Standardized clinical interviews of 48 alcoholic patients consecutively admitted to an alcoholism treatment program revealed that 22 (46%) had suffered major depressive episodes. However, only two had the typical depressed affect at the time of the interview. Cyclic mood swings, panic attacks and hypomania were common, indicating that this was a heterogeneous group of depressed patients. The alcoholism tended to precede the onset of depression, which was then followed by the seeking of help, but the whole sequence developed over a few years, when the patients were in their early 20s. The depressed patients had more psychiatric, marital and legal difficulties than the nondepressed patients. There is a need for better definitions of affective disorders in alcoholic patients.
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