Skip to main content
SpringerLink
Log in

Alcohol and Psychiatric Comorbidity

  • Chapter
Recent Developments in Alcoholism

Part of the book series: Recent Developments in Alcoholism ((RDIA,volume 16))

Abstract

Comorbid psychiatric disorders and drug use disorders (DUDs) are common among alcoholics (Regier, Farmer, Rae, Locke, Keith, Judd, & Goodwin, 1990; Kessler, McGonagle, Zhao, Nelson, Hughes, Eshleman, Wittchen, & Kendler, 1994). These comorbid disorders often predict a shorter time to relapse of alcoholism (Greenfield, Weiss, Muenz, Vagge, Kelly, Bello, & Michael, 1998). However, despite the prevalence and the adverse effects of this comorbidity, few controlled treatment studies have been conducted involving this dual diagnosis population (Litten & Allen, 1999). To date, most of these few studies of alcoholics with comorbid disorders have been restricted to studies of alcoholics with either comorbid major depression or comorbid anxiety disorders (Litten & Allen, 1995). The results of these trials suggest efficacy for SSRI antidepressants and tricyclic antidepressants for treating alcoholics with comorbid major depression and suggest efficacy for buspirone for treating alcoholics with comorbid anxiety disorders (Mason, Kocsis, Ritvo, & Cutler, 1996; Cornelius, Salloum, Ehler, Jarrett, Cornelius, Perel, Thase, & Black, 1997; Kranzler, Burleson, Del Boca, Babor, Korner, Brown, & Bohn, 1994). However, controlled treatment studies involving alcoholics with other comorbid disorders are almost totally lacking. Consequently, to date, no empirically proven treatment exists for most of these comorbid disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Anthony, J.C., Warner, L.A., & Kessler, R.C. (1994). Comparative epidemiology of dependence on tobacco, alcohol, and controlled substances and inhalants: Basic findings from the National Comorbidity Survey. Experimental and Clinical Psychopharmacology 2, 244–268.

    Article  Google Scholar 

  • Batki, S.L., Manfredi, L.B., Jacob, P., & Jones, R.T. (1993). Fluoxetine for cocaine dependence in methadone maintenance: Quantitative plasma and urine cocaine benzoylecgonine concentrations. Journal of Clinical Psychopharmacology 13, 243–250.

    PubMed  Google Scholar 

  • Bowden, C.L., Brugger, A.M., Suann, A.C., Calabrese, J.R., Janicak, P.G., Petty, F, Dilsaver, S.C., Davis, J.M., Rush, A.J., Smally, J.G., Garza-Trevino, E.S., Risch, C, Goodnick, P.J., & Morris, D.D. (1994). Efficacy of divalproex vs. lithium and placebo in the treatment of mania. Journal of the American Medical Association 271, 918–924.

    Article  PubMed  Google Scholar 

  • Brady, K.T., Halligan, P., & Malcolm, R.J. (1999). Dual diagnosis. In M. Galanter & H.D. Kleber (eds.), Textbook of Substance Abuse Treatment, 2nd ed., Washington, DC: The American Psychiatric Press, pp. 475–483.

    Google Scholar 

  • Brady, K.T., Sonne, S.C., Anton, R., & Ballenger, J.C. (1995). Valproate in the treatment of acute bipolar affective episodes complicated by substance abuse: A pilot study. Journal of Clinical Psychiatry 56, 118–121.

    PubMed  Google Scholar 

  • Bruno, F. (1989). Buspirone treatment of alcoholic patients. Psychopathology 22, 49–59.

    Article  PubMed  Google Scholar 

  • Bukstein, O.G., Glancy, L.J., & Kaminer, Y. (1989). Comorbidity of substance abuse and other psychiatric disorders in adolescents. American Journal of Psychiatry 146, 1131–1141.

