Disproportionate suicidality in patients with comorbid major depression and alcoholism

J. R. Cornelius, Ihsan M Salloum, J. Mezzich, M. D. Cornelius, H. Fabrega, J. G. Ehler, R. F. Ulrich, M. E. Thase, J. J. Mann

Research output: Contribution to journalArticle

236 Citations (Scopus)

Abstract

Objective: The two purposes of this study were to provide a comprehensive description of the clinical features of patients who presented to an intake psychiatric setting with major depression and alcohol dependence and to determine which clinical features distinguished this dual-diagnosis group from patients with the two relevant single diagnoses. Method: During a recent 5-year period, a total of 107 patients who came to a psychiatric facility for initial evaluation were diagnosed as having both major depression and alcohol dependence. The clinical profile of this dual-diagnosis group was compared to that of nondepressed alcoholics (N=497) and nonalcoholic patients with major depression (N=5,625), assessed at the same facility, on the basis of information from the Initial Evaluation Form, a semistructured instrument containing a standardized symptom inventory that includes ratings of severity. Results: The psychiatric symptom that most strongly distinguished the depressed alcoholics from the two comparison groups was the level of suicidality. The depressed alcoholics differed significantly from the nonalcoholic depressed patients on only two depressive symptoms, suicidality (59% higher) and low self-esteem (22% higher); they were also significantly distinguished from the nonalcoholic depressed patients by factors such as greater impulsivity, functional impairment, and abnormal personal and social history markers. Conclusions: Suicidality was disproportionately greater than other psychiatric symptoms in the depressed alcoholics. The clinical profile of depressed alcoholics suggests that they suffer an additive or synergistic effect of two separate disorders, resulting in a disproportionately high level of acute suicidality upon initial psychiatric evaluation.

Original languageEnglish
Pages (from-to)358-364
Number of pages7
JournalAmerican Journal of Psychiatry
Volume152
Issue number3
StatePublished - Jan 1 1995
Externally publishedYes

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Alcoholism
Alcoholics
Psychiatry
Depression
Dual (Psychiatry) Diagnosis
Impulsive Behavior
Self Concept
History
Equipment and Supplies

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Cornelius, J. R., Salloum, I. M., Mezzich, J., Cornelius, M. D., Fabrega, H., Ehler, J. G., ... Mann, J. J. (1995). Disproportionate suicidality in patients with comorbid major depression and alcoholism. American Journal of Psychiatry, 152(3), 358-364.

Disproportionate suicidality in patients with comorbid major depression and alcoholism. / Cornelius, J. R.; Salloum, Ihsan M; Mezzich, J.; Cornelius, M. D.; Fabrega, H.; Ehler, J. G.; Ulrich, R. F.; Thase, M. E.; Mann, J. J.

In: American Journal of Psychiatry, Vol. 152, No. 3, 01.01.1995, p. 358-364.

Research output: Contribution to journalArticle

Cornelius, JR, Salloum, IM, Mezzich, J, Cornelius, MD, Fabrega, H, Ehler, JG, Ulrich, RF, Thase, ME & Mann, JJ 1995, 'Disproportionate suicidality in patients with comorbid major depression and alcoholism', American Journal of Psychiatry, vol. 152, no. 3, pp. 358-364.
Cornelius JR, Salloum IM, Mezzich J, Cornelius MD, Fabrega H, Ehler JG et al. Disproportionate suicidality in patients with comorbid major depression and alcoholism. American Journal of Psychiatry. 1995 Jan 1;152(3):358-364.
Cornelius, J. R. ; Salloum, Ihsan M ; Mezzich, J. ; Cornelius, M. D. ; Fabrega, H. ; Ehler, J. G. ; Ulrich, R. F. ; Thase, M. E. ; Mann, J. J. / Disproportionate suicidality in patients with comorbid major depression and alcoholism. In: American Journal of Psychiatry. 1995 ; Vol. 152, No. 3. pp. 358-364.
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