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Anxiety and depression among abstainers and low-level alcohol consumers. The Nord-Trøndelag Health Study
Abstract
The aim of this study was to examine the levels of anxiety and depression among individuals consuming low levels of alcohol.
Prospective and cross-sectional population-based study.
This study employed data from the Nord-Trøndelag Health Survey (HUNT-2, n = 38 930).
Alcohol consumption was measured by self-report of usual alcohol consumption during a 2-week period. Low-level alcohol consumption was defined as self-reported abstainers and non-abstainers currently consuming no alcohol. Anxiety and depression were measured using the Hospital Anxiety and Depression Rating Scale. Potential explanatory variables included somatic illness and symptoms, health-related behaviour, socio-economic status and social activity. In a subsample (n = 20 337), we also looked at the impact of previous heavy drinking among abstainers ('sick-quitting').
A U-shaped association between alcohol consumption and the risk of anxiety and depression was found. Abstention was related to increased odds for both case-level anxiety [1.34, 95% confidence interval (CI) 1.19-1.52] and depression (1.52, 95% CI 1.30-1.77). This association was accounted for partly by adjustments for socio-economic status, social network, somatic illness, age (depression only), gender (anxiety only) and 'sick-quitting'. We also identified significant differences between participants who label themselves as abstainers compared to those who report no usual alcohol consumption, but who do not label themselves as abstainers.
The risk of case-level anxiety and depression is elevated in individuals with low alcohol consumption compared to those with moderate consumption. Individuals who label themselves as abstainers are at particularly increased risk. This increased risk cannot fully be explained by somatic illness, social activity or 'sick-quitting'.
... Também há quem considere que um dos principais sucessos da DM é o facto de esta estar associada a uma boa dose de "alegria de viver", isto é, uma vida maioritariamente sem ansiedade nem depressão. É aqui que entra o "The Nord-Trøndelag Health Study" [6] , um estudo que tem vários pontos fortes e de que daremos mais detalhes adiante neste artigo. Resumidamente, este estudo mostrou que, a nível de grupo, os indivíduos abstémios ou consumidores de muito pouco álcool tinham níveis significativamente aumentados de ansiedade e depressão. ...
... A "hipóte-se do desistente doente", no contexto dos estudos sobre alcoolismo, é uma teoria que sugere que as pessoas que deixam de beber sem assistência de um profissional de saúde ou a ajuda de grupos de recuperação, muitas vezes o fazem quando enfrentam consequências graves de saúde, ou outros problemas significativos relacionados com o consumo de álcool. No contexto do "The Nord-Trøndelag Health Study" [6] , verificou-se que o aumento do risco de ansiedade e depressão, que se observou no grupo dos abstémios, tem de ser calculado somando o risco dos "abstémios ao longo da vida" com o risco dos "abstémios que estão a recuperar de problemas anteriores com a bebida". ...
... O estudo de Nord-Trøndelag teve em conta, entre outros, os seguintes: número de amigos (variando entre "nenhum", "mais de 6", e "questão não respondida"); participação em atividades sociais organizadas (variando entre "nenhuma" e "mais do que uma por semana"). Usando dados de uma grande amostra baseada numa comunidade (N = 38 930), Tabela 1, o referido estudo [6] apresenta vários pontos fortes: primeiro, trata-se de uma pesquisa de base populacional, o que reduziu as hipóteses de seleção enviesada da amostra, fenómeno que se encontra frequentemente em amostras clínicas. Em segundo lugar, o tamanho da amostra era grande, produzindo uma capacidade e poder estatístico suficientes para detetar até mesmo pequenas correlações, e a taxa de participação também foi razoável, tendo em conta o tamanho da meta-população. ...
A Dieta Mediterrânica (DM) é um modelo de alimentação saudável, amplamente adotado devido aos seus benefícios para a saúde. Para além de boas características nutricionais, a DM contempla a convivialidade à mesa e o consumo moderado de vinho, elementos que contribuem para a “alegria de viver”. O estudo Nord-Trøndelag, que aqui abordamos, revela que indivíduos abstémios ou com baixo consumo de álcool apresentam níveis elevados de ansiedade e depressão, sugerindo que a abstinência pode, nas sociedades ocidentais, impactar negativamente a integração social e a experiência completa da DM. O referido
estudo sugere um risco aumentado de problemas de saúde mental entre abstémios, não totalmente explicado por fatores sociodemográficos ou outras condições.
... Extensive research indicates the presence of a relationship between alcohol use and mental health problems (21)(22)(23)(24)(25). This association may be particularly relevant to investigate among students since they are in an age-period where high-prevalence mental disorders (depression, and anxiety) emerge (26). ...