    PubMed  Google Scholar 

  • Clark, D.B., Parker, A.M., & Lynch, K.G. (1999). Psychopathology and substance-related problems during early adolescence: A survival analysis. Journal of Clinical Child Psychology 28, 333–341.

    Article  PubMed  Google Scholar 

  • Clark, D.B., Pollock, N.K., Bukstein, O.G., Mezzich, A.C., Bromberger, J.T., & Donovan, J.E. (1997). Gender and comorbid psychopathology in adolescents with alcohol dependence. Journal of the American Academy of Child and Adolescent Psychiatry 36, 1195–1203.

    PubMed  Google Scholar 

  • Cornelius, J.R., Bukstein, O.G., Birmaher, B., Salloum, I.M., Lynch, K., Pollock, N.K., Gershon, S., & Clark, D.B. (2001). Fluoxetine in adolescents with major depression and an alcohol use disorder: An open label trial. Addictive Behaviors 26, 735–739.

    PubMed  Google Scholar 

  • Cornelius, J.R., Fabrega, H., Cornelius, M.D., Mezzich J.E., Maher P.J., Salloum, I.M., Thase, M.E., & Ulrich, R.F. (1996). Racial effects on the clinical presentation of alcoholics at a psychiatric hospital. Comprehensive Psychiatry 37, 102–108.

    Article  PubMed  Google Scholar 

  • Cornelius, J.R., Jarrett, P.J., Thase, M.E., Fabrega, H., Haas, G.L., Jones-Barlock, J., Mezzich, J.E., & Ulrich, R.F. (1995). Gender effects on the clinical presentation of alcoholics at a psychiatric hospital. Comprehensive Psychiatry 36, 1–7.

    Google Scholar 

  • Cornelius, J.R., Perkins, K.A., Salloum, I.M., Thase, M.E., & Moss, H.B. (1999). Fluoxetine versus placebo to decrease the smoking of depressed alcoholic patients. Journal of Clinical Psychopharmacology 19, 183–184.

    Article  PubMed  Google Scholar 

  • Cornelius, J.R., Pringle, J., Jernigan J., Kirisci, L., & Clark, D.B. (2001). Correlates of mental health service utilization and unmet need among a sample of male adolescents. Addictive Behaviors 26, 11–19.

    PubMed  Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Cornelius, M.D., Perel, J.M., Thase, M.E., Ehler, J.G., & Mann, J.J. (1993). Fluoxetine trial in suicidal depressed alcoholics. Psychopharmacology Bulletin 29, 195–199.

    PubMed  Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Mezzich, J.E., Cornelius, M.D., Fabrega, H., Ehler, J.G., Ulrich, R.F., Thase, M.E., & Mann, J.J. (1995). Disproportionate suicidality in patients with comorbid major depression and alcoholism. American Journal of Psychiatry 152, 358–364.

    PubMed  Google Scholar 

  • Cornelius, J.R., Salloum I.M., Day, N.L., Thase, M.E., & Mann, J.J. (1996). Patterns of suicidality and alcohol use in alcoholics with major depression. Alcoholism: Clinical and Experimental Research 20, 1451–1455.

    Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Ehler, J.G., Jarrett, P.J., Cornelius, M.D., Perel, J.M., Thase, M.E., & Black, A. (1997). Fluoxetine in depressed alcoholics: A double-blind, placebo-controlled trial. Archives of General Psychiatry 54, 700–705.

    PubMed  Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Thase, M.E., Haskett, R.F., Daley, D.C., Jones-Barlock, A., Upsher, C, & Perel, J.M. (1998). Fluoxetine versus placebo in depressed alcoholic cocaine abusers. Psychopharmacology Bulletin 34, 117–121.

    PubMed  Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Haskett, R.F., Ehler, J.G., Jarrett, P.J., Thase, M.E., & Perel, J.M. (1999). Fluoxetine versus placebo for the marijuana use of depressed alcoholics. Addictive Behaviors 24, 111–114.

