Mood disorders and addiction

Abstract

Comorbidity of mood and substance use disorders is the most common dual pathologies in the substance abuse field. High prevalence rates and challenging clinical management of patients diagnosed with this dual disorder imply a great burden for health care systems. Major Depression has been studied in comorbi-dity with the different drugs of abuse (e.g., alcohol, nicotine, cocaine, heroin, cannabis) with consistent findings throughout the world. Various neurobiological mechanisms are believed to play a role in the etiology of this comorbidity, often determining a severe clinical phenotype with poorer prognosis when compared to addiction and mood disorders only. Treatment of the co-occurrence of depression and substance use disorder involves an integrated approach, simultaneously addressing both the psychiatric and the addictive disorder. Current research into pharmacological-in particular antidepressant drugs-and psychosocial treatments has provided controversial results. More data are needed to develop stronger evidence for the treatment of comorbid major depression and substance use disorders.