Is current alcohol consumption associated with increased lifetime prevalence of major depression and suicidality? Results from a pilot community survey

Binge drinking and the risk of suicidal thoughts, plans, and attempts

BACKGROUND

Major depression is one of the strongest known risk factors for suicide. However, of the estimated 8.5 million adults with serious thoughts of suicide in the past year, only half had a major depressive episode (MDE). Identifying risk factors for suicide in the absence of depression may provide additional targets for prevention and intervention. This study uses nationally representative data to evaluate the association of binge drinking with suicidal thoughts, plans, and attempts in adults with and without MDE.

METHODS

Combined 2008-2012 National Survey on Drug Use and Health data were analyzed. Sex-stratified prevalence estimates of past year suicide indicators were generated by past month binge drinking and past year MDE status. Logistic regression was used to evaluate the association of binge drinking with suicide indicators by sex with and without MDE.

RESULTS

Unadjusted prevalence estimates for suicide indicators in males and females were higher among binge drinkers than among nonbinge drinkers, regardless of MDE status. Regression analyses indicated that binge drinking was associated with suicidal thoughts (adjusted odds ratio [aOR]=1.51, 95% confidence interval [CI]=1.28-1.79), plans (aOR=1.75, CI=1.23-2.48), and attempts (aOR=2.57, CI=1.74-3.79) in females without MDE and with suicidal thoughts in males without MDE (aOR=1.25, CI=1.04-1.49). Among males and females with MDE, binge drinking was not associated with any of the suicide indicators (p>.05).

CONCLUSIONS

Binge drinking in females without MDE may be an indicator for identifying at risk individuals for targeting suicide prevention activities.

Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care

BACKGROUND

Alcohol consumption is associated with several complications of both physical and mental health. Light or moderate alcohol consumption may have beneficial effects on physical or mental health but this effect is still controversial and research in the mental health field is relatively scarce. Our aim was to investigate the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety in a large international primary care sample.

METHODS

The sample consisted of 5438 primary care attenders from 14 countries who participated in the WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT) and the mental disorders were assessed with the Composite International Diagnostic Interview (CIDI).

RESULTS

Light to moderate alcohol consumption was associated with a lower prevalence of depression and generalized anxiety disorder compared to abstinence while excessive alcohol consumption was associated with a higher prevalence of depression. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables, including the presence of chronic disease and the current physical status of participants and was evident in different drinking cultures.

CONCLUSION

The study confirms that excessive drinking is associated with an increased prevalence of depression, but also raises the possibility that light/moderate drinking may be associated with a reduced prevalence of both depression and anxiety. Any causal interpretation of this association is difficult in the context of this cross-sectional study and further longitudinal studies are needed.

Can patterns of alcohol use disorder in young adulthood help explain gender differences in depression?

OBJECTIVE

To test whether gender differences in the prevalence of major depressive disorder differ by longitudinal patterns of alcohol use disorder symptoms.

METHOD

Data are from a prospective longitudinal study examining a broad range of mental health and substance use problems. A gender-balanced sample of 808 participants was interviewed at ages 21, 24, 27, and 30. The sample was divided into subgroups corresponding to longitudinal patterns of alcohol use disorder derived from latent class growth analysis.

RESULTS

Four patterns of alcohol use disorder symptoms were identified: A "low disorder symptom" group, a "decreaser" group, an "increaser" group, and a "chronic disorder symptom" group. Rates of depression were significantly higher for females only among those with a pattern of chronic or decreasing alcohol disorder symptoms.

CONCLUSIONS

Elevated rates of depression among females in young adulthood may depend on patterns of co-occurring alcohol disorder symptoms. Practitioners should pay particular attention to signs of chronic alcohol use disorders and associated risks for depression among young adult women.

Self-reported life satisfaction and alcohol use: a 15-year follow-up of healthy adult twins

AIMS

To study the bidirectional relationships between life satisfaction (LS) and alcohol use.

METHODS

Health questionnaires were administered in 1975, 1981 and 1990 to a population-based sample of healthy Finnish twins aged 18-45 at baseline (n = 14,083). These included a LS scale and three indicators for adverse alcohol use: binge drinking, passing out and high consumption (women/men ≥400/800 g/month). In longitudinal analyses, logistic regression, pair-wise case-control analyses and growth models were applied.

