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Gender Comparisons on Quality-of-Life and Comorbid Alcohol Dependence and Major Depression

Scott M Hyman, Ladan Khazai, Mousa Botros, Yadira I. Torres, Jack R. Cornelius, Feng Miao, Juan E Mezzich, Ihsan M. Salloum


Introduction and Objectives: Compared to men, substance-addicted women have greater social vulnerabilities that may impact their symptom presentation and overall quality-of-life (QOL). The latter is gaining prominence as an outcome measure and key element of person-centered care. We aimed to compare in this study treatment-seeking men and women with co-morbid alcohol dependence and major depression on measures of depression severity, addiction severity, and quality-of-life and to examine associations between addiction/depression severity and quality-of-life separately in men and women.

Methods: Men (n = 34) and women (n = 33) participating in a psychopharmacology trial for co-morbid alcohol dependence and major depression were administered the Addiction Severity Index (ASI), the 25-item Hamilton Rating Scale for Depression (HAM-D), and the Multicultural Quality of Life Index at baseline as part of a large assessment battery.

Results: Women reported greater global QOL impairment than men despite being similar on measures of depression and addiction severity. Depression severity, but not addiction severity, was significantly associated with QOL impairment in both men and women.

Discussion and Conclusions: Treatment-seeking women with co-morbid major depression and alcoholism report lower QOL (i.e., happiness and life satisfaction) than their male counterparts. Depressive symptoms, but not addiction-related problems, may contribute to global QOL impairment. Alternatively, QOL impairment may increase depressed mood. Overall, QOL assessments may identify areas of impairment and opportunities for health promotion not assessed through traditional measures used in addiction treatment programs, and these measures may be more sensitive to the specific needs of women. Consideration of all these factors is likely to enhance person-centered care.


Quality of life, life satisfaction, addiction, alcohol dependence, depression, gender, person-centered care.

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. Gladis MM, Gosch EA, Dishuk NM, Crits-Christoph P. Quality of life: expanding the scope of clinical significance. Journal of Consulting and Clinical Psychology. 1999;67(3):320-31.

. Rapaport MH, Clary C, Fayyad R, Endicott J. Quality-of-life impairment in depressive and anxiety disorders. The American Journal of Psychiatry. 2005;162(6):1171-8.

. Keyes CL. The next steps in the promotion and protection of positive mental health. The Canadian Journal of Nursing Research (Revue Canadienne de Recherche en Sciences Infirmieres). 2010;42(3):17-28.

. Keyes CL, Dhingra SS, Simoes EJ. Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health. 2010;100(12):2366-71.

. Kobau R, Seligman ME, Peterson C, Diener E, Zack MM, Chapman D, et al. Mental health promotion in public health: perspectives and strategies from positive psychology. American Journal of Public Health. 2011;101(8):e1-9.

. Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. The American Psychologist. 2005;60(5):410-21.

. IsHak WW, Greenberg JM, Balayan K, Kapitanski N, Jeffrey J, Fathy H, et al. Quality of life: the ultimate outcome measure of interventions in major depressive disorder. Harvard Review of Psychiatry. 2011;19(5):229-39.

. Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M. Quality of life assessments in major depressive disorder: a review of the literature. General Hospital Psychiatry. 2004;26(1):13-7.

. Grant BF, Harford TC. Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey. Drug and Alcohol Dependence. 1995;39(3):197-206.

. Sullivan LE, Fiellin DA, O'Connor PG. The prevalence and impact of alcohol problems in major depression: a systematic review. The American Journal of Medicine. 2005;118(4):330-41.

. Cornelius JR, Salloum IM, Mezzich J, Cornelius MD, Fabrega H, Jr., Ehler JG, et al. Disproportionate suicidality in patients with comorbid major depression and alcoholism. The American Journal of Psychiatry. 1995;152(3):358-64.

. Salloum IM, Mezzich JE, Cornelius J, Day NL, Daley D, Kirisci L. Clinical profile of comorbid major depression and alcohol use disorders in an initial psychiatric evaluation. Comprehensive Psychiatry. 1995;36(4):260-6.

. Saatcioglu O, Yapici A, Cakmak D. Quality of life, depression and anxiety in alcohol dependence. Drug and Alcohol Review. 2008;27(1):83-90.

. Sinha R, Rounsaville BJ. Sex differences in depressed substance abusers. The Journal of Clinical Psychiatry. 2002;63(7):616-27.

. Salloum IM, Cornelius JC, Kirisci L and Douaihy AB. Pharmacotherapy of alcoholism with comorbid major depression: Predictors of alcohol outcomes. Alcoholism: Clinical and Experimental Research. 2010;34(8): 163a-163a.

. McLellan AT, Luborsky L, Woody GE, O'Brien CP. An improved diagnostic evaluation instrument for substance abuse patients. The Addiction Severity Index. The Journal of Nervous and Mental Disease. 1980;168(1):26-33.

. Trajkovic G, Starcevic V, Latas M, Lestarevic M, Ille T, Bukumiric Z, et al. Reliability of the Hamilton Rating Scale for Depression: a meta-analysis over a period of 49 years. Psychiatry Research. 2011;189(1):1-9.

. Mezzich JE, Cohen NL, Ruiperez MA, Banzato CE, Zapata-Vega MI. The Multicultural Quality of Life Index: presentation and validation. Journal of Evaluation in Clinical Practice. 2011;17(2):357-64.

. Liu JS, Mezzich JE, Zapata-Vega MI, Ruiperez MA, Yoon G. Development and validation of the Chinese version of the Multicultural Quality of Life Index (MQLI-Ch). Culture, Medicine and Psychiatry. 2008;32(1):123-34.

. Tuchman E. Women and addiction: the importance of gender issues in substance abuse research. Journal of Addictive Diseases. 2010;29(2):127-38.

. Cloninger CR, Cloninger KM. Person-centered therapeutics. International Journal of Person Centered Medicine 2011; 1: 43-52.



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