The DOI matches its Crossref record; 76 of the 77 references it cites were found in a registry or an index.
The prevalence and impact of alcohol problems in major depression: A systematic review
Abstract
Major depression and alcohol problems are common in primary care, yet little is known about the prevalence of alcohol problems in patients with depression or alcohol's effect on depression outcomes. We strove to answer the following questions: How common are alcohol problems in patients with depression? Does alcohol affect the course of depression, response to antidepressant therapy, risk of suicide/death, social functioning and health care utilization? In which alcohol categories and treatment settings have patients with depression and alcohol problems been evaluated? English language studies from MEDLINE, PsychINFO, and Cochrane Controlled Trial Registry were reviewed. Studies were selected using predefined criteria if they reported on the prevalence or effects of alcohol problems in depression. Thirty-five studies met criteria and revealed a median prevalence of current or lifetime alcohol problems in depression of 16% (range 5-67%) and 30% (range 10-60%), respectively. This compares with 7% for current and 16-24% for lifetime alcohol problems in the general population. There is evidence that antidepressants improve depression outcomes in persons with alcohol dependence. Alcohol problems are associated with worse outcomes with respect to depression course, suicide/death risk, social functioning, and health care utilization. The majority of the studies, 34 of 35 (97%), evaluated alcohol abuse and dependence, and 25 of 35 (71%) were conducted in psychiatric inpatients. We conclude that alcohol problems are more common in depression than in the general population, are associated with adverse clinical and health care utilization outcomes, and that antidepressants can be effective in the presence of alcohol dependence. In addition, the literature focuses almost exclusively on patients with alcohol abuse or dependence in psychiatric inpatient settings, and excludes patients with less severe alcohol problems and primary care outpatient settings.
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“For instance, systematic reviews have found that people with MDD are significantly more likely to engage in excessive alcohol and tobacco use131,132, and have a higher total food intake and reduced diet quality133, higher levels of sedentary behavior134, and poorer sleep continuity and quality135, compared to non-depressed people.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [132]
In the citing paper
“In addition to its role in the aetiology of depressive disorders, alcohol use has been associated with worsening the depression course, and worse outcomes such as suicide/death risk, social functioning and health care utilization (214; specifically for suicide, see section on injury below).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [214]
In the citing paper
“One explanation for these disparities in care is that clinicians may attribute emerging somatic symptoms to the underlying psychiatric disorder resulting in missed diagnoses, sometimes termed 'diagnostic overshadowing'.124,125”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [124]
In the citing paper
“Although health care should be the one sector where challenging behaviour might be recognized as a symptom of illness, there is evidence that various healthcare providers have stigmatised views on people with mental illness.124,125”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [124]
In the citing paper
“Finally, access may be compromised by financial costs, fragmentation of care and stigma.124,126,129”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [124]
Citations
Cites
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Downs, S. H., & Black, N. (1998) · Journal of Epidemiology and Community Health · doi:10.1136/jech.52.6.377 · Cited by 8,252
Spitzer, R. L. (1978) · Archives of General Psychiatry · doi:10.1001/archpsyc.1978.01770300115013 · Cited by 6,946
(1996) · Cited by 6,884
Endicott, J. (1978) · Archives of General Psychiatry · doi:10.1001/archpsyc.1978.01770310043002 · Cited by 5,686
Diagnostic criteria for use in psychiatric research.
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. A. (1972) · Archives of General Psychiatry · doi:10.1001/archpsyc.1972.01750190059011 · Cited by 5,491
Higgins, S. M. F., Macken, A. P., Cullen, W., Saunders, J., Dunne, C. P., & O’Gorman, C. S. (2013) · PubMed · doi:10.34961/9953 · Cited by 4,807
The Structured Clinical Interview for DSM-III-R (SCID): I: History, Rationale, and Description
Spitzer, R. L. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820080032005 · Cited by 4,336
Regier, D. A. (1990) · JAMA · doi:10.1001/jama.1990.03450190043026 · Cited by 3,962
Mendelson, G. (1995) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679509064964 · Cited by 2,592
Kessler, R. C. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830160031005 · Cited by 2,085
The de Facto US Mental and Addictive Disorders Service System
Regier, D. A. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820140007001 · Cited by 1,988
Why we need observational studies to evaluate the effectiveness of health care
Black, N. (1996) · BMJ · doi:10.1136/bmj.312.7040.1215 · Cited by 1,598
Clinical Epidemiology: The Architecture of Clinical Research.
(1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-103-4-649_2 · Cited by 954
Systems to rate the strength of scientific evidence.
