Nature and Course of Clinician and Self-Rated Depressive Features in Persons with Alcohol Use Disorders: A Preliminary Prospective Study among Men Seeking Treatment

INTRODUCTION: The trajectory and nature of depression in patients with alcohol use disorder as they enter treatment needs to be understood better. This study assessed the nature and course of depressive features among male patients with alcohol use disorder.

METHODS: Adult male patients with alcohol use disorders seeking treatment at an addiction treatment facility were recruited. They were assessed for depressive features using the Hamilton Rating Scale for Depression (HRSD), a clinicianrated instrument, and the Inventory of Depressive Symptoms – Self Report (IDS-SR), a self-rated instrument. The Severity of Alcohol Dependence Questionnaire (SADQ) was used to ascertain the severity of their alcohol dependence. The study participants were followed up and reassessed at two weeks and four weeks after recruitment, and depressive features were assessed using HRSD and IDS-SR.

RESULTS: Of the 43 participants recruited for the study, 33 could be assessed at two weeks and four weeks. The mean age of the sample was 35.7 years. The mean HDRS and IDS-SR scores at the baseline were 5.8, and 9.3 respectively, which came down to 2.5 and 4.4 respectively at four weeks. The decrease in the scores was significant. The most common depressive features at the baseline were related to the HRSD items covering work and interests, depressed mood, and feelings of guilt. The most common IDS-SR items related to feeling irritable, feeling sad, and the view of oneself. The HDRS and IDS-SR scores were highly correlated at the baseline and two and four weeks (Rho = 0.879, 0.937, 0.820 respectively; all p < .01). The reduction of depressive symptoms at four weeks was found to be higher among those who were abstinent from alcohol.

CONCLUSIONS: There was a reduction of depressive features over the first four weeks of treatment among the patients with alcohol dependence. Clinicians should consider waiting for this period before starting any additional treatment for depression among patients with alcohol dependence.