... Further evidence suggests that the association between mental health problems and alcohol use may not be linear (30). For instance, Skogen et al. (24) found a U-shaped relationship between alcohol consumption and the risk of depression and anxiety among Norwegian adults, while Caldwell et al. (31) found a J-shaped association between alcohol consumption and depression among Australian young adults. In addition, Peltzer and Pengpid (32) found an inverse Ushaped association between alcohol consumption and depression among students. ...
... Despite finding curvilinear associations, our results differ from other studies that also have investigated the shape of the relationship. Skogen et al. (24) found a U-shaped curve, where abstainers and heavy drinkers had the highest risk of reporting anxiety and depression. In contrast, Caldwell et al. (31) found a J-shaped curve, where heavy drinkers had a higher risk of reporting symptoms of depression. ...
Objective: Recent studies have shown that today's college students more than ever are struggling with mental health and alcohol problems. While poor satisfaction with life and mental health problems have been linked to higher alcohol consumption, there is still a lack of studies examining in detail the shape and nature of the relationship between mental health and alcohol consumption.
Aim: To investigate the associations between satisfaction with life, mental health problems and potential alcohol-related problems among Norwegian university students. The shape of the associations was also examined.
Methods: Data were drawn from a 2018 national survey of students in higher education in Norway (the SHoT-study). Associations between satisfaction with life, mental health problems and potential alcohol-related problems (AUDIT; risky and harmful alcohol use) were investigated using logistic regression. Both crude models and models adjusted for age, gender and marital status were conducted. To investigate the shape of the associations, logistic regression with quadric and cubic terms was tested.
Results: Decreased satisfaction with life and increased mental health problems were associated with potential alcohol-related problems. For satisfaction with life, a curvilinear association with risky alcohol use and a linear association with harmful alcohol use was identified. For mental health problems, curvilinear associations were found for both risky and harmful alcohol use.
Conclusion: Many students report potential alcohol-related problems. Students with harmful alcohol use seem to be more at risk of reduced satisfaction with life and increased mental health problems than students with risky alcohol use. Educational institutions may be an ideal setting for raising awareness of mental health issues and responsible alcohol consumption among students. The present study contributes with important information about the shape of the associations between satisfaction with life, mental health problems and potential alcohol-related problems in the student population.
... Instead, it is rather evident that the vast majority of non-addicted human users consume psychoactive drugs as a normal part of their lives with a high degree of environmental selectivity [225,301] and to use subsequent drug effects for their personal goals in these microenvironments. ...
... In Western societies, a legal drug that is frequently used for this instrumentalization goal is alcohol. Moderate consumption of alcohol has been associated with better health, more close friendships, and more family support than total abstinence [195,201,231,259,301,313,318]. It has also been linked to lower rates of stress-induced depression [318], and it appears to reduce the risk of somatic disorders, anxiety disorders, and depression when compared to people who J o u r n a l P r e -p r o o f completely abstain from alcohol [231,301]. ...
... Moderate consumption of alcohol has been associated with better health, more close friendships, and more family support than total abstinence [195,201,231,259,301,313,318]. It has also been linked to lower rates of stress-induced depression [318], and it appears to reduce the risk of somatic disorders, anxiety disorders, and depression when compared to people who J o u r n a l P r e -p r o o f completely abstain from alcohol [231,301]. Therefore, it has been suggested that alcohol may provide relief from negative affect in non-addicted consumers [231]. In clinical samples, however, a high co-morbidity appears between diagnoses of 'major depression' and 'alcohol addiction' [37,242]. ...
Psychoactive drugs with addiction potential are widely used by people of virtually all cultures in a non-addictive way. In order to understand this behaviour, its population penetrance, and its persistence, drug instrumentalization was suggested as a driving force for this consumption. Drug instrumentalization theory holds that psychoactive drugs are consumed in a very systematic way in order to make other, non-drug-related behaviours more efficient. Here, we review the evolutionary origin of this behaviour and its psychological mechanisms and explore the neurobiological and neuropharmacological mechanisms underlying them. Instrumentalization goals are discussed, for which an environmentally selective and mental state-dependent consumption of psychoactive drugs can be learned and maintained in a non-addictive way. A small percentage of people who regularly instrumentalize psychoactive drugs make a transition to addiction, which often starts with qualitative and quantitative changes in the instrumentalization goals. As such, addiction is proposed to develop from previously established long-term drug instrumentalization. Thus, preventing and treating drug addiction in an individualized medicine approach may essentially require understanding and supporting personal instrumentalization goals.
... Up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one or more anxiety disorders [18]. Studies have previously found that abstainers and heavier drinkers were at higher risk for depression than moderate drinkers [19,20]. Among university students, two studies established that problem drinking is related to depressive symptoms [8,20]. ...
... Studies have previously found that abstainers and heavier drinkers were at higher risk for depression than moderate drinkers [19,20]. Among university students, two studies established that problem drinking is related to depressive symptoms [8,20]. Both alcohol use and poor mental health have been identified to be associated with risky sexual behavior [13]. ...
