Co-occurring depression and alcohol misuse: an epidemiological investigation

Depression and alcohol misuse are large individual contributors to the burden of disease globally. These conditions also co-occur at high rates within the general population, with meta-analytic estimates indicating that mood disorders are 2-3 times more likely among those with alcohol use disorders. Individuals with these co-occurring conditions typically experience greater severity of symptoms, compared to those with a single condition, and utilise services at a higher rate. Nevertheless, there is a lack of epidemiological data examining the co-occurrence of depression and alcohol misuse. This thesis examines epidemiological factors associated with co-occurring alcohol misuse and depression in two health care settings: primary care and specialist alcohol and other drugs treatment clinics. It also examines the effectiveness of current interventions for treating this comorbidity. The six papers that comprise this thesis examine three different topics, with associated questions, which are listed below. In general practice settings: What are the prevalence and characteristics associated with co-occurring depression and alcohol misuse in general practice (Paper One)? How well are general practitioners able to identify these conditions (Paper Two)? In alcohol and other drugs settings: What is the most feasible method of data collection for alcohol and other drugs (AOD) outpatients (Paper Three)? What are the prevalence and characteristics associated with depression among a sample of AOD outpatients (Paper Four)? How well are AOD clinicians able to identify depression among their clients (Paper Five)? Treatment: Are psychosocial interventions for treating co-occurring depression and alcohol misuse of high methodological quality (Paper Six)? Is there is any evidence supporting dual treatment models over single treatment models (Paper Six)?