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A Prospective Study

Shelly F. Greenfield, MD, MPH; Roger D. Weiss, MD; Larry R. Muenz, PhD; Lisa M. Vagge; John F. Kelly; Lisa R. Bello; Jacqueline Michael, MSW

Arch Gen Psychiatry. 1998;55:259-265.

Background  The effect of depression on return to drinking among individuals with alcohol dependence is controversial. From February 1, 1993, to April 15, 1996, we consecutively recruited 40 women and 61 men hospitalized for alcohol dependence and followed them up monthly for 1 year to assess the effect of depression on drinking outcomes.

Methods  We conducted structured interviews during hospitalization and monthly following discharge for 1 year to determine whether depression at treatment entry affected the likelihood of return to drinking and whether this effect differed between sexes. Using survival analysis, we examined the effect of depressive symptoms and a diagnosis of current major depression at treatment entry on times to first drink and relapse during follow-up.

Results  A diagnosis of current major depression at the time of hospitalization was associated with shorter times to first drink (hazard ratio, 2.03; 95% confidence interval [CI], 1.28-3.21; P=.003) and relapse (hazard ratio, 2.12; 95% CI, 1.32-3.39; P=.002). There was no significant difference between women and men in this effect. Depressive symptoms as measured by the Beck Depression Inventory did not predict time to first drink or relapse in women or men.

Conclusions  A diagnosis of current major depression at entry into inpatient treatment for alcohol dependence predicted shorter times to first drink and relapse in women and men. Our results differ from earlier reports that men and women differ in the effect of depression on return to drinking.

From McLean Hospital, Belmont, Mass (Drs Greenfield, Weiss, and Muenz, Mss Vagge, Bello, and Michael, and Mr Kelly); the Consolidated Department of Psychiatry, Harvard Medical School, Boston, Mass (Drs Greenfield and Weiss).

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