GENDER DIFFERENCES IN COMORBIDLY DEPRESSED ALCOHOL-DEPENDENT OUTPATIENTS

Clinical profiles of alcohol-dependent male and female outpatients wer e evaluated at treatment entry to compare the level of; clinical sever ity in alcoholics with a coexistent comorbid depressive disorder to al coholics who have never been depressed. Due to a higher proportion of females than males in the depressed alcoholic population, selected pat ient groups were oversampled to create a study group with equivalent n umber of males and females with and without comorbid depression. Clini cal severity was assessed by examining both the extent of alcohol prob lems, and depressive symptomatology at treatment entry with respect to gender differences (unrelated to depression), effects of comorbid dep ression (unrelated to gender), and effects from the interaction of gen der and depression. There were 93 DSM-III-R alcohol-dependent outpatie nts (50 males, 43 females), half of whom had a current or lifetime DSM -III-R depressive disorder. The amount of drinking in the 90 days befo re treatment entry, the degree of alcohol severity, and the number of lifetime drinking-related consequences were collected in the first wee k after detoxification. Diagnoses of lifetime and current depression w ere determined via the Structured Clinical Interview for DSM-III-R, an d depressive symptoms were evaluated with rating scales 1 week after d etoxification. in most cases, a depressive disorder was diagnosed only if sometime in the patient's history depressive symptoms had either p redated problem drinking or been present during a 6-month abstinent pe riod, Results: depressed males had a more severe clinical profile with respect to their alcoholism (i.e., more drinking, drinking-related pr oblems, and alcohol severity than depressed females and never-depresse d males). Surprisingly, females who had never been depressed (also no family history of depression) reported drinking the same quantities of alcohol in the 90 days before treatment acid had comparable alcohol S everity and number of consequences as males who had never been depress ed. Depressed females, however, were more severely depressed (i.e., re ported more intensive depressive symptoms than depressed male alcoholi cs). Thus, determining the type and extent of clinical severity at tre atment entry in comorbidly depressed alcoholics depends on the gender of the patient. The significant interaction between gender and the pre sence of comorbid depression that was bound in this study may have imp ortant implications for predicting success in treatment.