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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Addiction Medicine

Advisor

Dr. Gregory Davenport

Abstract

ABSTRACT

The purpose of this review is to bring attention to the under-treatment of depressive symptoms and disorders in patients suffering from Alcohol Use Disorder (AUD). The subset of patients suffering from AUD is frequently neglected with regard to comorbid health conditions. However, the under-treatment of depressive symptoms and disorders has damaging effects that greatly complicate this problem.

An extensive analysis of professional literature and peer-reviewed research from various sources, including electronic engines such as Pubmed® and Google Scholar®, was conducted. Several key terms were utilized, including MDD, Dysthymia, depression, AUD, alcoholism, and suicide. Numerous pertinent articles, studies, and texts were retrieved. These served as the basis for this clinical review. Establishing relevance was ensured by citing research and reports that were sufficient in the relevant subject, free from bias, peer reviewed as appropriate, and timely concerning medical practice guidelines.

Substantial research and data support the proposition that patients with AUD are significantly more likely than those without to suffer from depressive symptoms. The study also bears out that this population is much less likely to receive treatment for these depressive symptoms than are those with similar symptoms across the larger population. Finally, those afflicted with AUD present with elevated risks for self-harm and social isolation. When coupled with untreated depression, these risks are escalated and are evidenced by significantly increased rates of self-harm such as suicide.

The under-treatment of depressive symptoms in this group is established. The reasons for this phenomenon are not so clear and appear to be multi-faceted. There seem to be legitimate concerns from health care providers regarding patient well-being. However, there also appear to be factors of provider bias toward these patients. Additionally, there seems to be a lack of understanding and education regarding the causal nature of the problem. For example, many providers feel that alcoholism is the driving force for depression. Providing a better understanding of the problem, the biases, and the latest treatment guidelines will help Primary Care providers address these concerns more effectively.

Keywords: MDD, Dysthymia, depression, AUD, alcoholism, suicide, bias.

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