West, S. L., King, V., Carey, T. S., Lohr, K. N., Mckoy, N. A., Sutton, S. F., & Lux, L. J. (2002) · PubMed Central · Cited by 873
A Multifaceted Intervention to Improve Treatment of Depression in Primary Care
Katon, W. (1996) · Archives of General Psychiatry · doi:10.1001/archpsyc.1996.01830100072009 · Cited by 835
Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey
Grant, B. F., & Harford, T. C. (1995) · Drug and Alcohol Dependence · doi:10.1016/0376-8716(95)01160-4 · Cited by 637
Traditional reviews, meta-analyses and pooled analyses in epidemiology
Blettner, M. (1999) · International Journal of Epidemiology · doi:10.1093/ije/28.1.1 · Cited by 596
Principles of Medical Statistics
Feinstein, A. R. (2001) · Chapman & Hall/CRC eBooks · doi:10.1201/9781420035681 · Cited by 525
Recognition, management, and outcomes of depression in primary care
Simon, G. E. (1995) · Archives of Family Medicine · doi:10.1001/archfami.4.2.99 · Cited by 521
Clinical Epidemiology: The Architecture of Clinical Research
Ehrlich, G. E. (1985) · JAMA · doi:10.1001/jama.1985.03360140159045 · Cited by 423
Prescribing Trends in Psychotropic Medications
Pincus, H. A., Tanielian, T., Marcus, S. C., Olfson, M., Zarin, D. A., Thompson, J., & ZITO, J. M. (1998) · JAMA · doi:10.1001/jama.279.7.526 · Cited by 423
Hazardous and Harmful Alcohol Consumption in Primary Care
Reid, M. C., Fiellin, D. A., & O’Connor, P. G. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.15.1681 · Cited by 368
Self-citation[Schedule for Affective Disorders and Schizophrenia (SADS)].
Endicott, J., & Spitzer, R. L. (1987) · PubMed · Cited by 367
Fluoxetine in Depressed Alcoholics
Cornelius, J. R. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830200024004 · Cited by 356
Major depression and the risk of attempted suicide
Malone, K. M., Haas, G. L., Sweeney, J. A., & Mann, J. J. (1995) · Journal of Affective Disorders · doi:10.1016/0165-0327(95)00015-f · Cited by 302
Diagnostic and statistical manual of mental disorders, third edition, revised (DSM-III-R)
Berner, P., Gabriel, E., Katschnig, H., Kieffer, W., Koehler, K., & Lenz, G. (1992) · Cambridge University Press eBooks · doi:10.1017/cbo9780511663208.013 · Cited by 291
Disproportionate suicidality in patients with comorbid major depression and alcoholism
Cornelius, J. R., Salloum, I. M., Mezzich, J. E., Cornelius, M. D., Fábrega, H., Ehler, J. G., Ulrich, R. F., Thase, M. E., & Mann, J. J. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.3.358 · Cited by 273
Melartin, T. K., Rytsala, H. J., Leskela, U. S., Lestela-Mielonen, P. S., Sokero, T. P., & Isometsa, E. T. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0207 · Cited by 260
Diagnostic and statistical manual of mental disorders, third edition (DSM-III)
Berner, P., Gabriel, E., Katschnig, H., Kieffer, W., Koehler, K., & Lenz, G. (1992) · Cambridge University Press eBooks · doi:10.1017/cbo9780511663208.012 · Cited by 255
Mueser, K. T., Yarnold, P. R., & Bellack, A. S. (1992) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1992.tb01441.x · Cited by 229
Bartels, S. J., Coakley, E., Oxman, T. E., Constantino, G., Oslin, D., Chen, H., Zubritsky, C., Cheal, K., Durai, U. N. B., Gallo, J. J., et al. (2002) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200207000-00008 · Cited by 216
Dawson, D. A., Grant, B. F., Chou, S. P., & Pickering, R. P. (1995) · Journal of Substance Abuse · doi:10.1016/0899-3289(95)90026-8 · Cited by 204
Sanderson, W. C., Beck, A. T., & Beck, J. (1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.8.1025 · Cited by 181
Prognostic effect of the variable course of alcoholism on the 10-year course of depression
Mueller, T. I., Lavori, P. W., Keller, M. B., Swartz, A., Warshaw, M. G., Hasin, D. S., Coryell, W. H., Endicott, J., Rice, J. P., & Akiskal, H. S. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.5.701 · Cited by 174
Drinking Patterns and Drinking Problems in 1984: Results from a General Population Survey
Hilton, M. E. (1987) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1987.tb01283.x · Cited by 173
Major Depressive Disorder and Axis I Diagnostic Comorbidity
Zimmerman, M., Chelminski, I., & McDermut, W. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0303 · Cited by 158
Order of onset of substance abuse and depression in a sample of depressed outpatients
Abraham, H. D., & D, M. F. M. (1999) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(99)90076-7 · Cited by 146
Substance Abuse in an Inpatient Psychiatric Sample
Brady, K. T., Casto, S., Lydiarcl, R. B., Malcolm, R. J., & Arana, G. W. (1991) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952999109001598 · Cited by 141
Alcoholism and drug abuse in three groups — bipolar I, unipolars and their acquaintances
Winokur, G., Turvey, C., Akiskal, H. S., Coryell, W. H., Solomon, D. A., Leon, A. C., Mueller, T., Endicott, J., Maser, J. D., & Keller, M. B. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00108-6 · Cited by 135
Medication management of depression in the United States and Ontario
Katz, S. J., Kessler, R. C., Lin, E. H. B., & Wells, K. B. (1998) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1998.00022.x · Cited by 131
Leibenluft, E., Fiero, P. L., Bartko, J. J., Moul, D. E., & Rosenthal, N. E. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.2.294 · Cited by 125
Mulder, R. T., Joyce, P. R., & Cloninger, C. R. (1994) · Comprehensive Psychiatry · doi:10.1016/0010-440x(94)90195-3 · Cited by 100
Hanna, E. Z., & Grant, B. F. (1997) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(97)90028-6 · Cited by 95
Occupation and the Prevalence of Major Depression, Alcohol, and Drug Abuse in the United States
Roberts, R. E., & Lee, E. S. (1993) · Environmental Research · doi:10.1006/enrs.1993.1071 · Cited by 69
Patterns of axis I comorbidity in early-onset versus late-onset major depressive disorder
Alpert, J. E., D, M. F. M., Uebelacker, L. A., Nierenberg, A. A., Pava, J. A., Worthington, J. J., & Rosenbaum, J. F. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00017-7 · Cited by 66
Fluoxetine trial in suicidal depressed alcoholics.
Cornelius, J. R., Salloum, I. M., Cornelius, M. D., Perel, J. M., Thase, M. E., Ehler, J. G., & Mann, J. J. (1993) · PubMed · Cited by 63
At-risk drinking in an HMO primary care sample: prevalence and health policy implications.
Fleming, M. F., Manwell, L. B., Barry, K. L., & Johnson, K. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.1.90 · Cited by 58
Gender differences in Axis I comorbidity among depressed outpatients
D, M. F. M. (1996) · Journal of Affective Disorders · doi:10.1016/0165-0327(96)00004-3 · Cited by 58
Davison, K. (1975) · Journal of the Neurological Sciences · doi:10.1016/0022-510x(75)90129-x · Cited by 55
Fluoxetine versus placebo in depressed alcoholics
Cornelius, J. R., Salloum, I. M., Haskett, R. F., Daley, D. C., Cornelius, M. D., Thase, M. E., & Perel, J. M. (2000) · Addictive Behaviors · doi:10.1016/s0306-4603(99)00065-9 · Cited by 50
Comorbid Mental and Substance Disorders among Older Psychiatric Patients
Speer, D. C., & Bates, K. (1992) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1992.tb01984.x · Cited by 48
Predictors of mortality among demented elderly in primary care
Schäufele, M., Bickel, H., & Weyerer, S. B. (1999) · International Journal of Geriatric Psychiatry · doi:10.1002/(sici)1099-1166(199911)14:11 · Cited by 48
Depression and Previous Alcoholism in the Elderly
Cook, B. L., Winokur, G., Garvey, M. J., & Beach, V. (1991) · The British Journal of Psychiatry · doi:10.1192/bjp.158.1.72 · Cited by 48
Depression in Ontario: under-treatment and factors related to antidepressant use
Parikh, S. V., LESAGE, A. D., Kennedy, S. H., & Goering, P. N. (1999) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00063-9 · Cited by 45
Preliminary report: double-blind, placebo-controlled study of fluoxetine in depressed alcoholics.
Cornelius, J. R., Salloum, I. M., Cornelius, M. D., Perel, J. M., Ehler, J. G., Jarrett, P. J., Levin, R. L., Black, A., & Mann, J. J. (1995) · PubMed · Cited by 44
The effect of a history of alcohol dependence in adult major depression
Rae, A. M., Joyce, P. R., Luty, S. E., & Mulder, R. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00365-2 · Cited by 42
Patients Excluded From an Antidepressant Efficacy Trial
Partonen, T., Sihvo, S., & Lönnqvist, J. K. (1996) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v57n1203 · Cited by 41
The influence of alcoholism on the course of depression
Hirschfeld, R. M. A., Kosier, T., Keller, M. B., Lavori, P., & Endicott, J. (1989) · Journal of Affective Disorders · doi:10.1016/0165-0327(89)90069-4 · Cited by 39
Fortney, J. C., Booth, B. M., & Curran, G. M. (1999) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1999.tb04033.x · Cited by 38
Effects of Alcohol Consumption on the Treatment of Depression Among Elderly Patients
Oslin, D. W., Katz, I. R., Edell, W. S., & Have, T. R. T. (2000) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200008000-00006 · Cited by 38
Salloum, I. M., Mezzich, J. E., Cornelius, J. R., Day, N. L., Daley, D. C., & Kirisci, L. (1995) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(95)90070-5 · Cited by 37
Lin, C. (1998) · General Hospital Psychiatry · doi:10.1016/s0163-8343(98)00003-6 · Cited by 37
The effect of comorbid alcoholism on recurrence in affective disorder: a case register study.
Kessing, L. (1999) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00095-0 · Cited by 33
Recidivism in Major Depressive Disorder
Labbate, L. A., & Doyle, M. E. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000289125 · Cited by 31
Experience with ICD-10/DSM-IV Substance Use Disorders
Rounsaville, B. J. (2002) · Psychopathology · doi:10.1159/000065124 · Cited by 28
Archer, L., Grant, B. F., & Dawson, D. A. (1995) · American Journal of Public Health · doi:10.2105/ajph.85.1.61 · Cited by 26
ICD‐10 harmful use of alcohol and the alcohol dependence syndrome: prevalence and implications
Grant, B. F. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00829.x · Cited by 23
Relationship between Concurrent Substance Abuse in Psychiatric Patients and Neuroleptic Dosage
D’Mello, D. A., Boltz, M. K., & Msibi, B. (1995) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952999509002693 · Cited by 19
Anxiety and Alcohol Abuse in Patients in Treatment for Depression
Fischer, E. H., & Goethe, J. W. (1998) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952999809016909 · Cited by 18
Prevalence of comorbid alcohol disorder and consumption in medically ill and depressed patients
Sherbourne, C. D. (1993) · Archives of Family Medicine · doi:10.1001/archfami.2.11.1142 · Cited by 14
Agreement among Feighner, RDC and DSM III criteria for alcoholism
Leonard, K. E., Bromet, E. J., PARKINSON, D. K., & Day, N. L. (1984) · Addictive Behaviors · doi:10.1016/0306-4603(84)90029-7 · Cited by 10
Lyketsos, C. G., Taragano, F. E., Treisman, G. J., & Paz, J. E. (1999) · Psychosomatics · doi:10.1016/s0033-3182(99)71274-0 · Cited by 8
Collaborative Management to Achieve Treatment Guidelines: Impact on Depression in Primary Care
Katon, W. (1995) · JAMA · doi:10.1001/jama.1995.03520370068039 · Cited by 6
Lôo, H., Rein, W., Souché, A., Dufour, H., Guelfi, J., Malka, R., & Olié, J. (1990) · Psychiatry and Psychobiology · doi:10.1017/s0767399x00003096 · Cited by 4
Research works printed but not linked: 1
- Cornelius, 1995, Preliminary report, Psychopharmacol Bull, 31, 297
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The relationship between different dimensions of alcohol use and the burden of disease—an update
Rehm, J., Gmel, G. E., Gmel, G., Hasan, O. S. M., Imtiaz, S., Popova, S., Probst, C., Roerecke, M., Room, R., Samokhvalov, A. V., et al. (2017) · Addiction · doi:10.1111/add.13757 · Cited by 1,204
Holdeman, T. C. (2009) · Psychiatric Services · doi:10.1176/appi.ps.60.2.273 · Cited by 741
Is depression associated with increased oxidative stress? A systematic review and meta-analysis
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Metadata
- Authors
- Sullivan, L. E., Fiellin, D. A., & O’Connor, P. G.
- Affiliations
- Yale University (US)
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2005-04
- Volume
- 118
- Issue
- 4
- Pages
- 330-341
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2015198281
- Cited by
- 489
- References
- 77
- Citations by year
- 2026: 6 · 2025: 25 · 2024: 26 · 2023: 25 · 2022: 36 · 2021: 26 · 2020: 33 · 2019: 34 · 2018: 30 · 2017: 30 · 2016: 26 · 2015: 26 · 2014: 30 · 2013: 25 · 2012: 23
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (K12 DA00167, K12DA000167)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- major depressive disorder, alcohol problems, alcoholism, alcohol abuse, prevalence, antidepressant treatment, suicide risk, social functioning, health care utilization, psychiatric inpatients, primary care
- MeSH terms
- Alcoholism, Antidepressive Agents, Depressive Disorder, Major, Major Depressive Disorder, Humans, Suicide, Prevalence, Randomized Controlled Trials as Topic
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