Background
Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population.
Methods
This was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio.
Results
We enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ² = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001).
Conclusion
AUD, depression and anxiety are a significant burden in this health professional student population and there’s need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.
... Association studies have reported numerous benefits of moderate alcohol consumption during adulthood, such as more close friendships, and more family support than total abstinence [101,102]. Compared to complete abstinence, moderate alcohol consumption is also associated with less anxiety and depression [101,102] and better stress management. However, these studies do often not consider the neuroeconomic trade-off made by the individual consumer. ...
... Association studies have reported numerous benefits of moderate alcohol consumption during adulthood, such as more close friendships, and more family support than total abstinence [101,102]. Compared to complete abstinence, moderate alcohol consumption is also associated with less anxiety and depression [101,102] and better stress management. However, these studies do often not consider the neuroeconomic trade-off made by the individual consumer. ...
Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.
... This might be partially explained by the fact that nondrinkers are more likely to be older and in turn suffer from chronic conditions or take medication that require them to abstain from alcohol. 40 Furthermore, nondrinkers are more likely to have a smaller social network, 40 which may in turn increase their depression risk. ...
... This might be partially explained by the fact that nondrinkers are more likely to be older and in turn suffer from chronic conditions or take medication that require them to abstain from alcohol. 40 Furthermore, nondrinkers are more likely to have a smaller social network, 40 which may in turn increase their depression risk. ...
Background:
More recent birth cohorts are at a higher depression risk than cohorts born in the early 20th century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity, and obesity contribute to these birth cohort variations.
Methods:
We analyzed panel data from US adults born 1916-1966 enrolled in the Health and Retirement Study (N=163,760 person-years). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. We thereby compared the predicted probability of elevated depressive symptoms (CES-D 8 score ≥3) in the natural course to a counterfactual scenario where all birth cohorts had the health behaviors of the 1945 birth cohort. We stratified analyses by sex and race-ethnicity.
Results:
We estimated that depression risk of the 1916-1949 and 1950-1966 birth cohort would be on average 2.0% (-2.3 to -1.7) and 0.5% (-0.9 to -0.1) higher with the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1% (1.8 to 2.4) higher for the 1916-1940 cohorts and 1.8% (-2.2 to -1.5) lower for the 1950-1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race-ethnicity groups, and the contribution of BMI more pronounced for women than for men.
Conclusions:
Increased obesity levels were associated with exacerbated depression risk in recent birth cohorts in the US, while drinking patterns only played a minor role.
... Up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one or more anxiety disorders [18]. Studies have previously found that abstainers and heavier drinkers were at higher risk for depression than moderate drinkers [19,20]. Among university students, two studies established that problem drinking is related to depressive symptoms [8,20]. ...
... Studies have previously found that abstainers and heavier drinkers were at higher risk for depression than moderate drinkers [19,20]. Among university students, two studies established that problem drinking is related to depressive symptoms [8,20]. Both alcohol use and poor mental health have been identified to be associated with risky sexual behavior [13]. ...
Background: Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population. Methods: This was an online cross-sectional study among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio. Results: We enrolled a total of 531 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ ² = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be a significant predictor of risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001). Conclusion: AUD, depression and anxiety are a significant burden in this health professional student population and there’s need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students .
... Many studies have observed that heavier drinkers are more likely to show evidence of AMD (Mann et al., 2012). Interestingly, some research suggests that moderate drinkers may be less likely to show evidence of AMD than abstainers or heavy drinkers (Mann et al., 2012;Skogen et al., 2009). However, as with the relationship of alcohol consumption and cardiovascular disease, these findings may result from confounding of the abstaining group by the inclusion of large numbers of former abusive drinkers or individuals who are otherwise medically compromised (Zhao et al., 2017). ...
... We also examined the relationship between recent drinking and probable AMD. Previous research suggests that heavier drinking is associated with negative affect and increased likelihood of AMD, but also that moderate drinking may be associated with reduced likelihood of AMD, similar to the Jshaped relationship reported between alcohol consumption and heart disease (Mann et al., 2012;Skogen et al., 2009). However, the present results provide only modest support for an impact of recent consumption on probable AMD. ...
This study examined the associations of cannabis use, alcohol use and alcohol problems with probable anxiety and mood disorders (AMD) in young, middle-aged and older adults. Method: Data are based on the CAMH Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 years and older. For the purposes of the current study, a merged dataset from the years 2001 through 2009 inclusive was separated into three individual datasets: 18-34 year olds (n=4,211), 35-54 year olds (n=7,874), and 55 years of age and older (n=6,778). The survey included the 12-item version of the General Health Questionnaire, which provides a measure of probable AMD for the general population. Logistic regression analyses examined the odds of probable AMD in three age groups associated with alcohol measures (number of drinks per day and alcohol problems (AUDIT 8+)) and cannabis use, while controlling for self-reported physical health, religious service attendance, and demographic factors. Due to listwise deletion, the logistic regression models were based on reduced samples. Results: Lifetime cannabis use and past year cannabis use predicted probable AMD in young and middle-aged adults, but only lifetime cannabis use predicted probable AMD among older adults. Alcohol problems predicted probable AMD among middle aged and older adults, but not among younger adults. No consistent link between recent alcohol consumption and probable AMD was observed. Conclusion: These analyses suggest that the impact of alcohol and cannabis use and problems on probable AMD may differ across age groups.
