Combination of mood disorders and alcohol dependence: clinical significance of comorbidity, social adaptation of patients

Background. Manifestations of anxiety and depression exacerbate the course of destructive processes in alcoholism. The prevalence of depressive and anxiety disorders in the contingent of people who abuse alcohol is higher thanin the global and Russian population as a whole. In the structure of mental pathology, there is an increase in comorbid conditions, which is associated with an increase in the level of hospitalization and rehospitalization of comorbid patients. The comorbidity of mood disorders (MD) and alcohol dependence worsens the prognosis and effectiveness of the therapy, enhances patient non-compliance, reduces their level of social adaptation and quality of life, causes serious economic problems in the family due to increased disability of patients and adverse medical and social consequences. Objective: to identify the clinical and dynamic characteristics of mood disorders in their comorbid course with alcohol dependence. Material and Methods. The study was carried out based on Affective States Department of Mental Health Research Institute of Tomsk National Research Medical Center. Of the examined, two groups of patients (n=63) with MD were formed with a predominance of men (n=43) compared with women (n=20). The main group (n=32) included patients with MD and concurrent alcohol dependence, the comparison group (n=31) consisted of patients with MD without concurrent addictive pathology. Comparison for three variables (gender, age, and nosological assessment of MD) did not reveal statistically significant (p>0.05) differences between patients in both groups. The Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS-17), the Hamilton Anxiety Rating Scale (HARS), and the Social Adjustment Self-evaluation Scale (SASS) were used. Results. Suicidal thoughts were more often detected in the main group (n=21; 65.6%) than in the comparison group (n=15; 48.4%). Suicidal attempts in history statistically significantly (p2=4.58) more common in the main group. Severe disorder (according to S-CGI score >6) was statistically significant (p=0.04, x2=4.00) more often in the main group (n=11; 34.4% and n=4; 12.9%). According to SASS in both groups, the majority were patients with difficult and poor social adaptation. In MD with comorbid alcohol dependence, compared with MD without alcohol dependence, exacerbations of mood pathology occur more often, higher levels of anxiety, disease severity, and the risk of suicidal behavior are noted. Patients with a comorbid course of disorders have a lower level of social adaptation than patients with isolated MD. Conclusion. Alcohol dependence, combined with MD disorders, negatively affects the clinical and dynamic parameters and the level of social adaptation of patients.