    Article  PubMed  Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Haskett, R.F., Daley, D.C., Cornelius, M.D., Thase, M.E., & Perel, J.M. (2000). Fluoxetine versus placebo in depressed alcoholics: A one-year follow-up study. Addictive Behaviors 25, 307–310.

    Article  PubMed  Google Scholar 

  • Cornelius, J.R., Salloum, I.M., Lynch, K., Clark, D.B., & Mann, J.J. (2001). Treating the substance-abusing suicidal patient. In H. Hendin & J.J. Mann (eds.), The Annals of the New York Academy of Sciences, 932, 78–93.

    Google Scholar 

  • Cornelius, J.R., Thase, M.E., Salloum, I.M., Cornelius, M.D., Black, A., & Mann, J.J. (1998). Cocaine use associated with increased suicidal behavior in depressed alcoholics. Addictive Behaviors 23, 119–121.

    Article  PubMed  Google Scholar 

  • Dorus, W., Ostrow, D.G., Anton, R., Cushman, P., Collins, J.F., Schaefer, V., Charles, H.L., Desai, P., Hayashida, M., Malkerneker, U., Willenbring, M., Fiscella, R., & Sather, M.R. (1989). Lithium treatment of depressed and nondepressed alcoholics. Journal of the American Medical Association 262, 1646–1652.

    Article  PubMed  Google Scholar 

  • Emslie, G.J., Rush, A.J., Weinberg, W.A., Kowatch, R.A., Hughes, C.W., Carmody, T., & Rintelmann, J. (1997). A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Archives of General Psychiatry 54, 1031–1037.

    PubMed  Google Scholar 

  • Fawcett, J., Clark, D.L., Aagesen, C.A., Pinasi, V.D., Tilkin, J.M., Sellers, D., McGuire, M., & Gibbons, R.D. (1987). A double-blind, placebo-controlled trial of lithium carbonate therapy for alcoholism. Archives of General Psychiatry 44, 248–256.

    PubMed  Google Scholar 

  • George, D.T., Rawlings, R., Eckardt, M.J., Phillips, M.J., Shoaf, S.E., & Linnoila, M. (1999). Buspirone treatment of alcoholism: Age of onset and cerebrospinal fluid 5-hydroxyindolacetic acid and homovanillic acid concentrations, but not medication treatment, predict return to drinking. Alcoholism: Clinical and Experimental Research 23, 272–278.

    Google Scholar 

  • Greenfield, S.F., Weiss, R.D., Muenz, L.R., Vagge, L.M., Kelly, J.F., Bello, L.R., & Michael, J. (1998). The effect of depression on return to drinking. Archives of General Psychiatry 55, 259–265.

    Article  PubMed  Google Scholar 

  • Helzer, J.E., & Pryzbeck, T.R. (1998). The co-occurrence of alcoholism and other psychiatric disorders in the general population and its impact on treatment. Journal of Studies on Alcohol 49, 219–244.

    Google Scholar 

  • Kessler, R.C., Crum, R.M., Warner, L.A., Nelson, C.B., Schulenberg, J., & Anthony, J.C. (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of General Psychiatry 54, 313–321.

    PubMed  Google Scholar 

  • Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.U., & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.

    PubMed  Google Scholar 

  • King, C.A., Naylor, M.W., Hill, E.M., Shain, B.N., & Greden, J.F. (1993). Dysthymia characteristic of heavy alcohol use in depressed adolescents. Biological Psychiatry 33, 210–212.

    Article  PubMed  Google Scholar 

  • Kranzler, H.R., Burleson, J.A., Del Boca, F.K., Babor, T.F., Korner, P., Brown, J., & Bohn, M. (1994). Buspirone treatment of anxious alcoholics. Archives of General Psychiatry 51, 720–731.

    PubMed  Google Scholar 

  • Kranzler, H.R., Burleson, J.A., Korner, P., Del Boca, F.K., Bohn, M.J., Brown, J., & Liebowitz, N. (1995). Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. American Journal of Psychiatry 152, 391–397.