... While there is evidence that smoking is associated with severity of depression in older individuals [15,[17][18][19], research findings are inconsistent regarding alcohol consumption. A number of studies found no association between depressive symptoms and alcohol consumption [14,15,[20][21][22][23], while some researchers found an inverse association between alcohol use and depression severity [24,25]. However, substance use is often not limited to one substance. ...
... After controlling for a large number of lifestyle and morbidity variables, earlier studies showed that the inverse association between moderate alcohol consumption and mortality remains consistent when considering other independent risk factors such as body mass index, health/functioning, physical health, social activities, and support of friends [24,28]. Nonetheless, the inverse association seems to be prone to factors like smoking and alcohol quantity [28]. ...
This study aimed to examine the association of alcohol and tobacco use with severity of depression in older age. Analyses were performed on a pooled data set (n = 3,724) from two German old-age cohort studies (LEILA 75+, 6 follow-ups and AgeCoDe/AgeQualiDe, 9 follow-ups). Depressive symptoms were assessed via two screening scales for depression (CES-D and GDS-15) which were harmonized for pooled analysis. A mixed-effects linear regression model for the total sample
and additional stratified models for men and women were used. Smoking at baseline was significantly associated with a higher level of depression severity (β = 0.142, 95% CI: 0.051 to 0.233, p = 0.002), whereas drinking was significantly associated with a decreased level of depression (β = -0.069, 95% CI: -0.119 to -0.021, p = 0.005). Concurrent substance use at baseline increased longitudinal depression severity (β = 0.193, 95% CI: 0.011 to 0.375, p = 0.037). Analyses stratified by gender showed a significant inverse association between drinking and depressive symptoms in men (β = -0.138, 95% CI: -0.231 to -0.045, p = 0.004), but not in women (β = -0.060, 95% CI: -0.120 to 0.001, p = 0.052). Given the burden of major depression, it is important that health care providers, especially primary care physicians, assess and monitor lifestyle factors, even at older ages.
... Alcohol consumption, and especially heavy drinking, begins globally in adolescence in many countries [1]. Heavy drinking, at least occasionally, may be culturally normative and has been reported to associate with better wellbeing and a lower level of depression and anxiety than abstinence or excess drinking [2][3][4][5]. Nonetheless, for those individuals who develop problems with substance use, some drinking patterns may confer risk. Indeed, drinking frequency in adolescence was related to alcohol use disorders (AUDs) and alcohol dependence rather than the amount of alcohol consumed per event or frequency of heavy episodic drinking [6]. ...
... Previous research testing the association of heavy drinking (defined as consuming three or more drinks in a row at least once a month) with major depressive disorder and anxiety in adolescent and adults has yielded contradictory results [3,7,15,28,29]. In our work, frequency of intoxication appeared to have a prospective association with any mood disorder, but not with any psychosis or anxiety disorder. The association attenuated after adjusting for other drug use and psychopathology symptoms at age 15-16. ...
Aims:
To assess the associations of intoxication frequency and number of drinks needed to become intoxicated in mid-adolescence with onset of psychiatric disorders in early adulthood.
Design, setting and participants:
Prospective cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986 who self-reported adolescent alcohol use: 6548 subjects (69.4% of the original sample). Data on alcohol use were collected using questionnaires at ages 15-16 years.
Measurements:
Outcomes were any non-organic psychosis, mood disorder, anxiety disorder, any substance use disorder (SUD) and all the studied psychiatric disorders in early adulthood gathered from nation-wide health care, pension and insurance registers. Number of drinks needed to become intoxicated was categorized into three classes: (1) no alcohol use or intoxication, and (2) low and (3) high alcohol tolerance (more than seven/nine drinks for females/males) groups. Similarly, intoxication frequency was divided into three classes: (1) never, (2) one to two times and (3) three or more times during the past 30 days. Information regarding gender, family type, other drug use, psychopathology using Youth Self-Report (YSR) total score and parental psychiatric disorders were used as covariates.
