PROGNOSTIC EFFECT OF THE VARIABLE COURSE OF ALCOHOLISM ON THE 10-YEARCOURSE OF DEPRESSION

Objective: of patients' alcohol use on the course of major depressive disorder. Method: One hundred seventy-six probands with Research Diagn ostic Criteria (RDC) diagnoses of both major depressive disorder and a lcoholism were compared to 412 probands with major depressive disorder only by using 10 years of short-interval, prospective follow-up data collected as part of the National Institute of Mental Health Collabora tive Depression Study. The course of depression was examined by using intensity analysis to represent transitions between states of major de pressive disorder. The effect of patients' RDC alcoholism status on th e long-term course of major depressive disorder was examined by strati fying the analyses by three levels of alcoholism-never alcoholic, not meeting criteria for current alcoholism, and current alcoholism. Resul ts: Depressed probands who were either never alcoholic or currently no nactive alcoholic had twice the likelihood of recovery from major depr essive disorder than did actively alcoholic depressed probands. The th ree levels of alcoholism did not differentially predict recurrence of major depressive disorder. Conclusions: These findings provide long-te rm, empirically derived evidence for the deleterious effect of current alcoholism on recovery from depression. The lack of a differential ef fect of the three levels of alcoholism on a recurrence of major depres sive disorder suggests that other factors may have greater predictive value.