Depressive syndromes associated with alcohol dependence

SUBMITTED NOVEMBER 2019, ACCEPTED DECEMBER 2019 © 2019 Giovanni Fioriti Editore s.r.l. 206 Introduction Nowadays alcoholism is an increasing problem all over the world, especially amongst teenagers, that represents a crucial and medical burden for society (Beresford et al., 2014; Gutierrez and Sher, 2015; Marazziti et al., 2015; Derges et al, 2017). The association between depressive syndromes (DSs) and alcohol abuse is also well established, as it is the notion that a progressive involvement with alcohol may increase the risk for depression (Davis et al., 2008; Boden and Ferguson, 2011). Depressive syndromes (DSs) are a heterogeneous group of conditions of diff erent severity, duration and prognosis, representing one of the most common types of psychiatric disorders amongst people suff ering from alcohol dependence (AD) (Saykov and Sosin, 2004; Satre et al., 2011; Pilling et al., 2011; Napryeyenko et al., 2011; 2013a; 2013b). AD-associated DSs often induces actualization of morbid attraction to alcohol and poses a relapse risk that, to a considerable extent, may induces poor quality and duration of remissions (Haller et al, 2014). Clinical surveillance studies of AD patients showed that those also suff ering from DSs are diffi cult to manage in terms of diagnosis, treatment, preventive healthcare, as well as medical and social rehabilitation (Grothues et al., 2008; Iovieno et al., 2011; Berking et al., 2011). Diagnosis of DSs in AD turns out to be problematic because of the dominance of unclear clinical pictures that are connected to diff erent casual factors triggering the onset of DSs. Depressive symptoms, although representing a main attribute of AD, are frequently ignored by the patients themselves, and cannot be easily detected by the surrounding people. Again, their existence can be “hidden” behind systematic excessive alcohol consumption, or several somatic and cerebral-organic sequelae. Such patients neither seek medical help at all, or the reason for their consulting a doctor is the consecutive alcohol consumption relapses. Further, a tendency towards lingering course Objective: Depressive syndromes (DSs) are some of the most common mental disorders in individuals suff ering from alcohol dependence (AD). The aim of the study was to investigate the characteristics of DSs associated with AD in a group of inpatients admitted in a psychiatric hospital. Method: One hundred sixty inpatients between 25 and 58 years of age (mean ± SD: 37.30 ± 7.97), suff ering from AD and DSs and recruited from a larger clinical sample, were included. They were evaluated by means of a battery of diagnostic/rating scales for assessment of both diagnosis and symptoms severity. Results: Complete physical and psychiatric examinations of AD patients showed that DSs represent a very heterogeneous group that can be divided in: psychogenic (66.3%), endogenous (11.3%), organic (22.4%), and mixed. The following clinical depressive subtypes could be identifi ed: hypochondriac (42.5%), asthenic (20.6%), agitated (19.4%), dysphoric (8.8%), simple (4.35%), and apathetic (4.35). Conclusions: Our study indicates that DSs during AD represent a constant association that frequently complicates the clinical pictures, induces low quality of life and personal adjustment, and impairs remission. Investigation of the casual and intertwined factors, developmental patterns and clinical structure of the AD-associated DSs should allow optimizing a tailored and integrated system of medical rehabilitation