Over three million Australians have a lifetime alcohol use disorder and one in five will have co-occurring major depression in the last year. The clinical outcomes for those presenting with co-occurring major depression and alcohol use disorders are poor and this is a major health concern for Australia. DSM-IV distinguishes between transient, substance-induced depressive episodes and enduring, independent depressive episodes. This diagnostic distinction marked recognition that these syndromes are likely to differ in their etiology, clinical course, and response to treatment. However,little longitudinal research has evaluated these syndromes. This novel and timely project prospectively examines the depressive episodes of alcohol dependent patients.

Project Collaborators External

• Dr Rebecca McKetin (Australian National University)

Project Supporters

UNSW Early Career Researcher Award

Identify the proportion of episodes initially classified as substance-induced but later reclassified as independent (and vice-versa) andexamine predictors of diagnostic change.

Design and Method

Secondary analyses of data from the Depression and Alcohol Integrated and Single-focused Interventions study (DAISI). This is a multi-site randomized controlled trial which compared the effectiveness of psychological treatments for 282 patients with co-occurring depression and alcohol use problem.

Benefits

The expected outcomes of this project include:

• critical insights into the course of depressive episodes in alcohol dependent patients;
• identification of potential predictors of diagnostic change and associated clinical features that may help differentiate the two syndromes;
• development of more targeted treatment approaches;
• advances in etiological research;
• generation of a set of empirically-based recommendations for refining and improving the specificity of the independent versus substance-induced criteria in DSM-5.

This project will provide the first important information for Australia in this area.