Addiction Disorders
density of substance abuse in family members. It is likely that the two groups would benefit from different treatment strategies.
Clinical Implications and Future Research Directions
If LHPA activity is involved in the pathophysiology of depressive and addictive disorders, this system can be considered as a potential target of intervention for these disorders. Research in animals suggests that the administration of CRF antagonists or antiglucocorticoid compounds ameliorates anxiety-related symptoms associated with alcohol/drug withdrawal, and also reduces the self-administration of addictive drugs.109–112 Antiglucocorticoid agents and CRH antagonists appear to have antidepressant properties, and have been tested in humans for the treatment of depression.113,114
reducing substance use, particularly in those with comorbid depression.115,116
1. 2.
Kessler RC, Aguilar-Gaxiola S, Andrade L, et al., Mental- substance comorbidities in the ICPE surveys, Psychiatria Fennica, 2001;32(Suppl. 2):62–80.
Hankin BL, Abramson LY, Moffitt TE, et al., Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study,
J Abnorm Psychol, 1998;107:128–40.
3. 4. 5. 6.
Weissman MM, Warner V, Wickramaratne P, et al., Offspring of depressed parents. 10 Years later, Arch Gen Psychiatry, 1997;54:932–40.
Birmaher B, Ryan ND, Williamson DE, et al., Childhood and adolescent depression: a review of the past 10 years. Part II,
J Am Acad Child Adolesc Psychiatry, 1996;35:1575–83.
Rao U, Chen LA, Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders, Dialogues
Clin Neurosci, 2009;11:45–62.
Giaconia RM, Reinherz HZ, Silverman AB, et al., Ages of onset of psychiatric disorders in a community population
of older adolescents, J Am Acad Child Adolesc Psychiatry,
1994;33:706–17.
7. 8. 9.
Armstrong TD, Costello EJ, Community studies on adolescent substance use, abuse, or dependence and psychiatric
comorbidity, J Consult Clin Psychol, 2002;70:1224–39.
DeWit DJ, Adlaf EM, Offord DR, et al., Age at first alcohol use: a risk factor for the development of alcohol disorders,
Am J Psychiatry, 2000;157:745–50.
Grant BF, Dawson DA, Age of onset of drug use and its association with DSM-IV drug abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic
Survey, J Subst Abuse, 1998;10:163–73.
10. Rohde P, Lewinsohn PM, Kahler CW, et al., Natural course of alcohol use disorders from adolescence to young
adulthood, J Am Acad Child Adolesc Psychiatry, 2001;40:83–90.
11. Davis L, Uezato A, Newell JM, et al., Major depression and comorbid substance use disorders, Curr Opin Psychiatry, 2008;21:14–18.
12. Kuo PH, Gardner CO, Kendler KS, et al., The temporal relationship of the onsets of alcohol dependence and major depression: using a genetically informative study design,
Psychol Med, 2006;36:1153–62.
13. Rao U, Chen L, Neurobiological and psychosocial processes associated with depressive and substance-related disorders
in adolescents, Current Drug Abuse Reviews, 2008;1:68–80.
14. Deas D, Thomas S, Comorbid pyschiatric factors contributing to adolescent alcohol and other drug use,
Alcohol Research & Health, 2002;26:116–21.
15. King RD, Gaines LS, Lambert EW, et al., The co-occurrence of psychiatric and substance use diagnoses in adolescents in different service systems: frequency, recognition, cost,
and outcomes, J Behav Health Serv Res, 2000;27:417–30.
16. Volkow ND, The reality of comorbidity: depression and drug
abuse, Biol Psychiatry, 2004;56:714–17.
However, some individuals with comorbid depressive and addictive disorders show a poor response to antidepressant drugs.116
The differential
response to antidepressant compounds in patients with comorbid depressive and addictive disorder might be related to the LHPA activity.
It is postulated that, specifically, persons with elevated LHPA activity benefit most from antidepressant agents. Data from clinical and pre-clinical studies suggest that treatment with antidepressant agents reduces responsiveness to stress.114,117
Second, the additional
contribution of stressful life experiences in increasing the vulnerability to SUD suggests that such persons might benefit from adjunctive psychosocial interventions.118
Future studies should evaluate the Antidepressant agents also are helpful in
efficacy of pharmacotherapy and psychosocial interventions, singly and in combination, in patients with depressive and/or addictive disorders stratified on LHPA activity and stress levels. n
17. Garber J, Depression in children and adolescents: linking risk
research and prevention, Am J Prev Med, 2006;31:S104–125.
18. Grant KE, Compas BE, Thurm AE, et al., Stressors and child and adolescent psychopathology: measurement issues and
prospective effects, J Clin Child Adolesc Psychol, 2004;33:412–25.
19. Hammen C, Stress and depression, Annu Rev Clin Psychol, 2005;1:293–319.
20. Ge X, Lorenz FO, Conger RD, et al., Trajectories of stressful life events and depressive symptoms during adolescence,
Developmental Psychology, 1994;30:467–83.
21. Larson R, Ham M, Stress and storm and stress in early adolescence—the relationship of negative events with dysphoric affect, Developmental Psychology, 1993;29:130–40.
