Dysthymia characteristic of heavy alcohol use in depressed adolescents.

The increased prevalence of heavy alcohol use and abuse among depressed adolescents has been well documented (as reviewed in Bukstein et al 1989). As an example, Greenbaum et al (1991) studied 547 adolescents having serious emotional disturbances, and found that adolescents with severe depressive disorders were more likely to be diagnosed with a substance-abuse disorder, including alcohol abuse/dependency, than were adolescents without depressive disorders (48.3% versus 17.0%). A high prevalence of-alcohol abuse in depressed adolescents also has been documented in nonclinical samples (Deykin et al 1987). Recognition and appropriate treatment of alcohol abuse in depressed adolescents are critical. Both alcohol abuse and depression tend to be chronic conditions with high rates of secondary problems. The co-occurrence of alcohol abuse and depression is particularly problematic, having been associated with an increased risk for suicidal behavior in adolescents (King et al 1993; Pfeffer et al 1988). Despite the importance of identifying and treating each of these conditions, common clinical features make differentiation difficult. Studies with adults suggest that depression may actually motivate treatment-seeking in alcohol abusers (Regier et al 1990), but that the alcohol abuse often goes unrecognized by treatment providers (Helzer and Pryzbeck 1988). The recognition of alcohol-abuse patterns in depressed adolescents would be assisted by information on the phenomenology of depression in adolescents who abuse alcohol. This study was conducted to determine the nhennmennlcmv of depressive symn. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 " . . . . . . . . . ~ . . . . . ~ d " " 1 "