RESULTS

All alcohol indicators increased the age-adjusted risk of becoming dissatisfied regardless of study period [binge drinking odds ratio (OR)(1975-1990 )= 1.29; 95% confidence interval (CI) 1.12-1.50; high consumption OR(1975-1990 )= 1.60; 1.29-1.99 and passing out OR(1981-1990 )= 2.01; 1.57-2.57]. Also, the dissatisfied had an increased subsequent risk for adverse alcohol use. The risk for passing out due to drinking (OR(1975-1990 )= 1.50; 1.22-1.86) was increased regardless of study period, while high consumption (OR(1975-1981 )= 1.97; 1.40-2.77; OR(1981-1990 )= 2.48; 1.50-4.12) and binge drinking (OR(1975-1981 )= 1.37; 1.12-1.67) showed some variation by the study period. Predictions remained after multiple adjustments. Longitudinally, high consumption predicted dissatisfaction somewhat more strongly than vice versa. The change/levels within the whole range of LS and alcohol consumption were only slightly associated in the entire study population.

CONCLUSION

Life dissatisfaction and adverse alcohol use reciprocally predict each other prospectively. The heavier the alcohol use the stronger the relationship.

The impact of alcohol use on depressive symptoms in human immunodeficiency virus-infected patients

AIMS

To examine the impact of alcohol use on depressive symptoms in human immunodeficiency virus (HIV)-infected patients.

DESIGN

Data were collected at 6-month intervals and analyzed to evaluate the association between alcohol dependence and consumption on depressive symptoms using longitudinal mixed-effects regression models controlling for specified covariates.

MEASUREMENTS

The two independent variables were current alcohol dependence assessed using the Composite International Diagnostic Interview (CIDI) and past month consumption (heavy versus not heavy drinking) using a validated calendar-based method. The primary outcome was depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D).

PARTICIPANTS

HIV-infected adults with current or past alcohol problems.

FINDINGS

Alcohol dependence and heavy alcohol use were significantly associated with higher CES-D scores in unadjusted models. In adjusted analyses, the association of current alcohol dependence persisted [mean difference in CES-D was 3.49 for dependence versus non-dependence; 95% confidence interval (CI): 1.76-5.22]; however, the effect of heavy drinking was no longer statistically significant (mean difference in CES-D was 1.04 for heavy versus not heavy drinking; 95% CI: -0.24-2.32).

CONCLUSIONS

Alcohol use is associated with more depressive symptoms in HIV-infected patients with alcohol problems. This association remains significant after adjusting for potential confounders only when alcohol use meets the criteria for alcohol dependence.

Alcohol misuse and report of recent depressive symptoms among ED patients

OBJECTIVE

This study examined the magnitude of association between alcohol misuse and recent depressive symptoms.

METHODS

We conducted a cross-sectional study of 412 randomly selected patients at least 18 years old and seeking emergency department (ED) care.

RESULTS

Of the patients, 51.0% reported depressive symptoms. At-risk drinking was reported by 26.0%, and 28.2% scored positive on the Rapid Alcohol Problems Screen 4. Alcohol abuse and binge drinking were reported by 25.1% and 28%, respectively, of the patients. According to our results, at-risk drinking (odds ratio [OR] = 2.49, 95% confidence interval [CI] = 1.47-4.20, P < or = .001), problem drinking (OR = 2.11, 95% CI = 1.27-3.51, P < or = .004), drinking abuse (OR = 2.58, 95% CI = 1.51-4.40, P < .001), and binge drinking (OR = 1.89, 95% CI = 1.13-3.15, P < .001) were all related to the manifestation of depressive symptoms.

CONCLUSIONS

The findings of this study yield information that could be used by ED health care practitioners and health educators to educate ED patients at risk for alcohol misuse and depression.

Relationship between quantity and frequency of alcohol use and indices of suicidal behavior in an elderly Australian sample

Relatively little research has been conducted on the relationship between alcohol misuse and suicidal behavior among the elderly. The current study's aim was to examine whether quantity and frequency of alcohol use and the interaction between these variables are related to current suicidal ideation, previous suicidal ideation/intent, and past suicide attempts in a community sample of 1,010 Australian adults over age 60. Results partially supported our hypotheses. The interaction between quantity and frequency of alcohol use was significant, suggesting that those who use alcohol less frequently but in greater quantities (i.e., binge drinking) are more likely to have a history of suicide attempts.