Epidemiology, aetiology and management of major depression with comorbid alcohol use disorder-a review of the literature

Among the numerous forms of comorbid mental health and substance use disorders, co-morbidity between alcohol use disorders (AUD) and depression has received considerable attention. AUDs and depression co-occur at levels greater than expected by chance in clinical and epidemiological samples. Studies suggest that about 80% of patients with AUD experience depressive symptoms at some stage in their lives including 30% or more who describe significant depression which lasts for weeks and which meets criteria for a major depressive episode. Several hypotheses have been proposed to explain why the two disorders co-occur in individuals at higher than expected rates. There is also emerging evidence to suggest that pharmacological treatment of depressive symptomatology as an adjunct to treatment for alcohol dependence may be effective not only in treating depression but also in reducing alcohol consumption and alcohol related harm. This review explores the literature on the epidemiology, etiology and management of depression and co-morbid AUD. It also identifies the areas for further research.