    PubMed  Google Scholar 

  • Litten, R.Z., & Allen, J.P. (1995). Pharmacotherapy for alcoholics with collateral depression or anxiety: An update of research findings. Experimental and Clinical Psychopharmacology 3, 87–93.

    Article  Google Scholar 

  • Litten, R.Z., & Allen, J.P. (1998). Pharmacologic treatment of alcoholics with collateral depression: Issues and future directions. Psychopharmacology Bulletin 34, 107–110.

    PubMed  Google Scholar 

  • Litten, R.Z., & Allen, J.P. (1999). Medications for alcohol, illicit drug, and tobacco dependence: An update of research findings. Journal of Substance Abuse Treatment 16, 105–112.

    Article  PubMed  Google Scholar 

  • Litten, R.Z., & Fertig, J. (1996). International update: New findings on promising medications. Alcoholism: Clinical and Experimental Research 20(Suppl), 216A–218A.

    Google Scholar 

  • Malcolm, R., Anton, R.F., Randall, C.L., Johnston, A., Brady, K., & Thevos, A. (1992). A placebo-controlled trial of buspirone in anxious inpatient alcoholics. Alcoholism: Clinical and Experimental Research 16, 1007–1013.

    Google Scholar 

  • Malec, E., Malec, T., Gagne, M.A., & Dongier, M. (1996). Buspirone in the treatment of alcohol dependence: A placebo-controlled trial. Alcoholism: Clinical and Experimental Research 20, 307–312.

    Google Scholar 

  • Martin, C.S., Kaczynski, N.A., Maisto, S.A., Bukstein, O.G., & Moss, H.B. (1995). Patterns of DSM-IV alcohol abuse and dependence symptoms in adolescent drinkers. Journal of Studies on Alcohol 56, 672–680.

    PubMed  Google Scholar 

  • Mason, B.J., Kocsis, J.H., Ritvo, C.E., & Cutler, R.B. (1996). A double-blind, placebo-controlled trial of desipramine for primary alcohol dependence stratified on the presence or absence of major depression. Journal of the American Medical Association 275, 761–767.

    Article  PubMed  Google Scholar 

  • McGrath, P.J., Nunes, E.V., Stewart, J.W., Goldman, D., Agosti, V., Ocepek-Welikson, K., & Quitkin, P.M. (1996). Imipramine treatment of alcoholics with major depression: A placebo-controlled clinical trial. Archives of General Psychiatry 53, 232–240.

    PubMed  Google Scholar 

  • McLellan, A.T., Luborsky, L., Woody, G.E., O’Brien, C.P., & Druley, K.A. (1983). Predicting response to alcohol and drug abuse treatments. Archives of General Psychiatry 40, 620–625.

    PubMed  Google Scholar 

  • Naranjo, C.A., Kadlec, K.E., Sanhueza, P., Woodley-Remus, D., & Sellers, E.M. (1990). Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers. Clinical Pharmacology and Therapeutics 47, 490–498.

    PubMed  Google Scholar 

  • Nunes, E.V., McGrath, P.F., Quitkin, F.M., Stewart, J.W., Goehl, L., & Ocepek-Welikson, K. (1996). Predictors of antidepressant response in depressed alcoholic patients. American Journal of Addiction 5, 308–312.

    Google Scholar 

  • O’Malley, S.S., & Carroll, K.M. (1996). Psychotherapeutic considerations in pharmacological trials. Alcoholism: Clinical and Experimental Research 20, 17A–22A.

    Google Scholar 

  • Paille, F.M., Guelfi, J.D., Perkins, A.C., Royer, R.J., Steru, L., & Parot, P. (1995). Double-blind randomized multicenter trial of acamprosate in maintaining abstinence from alcohol. Alcohol and Alcoholism 30, 239–247.