Findings:
In the multivariable analyses, both low [odds ratio (OR) = 3.0, 95% confidence interval (CI) = 1.3-6.7, P-value = 0.009] and high (OR = 4.4, 95% CI = 1.8-11.1, P-value = 0.001) alcohol tolerance were associated with increased risk of SUD. More frequent intoxication was associated with increased frequency of SUD (OR = 3.9, 95% CI = 2.0-7.3, P-value < 0.001) and mood disorder (OR = 1.6, 95% CI = 1.1-2.3, P-value = 0.008). The latter was attenuated after adjusting with concurrent psychopathology (YSR) and other drug use.
Conclusions:
Both higher alcohol tolerance and frequent intoxication in adolescence appear to be associated with increased risk of future substance use disorder.
... However, such behavioral changes, particularly the initiation of alcohol use, could paradoxically contribute to depressive symptoms, potentially due to the synergistic effects of psychosocial stress from significant lifestyle alterations and the mood-altering effects of alcohol [69]. Conversely, stopping alcohol consumption after a cancer diagnosis could lead to feelings of isolation or loss of a familiar coping mechanism, increasing depression risk [70]. The 'sick quitter' effect, where individuals in compromised health states following a cancer diagnosis might stop drinking due to health concerns, could also contribute to our findings. ...
Purpose
Protective lifestyle behaviors could potentially mitigate the risk of depression in breast cancer survivors. This study examined the association between changes in key health behaviors and depression risk after breast cancer diagnosis and treatment.
Methods
This nationwide cohort study assessed 30,523 breast cancer survivors without a prior history of depression, focusing on changes in weight, smoking habits, alcohol consumption, and physical activity from pre- to post-cancer diagnosis. The primary outcome was incident depression, with adjusted hazard ratios and confidence intervals calculated to consider potential confounders.
Results
During an average follow-up of 5.3 years (160,755 person-years), lifestyle changes post-diagnosis included decreases in smoking (2.8% to 0.9%) and alcohol consumption (24.9% to 7.5%) and an increase in physical activity (18.9% to 32.1%). Substantial weight gain (> 10%) was associated with a 27% elevated risk of depression compared to those who maintained weight. Both continuation and cessation of smoking were associated with increased depression risk compared to sustained non-smokers. Changes in alcohol consumption, either initiation or cessation, were associated with increased depression risk compared to sustained non-drinkers. Conversely, breast cancer survivors who became inactive post-diagnosis had a reduced risk of depression compared to those who remained inactive. Our exploratory analysis showed that regular physical activity prior to diagnosis was associated with a 7% lower risk of depression compared to inactivity.
Conclusion
We observed that post-diagnosis weight gain exceeding 10%, sustaining or quitting smoking, starting or stopping alcohol consumption, and pre-diagnosis physical inactivity were all associated with an increased risk of depression in breast cancer survivors. Healthcare providers should support healthy behaviors to mitigate depression risk after breast cancer diagnosis and treatment.
... O estudo aborda a importância da terapia nutricional para a saúde mental, justificando nossa decisão de analisar o consumo alimentar da PNS. Outros estudos, como [Lai et al. 2015] e [Skogen et al. 2014], também reforçam a relação entre alimentação e a depressão. ...
O objetivo do estudo é a caracterização do perfil de indivíduos adultos com depressão a partir da mais recente Pesquisa Nacional de Saúde (PNS 2019). Como metodologia, é proposto um método para descoberta de conhecimento por meio da aplicação de algoritmos caixa-branca e caixa-preta. O algoritmo Floresta Aleatória se destacou pelo melhor desempenho geral, atingindo uma média da medida F1-score de 82% para o conjunto de teste. Os resultados também corroboram a necessidade de considerar fatores socioeconômicos, estilo de vida e condições de saúde física na prevenção e tratamento da depressão.
... Furthermore, habitual alcohol intake, compared to abstaining from alcohol entirely, was a predictor of decrease in FCV-19S scores. Previous research has indicated that moderate alcohol consumption has a calming effect on anxiety and depression [36]. Therefore, in the context of the unstable societal situation with the spread of emerging infectious diseases, moderate alcohol consumption was suggested to have a protective effect on mental health. ...
Background
Coronavirus disease 2019 (COVID-19) is a respiratory infection that considerably impacts both physical and mental health. In particular, the prolonged nature of psychological issues associated with COVID-19 has become a concern. However, evidence based on longitudinal studies investigating the changes in fear of COVID-19 has been limited, posing a public health challenge.
Methods
We investigated the predictors of changes in the Fear of COVID-19 Scale (FCV-19S) scores in the general Japanese population using data from a large-scale internet-based cohort study.
Results
We included 20,712 study participants (mean age = 51.1 years, percentage of males = 49.9%). The baseline FCV-19S score for the research participants was 17.0, and one year later, the FCV-19S score decreased to 15.8. The predictors of increase in FCV-19S scores were older age, male sex, COVID-19 requiring oxygen therapy, higher baseline FCV-19S total score, severe psychological distress, never married, worsening subjective health status, a greater number of COVID-19 vaccinations, a history of alcohol dependency, and living with family members. Conversely, the predictors of decrease in FCV-19S scores included habitual alcohol intake, COVID-19 not requiring oxygen therapy and a higher household income. Our study was an internet-based survey focused on residents of Japan, which raises the possibility of selection bias and makes it unclear whether the findings can be extrapolated to other countries and cultures.
Conclusion
During the observation period, the FCV-19S scores significantly decreased. Severe COVID-19 requiring oxygen therapy within one year of baseline was the most impactful predictor of an increase in FCV-19S score. On the other hand, mild COVID-19 not requiring oxygen therapy was a predictor of a decrease in FCV-19S scores. Therefore, we believe that it is necessary to adopt individualized approaches stratified by the severity of the infection when addressing the fear of COVID-19.
... This meticulous approach upholds the integrity of our MR framework, guaranteeing the autonomy of each instrumental variable. Additionally, we recognized smoking, alcohol consumption, and body mass index (BMI) as pertinent variables with the potential to confound the exposure-outcome relationship [16][17][18][19][20]. We systematically addressed potential confounding factors by excluding the SNPs associated with these variables(P < 5×10−8). ...
Background
Observational studies have previously shown a potential link between psycho-emotional disorders, such as mood swings, highly strung, anxious feelings, and gastroesophageal reflux disease (GERD). However, the credibility of these associations could be influenced by various confounding factors. Consequently, our study sought to employ a Mendelian randomization (MR) approach to elucidate a potential causal relationship between psycho-emotional disorders and GERD.
Method
Information on independent genetic variants linked to mood swings, highly strung, and anxious feelings was gathered from European populations participating in the IEU Open GWAS research. The FinnGen Consortium provided the genome-wide association study (GWAS) summary statistics for GERD. Our analysis employed the inverse variance weighted (IVW) method under the random effects model as the main analytical method. To further bolster our findings, we employed the weighted median and MR Egger methods. In addition, we conducted a series of sensitivity analyses.
Results
Our study supports the existence of a causal relationship between psycho-emotional disorders and GERD. Mood swings, highly strung, and anxious feelings adversely affected GERD risk (mood swings: OR 2.21, 95% CI 1.19–5.59, p = 3.09 × 10–2; highly strung: OR 5.63, 95% CI 1.77–17.94, p = 3.42 × 10–3; anxious feelings: OR 2.48, 95% CI 1.08–4.33, p = 2.89 × 10–2).
Conclusion
This Mendelian randomization study provides robust support for the notion that mood swings, highly strung and anxious feelings, are associated with an increased risk of developing GERD.
... We hypothesised that more advantaged SES classes would have increased odds of non-drinking and decreased odds of harmful drinking, however, compared to "professional occupation, degree-level educated, homeowners", we found that all other lower SES classes were more likely to report non-drinking. These findings may be explained by the "sick-quitter" hypothesis which suggests that individuals no longer drink because they were a previous harmful drinker [55] or have a pre-existing condition [56], which in the context of this study was having a mental health problem. However, it was not possible to explore the reasons for non-drinking in this sample. ...
Purpose
Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment.
Methods
A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment.
Results
A four-class model of SES was best-fitting; “economically inactive,GCSE-level and lower educated,social renters”, “intermediate/routine occupation,GCSE-level educated,mixed owner/renters”, “retired, no formal education,homeowners”, and “professional occupation,degree-level educated,homeowners”. Compared to “professional occupation,degree-level educated, homeowners”, SES classes were more likely to be non-drinkers; odds were highest for “economically inactive,GCSE-level and lower educated,social renters” (OR = 4.96,95%CI 3.10–7.93). “Retired, no formal education,homeowners” were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20–0.59). Associations between “economically inactive,GCSE-level and lower educated,social renters” and “retired, no formal education,homeowners” and non- and harmful drinking via social support and neighbourhood environment were significant.
Conclusions
In contrast to the alcohol harms paradox, among individuals with a mental health problem, lower SES groups were more likely to be non-drinkers while no associations with harmful drinking were found. There is also a need to examine the alcohol harms paradox in the context of the area in which they live.
... HFE and TMPRSS6 are important proteins that directly participant in the signaling pathways of iron status regulation [7]. Next, we searched the selected SNPs in Phenoscanner database (http://www.phenoscanner.medschl.cam.ac.uk/) to identify whether they were associated with potential confounders including smoking [13], alcohol intake [14], body mass index [15] and outcome (i.e., anxiety disorders). SNPs highly associated with these phenotypes (p<5×10 −8 ) were excluded. ...
Objectives
Observational studies had investigated the association of iron metabolism with anxiety disorders. The conclusions were inconsistent and not available to reveal the causal or reverse-causal association due to the confounding. In this study we estimated the potential causal effect of iron homeostasis markers on anxiety disorders using two-sample Mendelian randomization (MR) analysis.
Methods
Summary data of single nucleotide polymorphisms (SNPs) associated with four iron-related biomarkers were extracted from a recent report about analysis of three genome-wide association study (GWAS), the sample size of which ranged from 131471 to 246139 individuals. The corresponding data for anxiety disorders were from Finngen database (20992 cases and 197800 controls). The analyses were mainly based on inverse variance weighted (IVW) method. In addition, the heterogeneity and pleiotropy of the results were assessed by Cochran’s Q test and MR-Egger regression.
Results
Basing on IVW method, genetically predicted serum iron level, ferritin and transferrin had negative effects on anxiety disorders. The odd ratios (OR) of anxiety disorders per 1 standard deviation (SD) unit increment in iron status biomarkers were 0.922 (95% confidence interval (CI) 0.862–0.986; p = 0.018) for serum iron level, 0.873 (95% CI 0.790–0.964; p = 0.008) for log-transformed ferritin and 0.917 (95% CI 0.867–0.969; p = 0.002) for transferrin saturation. But no statical significance was found in the association of 1 SD unit increased total iron-binding capacity (TIBC) with anxiety disorders (OR 1.080; 95% CI 0.988–1.180; p = 0.091). The analyses were supported by pleiotropy test which suggested no pleiotropic bias.
Conclusion
Our results indicated that genetically determined iron status biomarkers causally linked to the risk of anxiety disorders, providing valuable insights into the genetic research and clinical intervention of anxiety disorders.
... During adolescence, this means that abstaining from alcohol becomes increasingly outside social norms across this life stage as more and more young people initiate consumption. In earlier research, when drinking was more common and began at younger ages, abstainers had more mental health problems and social problems than drinkers during adolescence [59, 60,62,119,[197][198][199][200][201][202]. This implies that abstaining from alcohol also might be associated with risks. ...
Abstract
Background: Drinking among adolescents has declined in most high-income countries during the past two decades. In Sweden, the reduction in youth drinking has been more pronounced than in many other parts of the world. The lower alcohol consumption has been reflected in several indicators. However, many adolescents still drink, and there is an urgency to understand the current situation in light of the non-drinking trend. The studies in this thesis examine concurrent and longitudinal factors not previously examined in a Swedish context.
Overall aim: The overarching objective of this thesis is to improve our understanding of alcohol use during mid and late adolescence among contemporary youth. The four studies included in this thesis address this aim by answering the following research questions: (I) What are the motivations for drinking, and how are motives associated with drinking? (II) How are general and institutional trust associated with drinking? (III) How are psychosocial factors related to two-year drinking status? and (IV) Does the age of onset have an independent effect on subsequent drinking?
Data and method: All studies of this thesis exploited data from the Futura01 project. Since 2017, this project has followed a cohort of Swedish adolescents born in 2001. A self-reporting school survey was carried out at baseline (T1), and at a follow-up (T2) in 2019, when the respondents were 15/16 and 17/18 years, respectively. At T1, 5,537 individuals (81.7%) participated; at T2, 4,018 individuals (72.4%) participated. Multivariable linear and logistic regression models examined associations with alcohol use.
Results: (I) Social and enhancement motives were most strongly associated with drinking frequency, whereas enhancement motives had the strongest association with heavy drinking frequency. Coping-depression motives also had a positive but weaker link with drinking and heavy drinking frequency. Conformity motives were negatively related to how often adolescents drank.
(II) General and institutional trust was found to be negatively associated with drinking status, and institutional trust had the stronger link. Cross-combinations with low scores on both trust dimensions were related to the highest probability of drinking. Parental control and support, along with school satisfaction, modified the associations.
(III) Abstainers reported better mental health and parental relationships, and worse friendships, whereas the opposite was true for early-onset drinkers. Later-onset drinkers were linked to a more favorable psychosocial situation than early drinkers.
(IV) An early drinking onset predicted higher alcohol consumption two years later. Those with the earlier onset scored higher on AUDIT-C and had a higher probability of risky and binge drinking in late adolescence. Early binge drinking was found to be more predictive of later binge drinking than the age of onset of any drinking. Those with early drinking onset were more exposed to risk factors.
Conclusions: Adolescents’ motivations for drinking are closely related to their consumption of alcohol. The social aspects of drinking are supported by the links between different forms of trust and alcohol use, in addition to patterns of parent/friend relationships and drinking status in adolescents. Early drinkers are a psychosocially vulnerable group burdened with numerous problems and risk factors for alcohol use. An early drinking onset is also related to more alcohol use in late adolescence. To prevent youth drinking, it is important to improve parent-child relationships, build trust, and support mental health. Preventing early drinking likely reduces alcohol consumption in late adolescence.
