BEGIN:VCALENDAR VERSION:2.0 PRODID:-//Vrije Universiteit Amsterdam//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:20260409T095119 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

Depression and smoking prove a persistent combination: research s hows why integrated care is urgently needed

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 thesis

DESCRIPTION:

Depression and smoking prove a persistent combination : research shows why integrated care is urgently needed

Psychiat ric disorders often occur together. This phenomenon - comorbidity - i s not only common but also remarkably persistent: people who develop multiple problems at the same time tend to keep them for long periods . Research by psychiatrist Wendela ter Meulen sheds light on why this happens and what the societal consequences are. More symptom s, more risks
A synthesis of existing studies on the most common combination - depression and anxiety - shows that people who experience both conditions suffer from more severe psychological symp toms and face a higher risk of physical health problems, social limit ations, and reduced quality of life. Psychosocial factors, such as ch ildhood trauma, play a significant role in the development of this do uble burden. People with depression smoke the mostIn a follow-up study, Ter Meulen compared risk factors for smoking among people with and without depression. The differences were striki ng: people with depression not only smoke far more often, but they al so encounter circumstances - such as financial hardship or stressful living conditions - that reinforce smoking behaviour. This makes quit ting substantially more difficult. Disease progression as the silent driver of comorbidity
Ter Meulen also examined th e long-term course of mood disorders. Some people recover less well f rom depression or experience more episodes of bipolar mood instabilit y. This so-called disease progression appears to be the main driver b ehind the persistent pairing of mood disorders and substance-use prob lems. In addition, a clinical assessment tool that measures comorbidi ty seems reasonably able to predict which people with depression late r develop bipolar disorder. Impact and opportunities for heal thcare
The findings make clear that comorbidity leads to a stacking of risks and adverse outcomes - psychological, physical, a nd social. This underscores the need for integrated care, in which co nditions are not treated separately but addressed together within a s ingle care pathway. A lesser-known but socially relevant insight is t hat early in the course of bipolar disorder, a vulnerable period may exist in which substance use is especially destabilising. According t o the researchers, education and prevention could yield significant b enefits here. Smokers with depression also deserve special attention: they often succeed in reducing their smoking only after their depres sive symptoms improve - sometimes even partially is enough. This call s for treatment approaches that tackle depression and addiction simul taneously, such as combined psychotherapy. Ter Meulen’s work shows that better, integrated care not only helps individual patients but m ay also reduce health problems, lower dropout from work or education, and ultimately decrease societal costs. More information on the thesis Comorbidity of mood disorders and substance use disorders: in concert and co-travelling END:VEVENT END:VCALENDAR