Comorbidity between major depression and alcohol use disorder from adolescence to adulthood
Open accessAbstract
Background Limited information exists regarding the long-term development of comorbidity between Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD; abuse/dependence). Using a representative prospective study, we examine multiple aspects pertaining to MDD+AUD comorbidity, with a focus on the relation between disorders across periods (adolescence, early adulthood, adulthood) and cumulative impairments by age 30.Method 816 participants were diagnostically interviewed at ages 16, 17, 24, and 30.Results Rates of comorbid MDD+AUD were low in adolescence (2%), but increased in early adulthood (11%) and adulthood (7%). Rates of cumulative comorbidity were elevated (21%). Most individuals with a history of MDD or AUD had the other disorder, except for women with MDD. Prospectively, adolescent AUD predicted early adult MDD, while early adult MDD predicted adult AUD. Compared to pure disorders, MDD+AUD was associated with higher risk of alcohol dependence, suicide attempt, lower global functioning, and life dissatisfaction.Conclusions Lifetime rates of comorbid MDD+AUD were considerably higher than in cross-sectional studies. Comorbidity was partly explained by bidirectional and developmentally-specific associations and predicted selected rather than generalized impairments. Clinically, our findings emphasize the need to always carefully assess comorbidity in patients with MDD or AUD, taking into account concurrency and developmental timing.
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Developing MDD can have a pronounced detrimental impact on an individual's health behaviors, including sleep impairment, low motivation for physical activity, over/under-eating, and a propensity to self-medicate with tobacco, alcohol or substance use.
“On the other hand, developing MDD can have a pronounced detrimental impact on an individual's health behaviors, including sleep impairment, low motivation for physical activity, over/under-eating, and a propensity to self-medicate with tobacco, alcohol or substance use138,139.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [139]
The Discussion (page not provided) reports that early-adult MDD predicted later AUD and proposes alcohol self-medication as one possible mechanism, while noting that the observed pattern did not frequently fit that mechanism. The paper does not support the claimed effects on sleep, physical activity, eating, or tobacco self-medication; the Methods (page not provided) explicitly exclude tobacco dependence from the substance-use diagnoses. (LLM, conf=0.88)
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- Authors
- Brière, F. N., Rohde, P., Seeley, J. R., Klein, D., & Lewinsohn, P. M.
- Affiliations
- Université de Montréal (CA)
- Oregon Research Institute (US)
- Stony Brook University (US)
- Corresponding author
- Brière, Frédéric N.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 55
- Issue
- 3
- Pages
- 526-533
- ISSN
- 0010-440X (ISSN-L)
- PMC
- PMC4131538
- OpenAlex
- W2072528158
- Cited by
- 328
- References
- 40
- Citations by year
- 2026: 11 · 2025: 34 · 2024: 37 · 2023: 29 · 2022: 39 · 2021: 28 · 2020: 41 · 2019: 32 · 2018: 29 · 2017: 19 · 2016: 13 · 2015: 8 · 2014: 6 · 2013: 1
- FWCI
- 6.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Papyrus : Institutional Repository (Université de Montréal) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA020968, AA020968)
- National Institute of Mental Health (50522, R01MH052858, R01MH040501, MH40501, R01MH050522, MH 52858)
- National Institute on Drug Abuse (R01DA012951, DA12951)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- major depressive disorder, alcoholism, comorbidities, bidirectional relationship, developmental timing, adolescence, early adulthood, suicide attempts, global functioning, life dissatisfaction, women
- MeSH terms
- Adolescent, Adult, Alcoholism, Cross-Sectional Studies, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Interviews as Topic, Longitudinal Studies, Male, Prospective Studies, Comorbidity, Prevalence, Young Adult
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