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

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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.

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Author Biography

Juan E Mezzich, Mount Sinai School of Medicine, New York University

Born in Lima, Peru, of Yugoslavian and Peruvian ancestries. Medical graduate of Cayetano Heredia Peruvian University and president of the University Student Association.Psychiatric residency training, M.Sc. in Academic Psychiatry, and M.A. and Ph.D. in Mathematical and Statistical Psychology, all at Ohio State University, and diplomate of the American Board of Psychiatry and Neurology.Professorial positions in psychiatry, sequentially at Stanford University, California, the University of Pittsburgh, Pennsylvania, and the Mount Sinai School of Medicine, New York University.Doctor Honoris Causa at Athens University (Greece), Cordoba University (Argentina), Cayetano Heredia Peruvian University (Peru), and Cluj-Napoca University, Timisoara University and Oradea University (Romania). Honorary Professorships at Cayetano Heredia Peruvian University and University of Belgrade (Serbia), World Psychiatric Association Honorary Fellow, Simon Bolivar Award of the American Psychiatric Association, Past-President of the American Society of Hispanic Psychiatry, honorary member/fellow of several national psychiatric associations, and visiting professor and lecturer at academic institutions over 80 countries across all continents.Earlier academic and international work: Secretary & Chair (1983-1996) and Honorary Chair (2008-) of the WPA Section on Classification and Diagnostic Assessment; member of the ICD-10 Work Group and the DSM-IV Task Force; chair of the US National Institute of Mental Health Group on Culture, Diagnosis and Care; consultant on the development of the Chinese Classification of Mental Disorders (3rd Ed.), the Japanese Modification of ICD-10, the Third Cuban Glossary of Psychiatry, and the Latin American Guide for Psychiatric Diagnosis (GLADP); and director of the 1993-2003 WPA International Guidelines for Diagnostic Assessment (IGDA).Author/coauthor of over 280 scientific journal articles and book chapters (including sections on diagnosis,   epidemiology, and culture in Kaplan & Sadock's and Tasman et al’s Textbooks of Psychiatry), and of 26 books and monographs, including Images of Latin American Psychiatry (2013), Coercive Treatment in Psychiatry (2011), Conceptual Bases of Psychiatry for the Person (2011), Conceptual Explorations on Person-centered Medicine (2010), Psychiatric Diagnosis: Challenges and Prospects (2009), Cultural Formulation: A Reader for Psychiatric Diagnosis (2008), Psychiatry and Sexual Health: An Integrative Approach (2006), Philosophical & Methodological Bases of Psychiatric Diagnosis (2005), Guía Latinoamericana de Diagnóstico Psiquiátrico (GLADP) (APAL, 2004), WPA International Guidelines for Diagnostic Assessment (IGDA) (2003), Cultural Psychiatry: International Perspectives (2001), Culture and Psychiatric Diagnosis: A DSM-IV Perspective (1996), Psychiatric Epidemiology (1994). Editor, Psychopathology, (2002-2010), Deputy Editor-in-Chief (2010-2011) and Editor in Chief (2013-  ), Int’l J Person Centered Medicine,  and editorial board member of 15 other medical journals in the Americas, Europe, Asia, and Africa.WPA Secretary General (1996-2002), Vice-President and President-Elect (2002-2005), President (2005-2008), and Council Member (2008- ). President (2009-2013) and then Secetary General (2013- ) of the International Network , now International College, of Person-centered Medicine.Current Work: 1) Person-centered Psychiatry and Medicine: Organization of the 2008, 2009, 2010 and 2011 Geneva Conferences on Person-centered Medicine, and Conferences in London (2007), Paris (2008), and Uppsala (2008) on Psychiatry for the Person; thematic publication of several monographs and journal editorials & papers, and initiating the International Network for Person-centered Medicine in collaboration with the World Medical Association, the World Health Organization and 25 other international medical and health bodies, 2) International diagnostic systems, particularly ICD-11, Person-centered Integrative Diagnosis, and Latin American Guide for Psychiatric Diagnosis, through monographs, journal papers, and conferences, 3) Culture-informed clinical concepts and procedures, including the Cultural Formulation, the Personal Health Scale, the Multi-ethnic Bicultural Scale, and the Multicultural Quality of Life Index through publications, conferences and research projects.


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