... In a recent commentary [14], it was argued that the decline in adolescent drinking may have altered the psychosocial correlates of alcohol consumption. In older studies, when drinking was a normative behaviour, non-drinking was associated with social and mental health adversities [15][16][17][18][19][20][21][22][23][24]. Furthermore, those individuals not following the mainstream regarding the age of alcohol initiation have shown worse mental health [17]. ...
Introduction:
Non-drinkers have been shown in older studies to have poorer mental health and social life compared to their alcohol-using counterparts. Given the profound decline in adolescent drinking observed in most high-income countries, this pattern may have changed. This study explores drinking transitions and examines psychosocial factors among adolescents by longitudinal drinking status.
Methods:
Data were based on two waves of a prospective longitudinal nationwide study (n = 4018). The first wave (T1) of data was collected in 2017 (age 15/16) and the second wave (T2) was in 2019 (age 17/18). Respondents were asked about their past year drinking status, general health, psychosomatic problems, psychiatric medication, school enjoyment, emotional symptoms, peer relationship problems, prosocial ability, friendships satisfaction and satisfaction with relation to mother/father. Comparisons by mean values were assessed and multinomial logistic regressions were used to examine associations.
Results:
Abstainers and later drinkers differed significantly from early drinkers on 9/10 factors respectively at T1. Fewer psychosomatic problems, less psychiatric medication, higher school enjoyment, more emotional symptoms, higher parental relationship satisfaction, more peer problems and lower friendships satisfaction at T1 were associated with abstaining and/or later drinking. All factors were more strongly associated with abstaining. School enjoyment predicted abstaining but not later drinking.
Discussion and conclusions:
Longitudinal drinking status relates to small to moderate systematic psychosocial differences. Adolescents with better mental health, more content relationships with parents and lower friendships satisfaction are more often abstainers. Those generally worse off are more likely early drinkers but they also have better friendships.
... Non-drinking parents were categorised as abstainers and those who drank less than once a month as low consumers. We wanted to keep these types of drinking patterns separate since current non-drinking or low consumption may be a result of prior heavy consumption and/or indicative of characteristics that may influence offspring health, such as severe health problems among parents or small social networks [25,26]. Parents who drank daily, regardless of quantity, or 2-4 times a week and at least 3 glasses per occasion, were categorised as heavy drinkers. ...
Background
Alcohol abuse is not only harmful to the consumer but may also negatively impact individuals in the drinker’s social environment. Alcohol’s harm to others is vital to consider when calculating the true societal cost of alcohol use. Children of parents who have alcohol use disorder tend to have an elevated risk of negative outcomes regarding, e.g., health, education, and social relationships. Research on the general youth population has established a link between parental drinking and offspring alcohol use. However, there is a lack of knowledge regarding other outcomes, such as health. The current study aimed to investigate the associations between parental drinking and children’s psychological and somatic complaints, and perceived stress.
Methods
Data were derived from a nationally representative sample, obtained from the 2010 Swedish Level-of-Living survey (LNU). Parents and adolescents (ages 10–18) living in the same households were interviewed independently. The final study sample included 909 adolescents from 629 households. The three outcomes, psychological and somatic complaints and perceived stress, were derived from adolescents’ self-reports. Parents’ self-reports of alcohol use, both frequency and quantity, were used to categorise adolescents as having abstaining, low-consuming, moderate-drinking, or heavy-drinking parents. Control variables included adolescents’ gender, age, family structure, and household socioeconomic status. Linear and binary logistic regression analyses were performed.
Results
Parental heavy drinking was more common among adolescents living in more socioeconomically advantaged households and among adolescents living with two custodial parents or in reconstituted families. Adolescents with heavy-drinking parents reported higher levels of psychological and somatic complaints and had an increased likelihood of reporting stress, compared with those having moderate-drinking parents. These associations remained statistically significant when adjusting for all control variables.
Conclusion
The current study’s results show that parental alcohol consumption is associated with poorer offspring adolescent health. Public health policies that aim to reduce parental drinking or provide support to these adolescents may be beneficial. Further studies investigating the health-related outcomes among young people living with heavy-drinking parents in the general population are needed to gain more knowledge about these individuals and to implement adequate public health measures.
... Similarly, low self-esteem increases the likelihood of an individual turning to alcohol to manage their negative feelings (Zhai et al., 2015). Excessive use of alcohol is strongly associated with depression and a higher risk of somatic conditions (Skogen et al., 2009). Moreover, students with low self-esteem turn to alcohol to manage their negative perception of themselves and adopt alcohol consumption to build a new social network with their peers (Masselink et al., 2018). ...
Depression is one of the leading mental health disorders that occurs frequently among university students. Self-esteem and lifestyle factors are modifiable factors that have the potential of preventing depression. The study aimed to explore the relationship for depression, self-esteem, and lifestyle factors among university students in Singapore and Malaysia, and whether individual lifestyle factors mediate the relationship. