Exploring the Comorbidity of Alcohol Use and Depression: A Review

This literature review explores the comorbidity between alcohol use disorders (AUD) and depression, focusing on the impact on adolescents and young adults. The research, grounded in a positivist philosophy, analyzes peer-reviewed articles from the past decade, primarily using quantitative dat...Read More

Running head: LITERATURE REVIEW
Literature Review
Student’s name
University
Author’s note

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LITERATURE REVIEW
Introduction
AOD (alcohol and other drug) use purportedly has an adverse effect on health. Along
with a range of physical ailments, AOD use also has a prominent impact on mental health.
Although AOD use has been identified as a major cause of psychological ailments such as
anxiety, depression, panic attacks, etc. the prevalence of AOD use among people, especially
among the youth is rampant. Researchers working in the field of psychology often argue that
these two have a reciprocal relationship. To elucidate, psychological disorders have a direct
impact on AOD use and vice versa. Apart from exacerbating or initiating psychiatric disorders,
AOD use and withdrawal can also cause psychiatric symptoms and subsequently mimic
psychological syndrome in its manifestation (Mahmoud et al, 2017). Hence, in order to design an
effective intervention or course of treatment, it is essential to discern the initiating point of
psychological syndromes. To this end, the present research seeks to identify the comorbidity
between AOD use disorders and mental illnesses, and establish the significance of the treatment
using differentiated psychiatric syndromes. However, given the variety of AOD use disorders
and the wide range of mental illnesses, the study restricts its scope within alcohol abuse and
depression. Further, it seeks to find comorbidity between alcohol use disorders and depression
and establish its importance in the treatment of adolescents as well as young adults.
Methodology
The research in question is essentially an exploratory analysis, grounded in positivist
research philosophy. Due to the constraints of time and resources, it adheres to a secondary
approach, and undertakes a survey of established literature existing in field of psychological
research. The articles reviewed in this research paper are extracted from scholarly peer-reviewed

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sources and are published within the last ten years. All the literature used for the survey
mandatorily based on primary quantitative data and use established scientific methods to obtain
their results.
Literature Survey
Many people who show signs of AOD use disorders are also diagnosed with mental
disorders and vice versa. This general finding, by and large, indicates a possibility of
comorbidity between AOD use and mental disorders. According to Goldstein, Faulkner &
Wekerle (2013), several receivers of psychological treatments also experience substance use
disorders and vice versa. However, there has not been adequate research on the comorbidity of
alcohol use disorders and depression among young adults and adolescents. Recent reports from
the Australian Institute of Health and Welfare shows that consumption of alcohol, illicit
marijuana, tobacco and other drugs are a major cause of preventable illnesses and diseases
among the adolescents and the youth in Australia. Although the legal age for buying and
consuming alcohol in Australia has been set at 18 years, 9.1% of males and 6.8% females within
the age group of 12 to 17 are reported to be indulging in alcohol use. (Australian Institute of
Health and Welfare, 2020). In majority of the people, moderate to heavy use of alcohol is
generally associated with euphoria, decreased impulse control, mood swings etc. On the other
hand, acute withdrawal from alcohol can also cause severe mood instability, insomnia, hostility,
fatigue and reduced sexual interest for a prolonged time. However, such symptoms are often
difficult to distinguish from major depression or anxiety disorders (Agyapong et al., 2013).
In patients with the history of alcohol use disorders, depression is commonly categorized
either as substance induced or as independent, i.e. without a correlation with alcohol use.

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Besides, it is difficult to establish whether these conditions will respond to treatments differently.
Bossarte and Swahn (2011), in their study on the associations between early alcohol use and
suicide attempts among adolescents, show that there is a significant correlation between early
alcohol use before the age of 13 years and suicidal tendencies. They confirm that the entire
sample population reported a positive history of major depression, which can be used as
evidence for the comorbidity of AOD use disorders and depression. In another study, Parker et al
(2011) conducted a survey on 1367 recently employed men and women in the demographic
region of Detroit, and collected information regarding their drinking practices as well as
symptoms of depression. The results showed that the increased amount of alcohol consumption
was directly associated with increased depression symptoms in sober condition in all the
respondents. In this case, the researchers argue that depression can be one of the many
unidentified alcohol use disorders, which otherwise may be absent in the respondents
independently.
However, there are counterexamples of comorbidity of depression and alcohol use
disorders, which essentially argue that there are evidences where depressive symptoms can be
found among non-users or moderate users of alcohol as well. In a study conducted by Paschall,
Freisthler and Lipton (2013), it has been established empirically that moderate or low use of
alcohol may not have any impact on depression in young adults. With the survey results
involving 13892 participants, they indicate that the frequency of depressive symptoms is similar
among low, moderate and heavy drinkers as well as lifetime abstainers.
Although non-essential, but the vast evidence of psychological researches indicates that
comorbidity between alcohol use disorder and depression is a general phenomenon. Brière et al.
(2013) suggests that the rate of comorbid depression and alcohol use disorders are relatively low,

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constituting only a 2% among adolescents and 11% among young adults, in comparison to adults
(21%). This makes the issue less researched, and often overlooked. However, a differentiated
approach towards depressive symptoms and alcohol use disorder symptoms is essentially
effective in developing intervention strategies and course of treatment. According to the meta-
analysis conducted by Fould et al. (2015), patients with symptoms of depression and history of
alcohol use showed significant improvement in differentiated depression, in comparison with the
sample group with undifferentiated depression.
Discussion
The findings from the literature confirm that there is an established comorbidity between
alcohol use disorder (AUD) and depressive symptoms. However, the prevalence of the said
comorbidity is less frequent among adolescent drinkers and young adults indulging in alcohol
use. Still, in case of designing effective interventions for treating adolescents and young adults
for depression, the possibility of such comorbidity cannot be denied. The wide range of current
therapies and approaches that are being used for treating alcohol use disorders, including both
dependence and withdrawal, all advocate client-treatment matching. To elucidate, given the
multiple approaches and therapies, no treatment has been yet found to be superior to the rest,
whereas different patients seem to respond better to different treatments. For example, patients
with a supportive family background may find help from family counselling, while extraverted
individuals may find relief in group therapy and so on (Merkx, 2016). Especially, in the case of
adolescents and young adults, the course of treatment has to be more carefully developed, since
it may affect their cognitive and psychological development, hampering their future lives
(McCauley et al., 2018). To this end, researchers have hypothesized if they can identify the

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specific characteristics of patients, it would be easier to match them with appropriate treatment
procedures. Hence, in the context of client-patient matching of adolescents and young adults
with symptoms of alcohol use disorders, it would be rather helpful if the depressive symptoms
arising from alcohol use disorder and clinical depression could be differentiated.
Conclusion
The analysis justifies the differentiated approach towards depressive symptoms and
alcohol use disorder symptoms. However, the low prevalence of comorbidity between depression
and alcohol use disorder often makes the issue neglected and overlooked. However, the review
of the analysis suggests that the comorbidity is not uncommon, and hence, it should be taken into
account for achieving an effective client-treatment matching. In this regard, the literature survey
conducted in this study could be a relevant work to begin with. It is relevant to the present
research on the merit that they all deal with a central issue: whether there is comorbidity between
depression and alcohol use disorders.

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References
Agyapong, V. I. O., Milnes, J., McLoughlin, D. M., & Farren, C. K. (2013). Perception of
patients with alcohol use disorder and comorbid depression about the usefulness of
supportive text messages. Technology and Health Care, 21(1), 31-39.
Australian Institute of Health and Welfare. (2020). Alcohol, tobacco & other drugs in Australia,
Introduction - Australian Institute of Health and Welfare. Retrieved 30 March 2020, from
https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/
introduction
Bossarte, R. M., & Swahn, M. H. (2011). The associations between early alcohol use and suicide
attempts among adolescents with a history of major depression. Addictive behaviors,
36(5), 532-535.
Brière, F. N., Rohde, P., Seeley, J. R., Klein, D., & Lewinsohn, P. M. (2014). Comorbidity
between major depression and alcohol use disorder from adolescence to adulthood.
Comprehensive psychiatry, 55(3), 526-533.
Foulds, J. A., Adamson, S. J., Boden, J. M., Williman, J. A., & Mulder, R. T. (2015). Depression
in patients with alcohol use disorders: systematic review and meta-analysis of outcomes
for independent and substance-induced disorders. Journal of affective disorders, 185, 47-
59.

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Goldstein, A. L., Faulkner, B., & Wekerle, C. (2013). The relationship among internal resilience,
smoking, alcohol use, and depression symptoms in emerging adults transitioning out of
child welfare. Child abuse & neglect, 37(1), 22-32.
Mahmoud, K. F., Finnell, D., Savage, C. L., Puskar, K. R., & Mitchell, A. M. (2017). A concept
analysis of Substance Misuse to inform contemporary terminology. Archives of
psychiatric nursing, 31(6), 532-540.
McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., ... & Linehan,
M. M. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for
suicide: a randomized clinical trial. JAMA psychiatry, 75(8), 777-785.
Merkx, M. J. M. (2016). Guidelines for patient treatment matching In the substance abuse
treatment system: Feasibility, predictive validity and improvement.
Parker, D. A., Parker, E. S., Harford, T. C., & Farmer, G. C. (1987). Alcohol use and depression
symptoms among employed men and women. American Journal of Public Health, 77(6),
704-707.
Paschall, M. J., Freisthler, B., & Lipton, R. I. (2013). Moderate alcohol use and depression in
young adults: findings from a national longitudinal study. American Journal of Public
Health, 95(3), 453-457.