Are depressive symptoms and disorders caused by substance misuse?
Alcohol intoxication can be accompanied by temporary but severe depressive symptoms. Long-term alcohol use is also associated with depressed mood, and almost all alcoholics report periods of intense sadness. A categorisation of the presentations of alcohol-associated mood disorders is given in Box 2 . This suggests that substance-induced disorders are commonly phenomenologically indistinguishable from independent major depressive disorders. However, they will remit 2 4 weeks after alcohol drinking has ceased, without the need for antidepressants. At presentation to an alcohol treatment programme, 42% of alcoholic men had significant depressive symptoms, but only 6% were clinically depressed after 4 weeks of abstinence ( Brown & Schuckit, 1998 ).