22. Rudolph KD, Hammen C, Age and gender as determinants of stress exposure, generation, and reactions in youngsters: a transactional perspective, Child Dev, 1999;70:660–77.
23. Zahn-Waxler C, Shirtcliff EA, Marceau K, Disorders of childhood and adolescence: gender and psychopathology,
Annu Rev Clin Psychol, 2008;4:275–303.
24. Hammen C, Henry R, Daley SE, Depression and sensitization to stressors among young women as a function of
childhood adversity, J Consult Clin Psychol, 2000;68:782–7.
25. Heim C, Newport DJ, Wagner D, et al., The role of early adverse experience and adulthood stress in the prediction of neuroendocrine stress reactivity in women: a multiple regression analysis, Depress Anxiety, 2002;15:117–25.
26. Rao U, Hammen C, Ortiz LR, et al., Effects of early and recent adverse experiences on adrenal response to psychosocial stress in depressed adolescents, Biol Psychiatry, 2008;64:521–6.
27. Turner RJ, Lloyd DA, Lifetime traumas and mental health: the significance of cumulative adversity, J Health Soc Behav, 1995;36:360–76.
28. Hazel NA, Hammen C, Brennan PA, et al., Early childhood adversity and adolescent depression: the mediating role of continued stress, Psychol Med, 2008;38:581–9.
29. Hammen C, Stress generation in depression: reflections on origins, research, and future directions, J Clin Psychol, 2006;62:1065–82.
30. Davila J, Hammen C, Burge D, et al., Poor interpersonal problem solving as a mechanism of stress generation in depression among adolescent women, J Abnorm Psychol, 1995;104:592–600.
31. Rudolph KD, Hammen C, Burge D, et al., Toward an interpersonal life-stress model of depression: the developmental context of stress generation, Dev
Psychopathol, 2000;12:215–34.
32. Daley SE, Hammen C, Davila J, et al., Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood, J Consult Clin
Psychol, 1998;66:595–603.
33. Nelson DR, Hammen C, Daley SE, et al., Sociotropic and autonomous personality styles: contributions to chronic life
stress, Cognitive Therapy and Research, 2001;25:61–76.
34. Herzberg DS, Hammen C, Burge D, et al., Social competence as a predictor of chronic interpersonal stress,
Personal Relationships, 1998;5:207–18.
35. Daley SE, Hammen C, Burge D, et al., Predictors of the generation of episodic stress: a longitudinal study of late
adolescent women, J Abnorm Psychol, 1997;106:251–9.
36. Cohen LH, Burt CE, Bjorck JP, Life stress and adjustment— effects of life events experienced by young adolescents and their parents, Developmental Psychology, 1987;23:583–92.
37. Kim KJ, Conger RD, Elder GH, Jr, et al., Reciprocal influences between stressful life events and adolescent internalizing and externalizing problems, Child Dev, 2003;74:127–43.
38. Compas BE, Connor-Smith J, Jaser SS, Temperament, stress reactivity, and coping: implications for depression in childhood
and adolescence, J Clin Child Adolesc Psychol, 2004;33:21–31.
39. Hankin BL, Abramson LY, Development of gender differences in depression: an elaborated cognitive vulnerability- transactional stress theory, Psychol Bull, 2001;127:773–96.
40. Hilsman R, Garber J, A test of the cognitive diathesis-stress model of depression in children: academic stressors, attributional style, perceived competence, and control,
J Pers Soc Psychol, 1995;69:370–80.
41. Lewinsohn PM, Joiner TE, Jr., Rohde P, Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents, J Abnorm Psychol, 2001;110:203–15.
42. Robinson NS, Garber J, Hilsman R, Cognitions and stress: direct and moderating effects on depressive versus externalizing symptoms during the junior high school
transition, J Abnorm Psychol, 1995;104:453–63.
43. Compas BE, Connor-Smith JK, Saltzman H, et al., Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research, Psychol Bull, 2001;127:87–127.
44. Lazarus R, Folkman S, Stress, appraisal, and coping, New York: Springer, 1984.
45. Koob G, Kreek MJ, Stress, dysregulation of drug reward pathways, and the transition to drug dependence,
Am J Psychiatry, 2007;164:1149–59.
46. Sinha R, Chronic stress, drug use, and vulnerability to
addiction, Ann N Y Acad Sci, 2008;1141:105–30.
47. Uhart M, Wand GS, Stress, alcohol and drug interaction: an update of human research, Addict Biol, 2009;14:43–64.
48. Baker TB, Piper ME, McCarthy DE, et al., Addiction motivation reformulated: an affective processing model of negative reinforcement, Psychol Rev, 2004;111:33–51.
49. Carter BL, Tiffany ST, Meta-analysis of cue-reactivity in addiction research, Addiction, 1999;94:327–40.
50. Pohorecky LA, Stress and alcohol interaction: an update
of human research, Alcohol Clin Exp Res, 1991;15:438–59.
51. Sinha R, How does stress increase risk of drug abuse and
relapse? Psychopharmacology (Berl), 2001;158:343–59.
42
US PSYCHIATRY
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68