The comorbidity of drug abuse with depression is well established and has important
therapeutic and prognostic implications. Although there is significant understanding
of the environmental and neurobiological factors involved in depression and drug addiction
considered separately, the mechanisms underlying comorbidity are not well understood.
It is likely that the high prevalence of co-occurrence of these two disorders reflects,
in part, overlapping environmental, genetic, and neurobiological factors (Figure 1). It is also possible that there will be differences in the neurobiology of comorbidity
depending on the temporal course of its development (i.e., depression followed by
drug abuse versus drug abuse followed by depression). It is possible that in the former,
drugs are used in attempts to self-medicate the depressive state, whereas in the latter
it is possible that early exposure to chronic drugs of abuse might lead to neurobiological
changes that increase the risk of depression. Areas of overlap in depression and addiction
will be discussed here to identify pertinent areas of research for understanding the
neurobiology of their comorbidity.
Figure 1Diagram illustrating the complex interaction between genes, environment, and brain
function that is likely to underlie the disrupted behavioral changes that occur in
drug abuse and in depression. Overlapping environmental, genetic and/or neurobiological
factors could account for the high degree of comorbidity between drug abuse and depression.
Modified from
: Genetics. Rethinking behavior genetics. Science 298:71–72.
Hamer 2002
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Evidence for enhanced neurobehavioral vulnerability to nicotine during periadolescence in rats.J Neurosci. 2003; 23: 4712-4716
- Methylphenidate treatment during pre- and periadolescence alters behavioral responses to emotional stimuli at adulthood.Biol Psychiatry. 2003; 54: 1317-1329
- Cannabis abuse as a risk factor for depressive symptoms.Am J Psychiatry. 2001; 158: 2033-2037
- Major depression and stages of smoking.Arch Gen Psychiatry. 1998; 55: 161-166
- Enduring behavioral effects of early exposure to methylphenidate in rats.Biol Psychiatry. 2003; 54: 1330-1337
- Influence of life stress on depression.Science. 2003; 301: 386-389
- Cigarette smoking and major depression.J Addict Dis. 1998; 17: 35-46
- Reciprocal changes in prefrontal and limbic dopamine responsiveness to aversive and rewarding stimuli after chronic mild stress.Biol Psychiatry. 1999; 46: 1624-1633
- Neuroimaging and neuropathological studies of depression.Curr Opin Neurobiol. 2001; 11: 240-249
- Monoamine oxidase and cigarette smoking.Neurotoxicology. 2003; 24: 75-82
- Heavy smokers, smoking cessation, and clonidine. Results of a double-blind, randomized trial.JAMA. 1988; 259: 2863-2866
- The relationship between anxiety and substance use disorders among individuals with severe affective disorders.Compr Psychiatry. 2002; 43: 245-252
- Genetics. Rethinking behavior genetics..Science. 2002; 298: 71-72
- Mesolimbocortical and nigrostriatal dopamine responses to salient non-reward events.Neuroscience. 2000; 96: 651-656
- Extent of smoking and nicotine dependence in the United States.Nicotine Tob Res. 2000; 2: 263-274
- The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women.Arch Gen Psychiatry. 2003; 60: 929-937
- The epidemiology of major depressive disorder.JAMA. 2003; 289: 3095-3105
- Onset of major depression during treatment for nicotine dependence.Addict Behav. 2003; 28: 461-470
- Cellular and molecular mechanism of drug dependence.Science. 1988; 242: 715-723
- Stress, corticotropin-releasing factor, and drug addiction.Ann N Y Acad Sci. 1999; 897: 27-45
- Neurochemical adaptation to cocaine abuse.Biol Psychiatry. 1999; 45: 1481-1487
- The role of functional neuroimaging in the neuropsychology of depression.J Clin Exp Neuropsychol. 2001; 23: 121-136
- Mood disturbances and regional cerebral metabolic abnormalities in recently abstinent methamphetamine abusers.Arch Gen Psychiatry. 2004; 61: 73-84
- Neurobiological similarities in depression and drug dependence.Neuropsychopharmacology. 1998; 18: 135-174
- Monitoring the Future. NIDA, Bethesda, Maryland2003
- Effect of nicotine and nicotinic receptors on anxiety and depression.Neuroreport. 2002; 13: 1097-1106
- Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.JAMA. 1990; 264: 2511-2518
- Treatment augmentation with opiates in severe and refractory major depression.Am J Psychiatry. 1999; 156: 2017
- 2002 National Survey on Drug Use and Health. SAMHSA, Bethesda, Maryland2003
- The burden of complex genetics in brain disorders.Arch Gen Psychiatry. 2004; 61: 223-229
- Differential effects of chronic antidepressant treatments on micro- and delta-opioid receptors in rat brain.Eur J Pharmacol. 2002; 443: 85-93
- The addicted human brain.J Cli Invest. 2003; 111: 1444-1451
- Dopamine in drug abuse and addiction.Mol Psychiatry. 2004; 9: 557-569
- Decreased striatal dopaminergic responsiveness in detoxified cocaine-dependent subjects.Nature. 1997; 386: 830-833
- Dopamine and depression: A review of recent evidence. II. Theoretical approaches.Brain Res. 1983; 287: 225-236
- Major depressive disorder and axis I diagnostic comorbidity.J Clin Psychiatry. 2002; 63: 187-193
Article Info
Publication History
Published online: September 13, 2004
Identification
Copyright
© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
