For people with psychiatric disorders, comorbidity — or the presence of two or more disorders in a single patient — is quite common.
One of the most common comorbidities is alcohol use disorder and major depressive disorder.
In fact, people with alcohol use dependence are almost four times more likely to also have a major depressive disorder.
Studies have already shown those patients tend to experience worse outcomes and higher rates of relapse after treatment.
But a new study found key predictors for the combination of these disorders, information that could aid in both prevention and treatment.
The research was led by Michigan State University.
The study specifically examined distress tolerance, or how well people tolerate stressful situations, and delay discounting, a type of impulsivity that causes people to choose immediate rewards over delayed, but more valuable, rewards.
The study looked into the roles distress tolerance and delay discounting play in the comorbidity of alcohol use disorders and major depressive disorders.
The scientists recruited 79 people (who were also part of a larger study on risk-taking and substance use) in Washington, D.C., within one week of entering treatment.
The majority of participants reported being diagnosed with at least one substance use disorder; and 64% met the criteria for at least one psychiatric disorder.
The researchers conducted a series of tests and interviews to measure delay discounting, distress tolerance, and alcohol use and major depressive disorders.
At the end of the study, they found that high rates of delay discounting and low ability to tolerate stress not only increases the likelihood that a person would have one of the diseases but also increases the likelihood that a person would have both diseases.
Specifically, the highest number of participants, 23%, reported having both alcohol use disorder and major depressive disorder.
Only 22% reported having alcohol use disorder alone, and 15% reported having major depressive disorder alone.
The team says the bottom line is that people who were more impulsive — so have higher rates of delay discounting — but also who were less tolerant of the stress were more likely to have both alcohol use disorder and major depression separately.
But also, they’re more likely to have the comorbid disorders.
The findings are important and can be helpful in identifying patients who are at-risk for those comorbid disorders, and helping successfully treat those patients, particularly in substance use treatment facilities.
One author of the study is Julia Felton, assistant professor in the College of Human Medicine, Division of Public Health.
The study is published in International Journal of Mental Health and Addiction.
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