    PubMed  Google Scholar 

  • Powell, B.J., Campbell, J.L., Landon, J.F., Liskou, B.I., Thomas, H.M., Nickel, E.J., Dale, T.M., Penick, E.C., Samuelson, S.D., & Lacoursiere, R.B. (1995). A double-blind, placebo-controlled study of nortriptyline and bromocriptine in male alcoholics subtyped by comorbid psychiatric disorders. Alcoholism: Clinical and Experimental Research 19, 462–468.

    Google Scholar 

  • Project MATCH Research Group. (1998). Matching alcoholism treatments to client heterogeneity: Project MATCH three-year drinking outcomes. Alcoholism: Clinical and Experimental Research 22, 1300–1311.

    Google Scholar 

  • Regier, D.A., Farmer, M.E., Rae, D.E., Locke, B.Z., Keith, E.J., Judd, L.L., & Goodwin, F.K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiologic Catchment Area (ECA) study. Journal of the American Medical Association 264, 2511–2518.

    Article  PubMed  Google Scholar 

  • Riggs, P.D., Mikulich, S.K., Coffman, L.M., & Crowley, T.J. (1997). Fluoxetine in drug-dependent delinquents with major depression: An open trial. Journal of Child and Adolescent Psychopharmacology 7, 87–95.

    Article  PubMed  Google Scholar 

  • Roy A. (1998). Placebo-controlled study of sertraline in depressed recently abstinent alcoholics. Biological Psychiatry 44, 633–637.

    PubMed  Google Scholar 

  • Salloum, I.M., Cornelius, J.R., Thase, M.E., Daley, D.C., Kirisci, L., & Spotts, C. (1998). Naltrexone utility in depressed alcoholics. Psychopharmacology Bulletin 34, 111–115.

    PubMed  Google Scholar 

  • Salloum, I.M., Cornelius, J.R., Mezzich, J.E., Kirisci, L., Daley, D.C., Spotts, C.R., & Zuckoff, A. (2001). Characterizing female bipolar alcoholic patients presenting for initial evaluation. Addictive Behaviors 26, 341–348.

    Article  PubMed  Google Scholar 

  • Tollefson, G.D., Montague-Clouse, J., & Tollefson, S.L. (1992). Treatment of comorbid generalized anxiety in a recently detoxified alcoholic population with a selective serotonergic drug (buspirone). Journal of Clinical Psychopharmacology 12, 19–26.

    PubMed  Google Scholar 

  • Vitiello, B., & Jensen, P.S. (1997). Medication development and testing in children and adolescents. Archives of General Psychiatry 54, 871–876.

    PubMed  Google Scholar 

  • Volpicelli, J.R., Alterman, A.I., Hayashida, M., & O’Brien, C.P. (1992). Naltrexone in the treatment of alcohol dependence. Archives of General Psychiatry 49, 876–880.

    PubMed  Google Scholar 

  • Wilkins, J.N. (1997). Pharmacotherapy of schizophrenia patients with comorbid substance abuse. Schizophrenia Bulletin 23, 215–228.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pittsburgh Adolescent Alcohol Research Center, Center for Education and Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15213

    Jack R. Cornelius, Oscar Bukstein, Ihsan Salloum & Duncan Clark

Authors
  1. Jack R. Cornelius
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oscar Bukstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ihsan Salloum
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Duncan Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. New York University School of Medicine, New York, New York

    Marc Galanter

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Kluwer Academic Publishers

About this chapter

Cite this chapter

Cornelius, J.R., Bukstein, O., Salloum, I., Clark, D. (2002). Alcohol and Psychiatric Comorbidity. In: Galanter, M., et al. Recent Developments in Alcoholism. Recent Developments in Alcoholism, vol 16. Springer, Boston, MA. https://doi.org/10.1007/0-306-47939-7_24

Download citation

  • DOI: https://doi.org/10.1007/0-306-47939-7_24

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-47258-9

  • Online ISBN: 978-0-306-47939-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation