%). The median age of patients in the DD group was 45 (33.0; 54.8) years, and 46.5 (39.0; 53.0) years in patients of DD + AD group. Results: data were obtained on the high comorbidity of alcoholism and dysthymia, comparable severity of current depression in the case of “pure” DD and in case of “dual diagnosis”; the formation of alcohol dependence syndrome occurred 7 years earlier than the onset of DD. Multimodal antidepressants and an augmentation strategy were more often used, instability in relation to changing jobs due to illness and less satisfaction with their income was more often noted in the comorbid group. Increase of physical and verbal aggression level as well as suspiciousness was statistically significant (p < 0.001) compared with the same indicators in patients with “pure” DD. Conclusions: in the study sample, the formation of comorbidity of DD and AD has a predominant pattern with the primary occurrence of AD. Such comorbidity affects professional functioning and is accompanied by marked indicators of aggressiveness and hostility, which can be considered as an important clinical vector for assessing the patient’s current condition in the case of isolated DD, as well as in case of DD and AD comorbidity.

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