Alcohol use disorder (AUD) and major depressive disorder (MDD) are common psychiatric disorders associated with substantial social and economic costs. It has long been acknowledged that these disorders co-occur more frequently than would be expected by chance, but mechanisms underlying this comorbidity are unclear. Khantzian1 has proposed that alcohol use to self-medicate negative affect plays a role in the observed association; other evidence suggests causation in the opposite direction,2 with AUD increasing one’s risk of MDD, potentially through the neurobiological consequences of sustained heavy alcohol consumption. Biometric models suggest shared liability between disorders,3 in that a subset of factors influencing liability to one disorder independently influences liability to the other. These mechanisms are not mutually exclusive, even within an individual, although their implications for prevention, intervention, and treatment differ.
Edwards AC. Challenges in the Study of Genetic Variants of Comorbid Alcohol Use Disorder and Major Depression. JAMA Psychiatry. 2017;74(12):1193–1194. doi:10.1001/jamapsychiatry.2017.3353
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