BEGIN:VCALENDAR VERSION:2.0 PRODID:-//Ä¢¹½ÊÓÆµ//NONSGML v1.0//EN NAME:PhD defence W.G. ter Meulen METHOD:PUBLISH BEGIN:VEVENT DTSTART:20260112T114500 DTEND:20260112T131500 DTSTAMP:20260112T114500 UID:2026/phd-defence-w-g-ter-meule@8F96275E-9F55-4B3F-A143-836282E12573 CREATED:20251215T025101 LOCATION:(1st floor) Auditorium, Main building De Boelelaan 1105 1081 HV Amsterdam SUMMARY:PhD defence W.G. ter Meulen X-ALT-DESC;FMTTYPE=text/html:
Comorbidity of mood dis orders and substance use disorders: in concert and co-travelling
Psychiatric disord ers often occur together. This phenomenon - comorbidity - is not only common but also remarkably persistent: people who develop multiple p roblems at the same time tend to keep them for long periods. Research by psychiatrist Wendela ter Meulen sheds light on why this happens a nd what the societal consequences are.
More symptoms, m
ore risks
A synthesis of existing studies on the most com
mon combination - depression and anxiety - shows that people who expe
rience both conditions suffer from more severe psychological symptoms
and face a higher risk of physical health problems, social limitatio
ns, and reduced quality of life. Psychosocial factors, such as childh
ood trauma, play a significant role in the development of this double
burden.
People with depression smoke the most
In a follow-up study, Ter Meulen compared risk factors for smokin
g among people with and without depression. The differences were stri
king: people with depression not only smoke far more often, but they
also encounter circumstances - such as financial hardship or stressfu
l living conditions - that reinforce smoking behaviour. This makes qu
itting substantially more difficult.
Disease progressio
n as the silent driver of comorbidity
Ter Meulen also exa
mined the long-term course of mood disorders. Some people recover les
s well from depression or experience more episodes of bipolar mood in
stability. This so-called disease progression appears to be the main
driver behind the persistent pairing of mood disorders and substance-
use problems. In addition, a clinical assessment tool that measures c
omorbidity seems reasonably able to predict which people with depress
ion later develop bipolar disorder.
Impact and opportun
ities for healthcare
The findings make clear that comorbi
dity leads to a stacking of risks and adverse outcomes - psychologica
l, physical, and social. This underscores the need for integrated car
e, in which conditions are not treated separately but addressed toget
her within a single care pathway. A lesser-known but socially relevan
t insight is that early in the course of bipolar disorder, a vulnerab
le period may exist in which substance use is especially destabilisin
g. According to the researchers, education and prevention could yield
significant benefits here.
Smokers with depression also deserv e special attention: they often succeed in reducing their smoking onl y after their depressive symptoms improve - sometimes even partially is enough. This calls for treatment approaches that tackle depression and addiction simultaneously, such as combined psychotherapy. Ter Me ulen’s work shows that better, integrated care not only helps indiv idual patients but may also reduce health problems, lower dropout fro m work or education, and ultimately decrease societal costs.
Mo re information on the
DESCRIPTION: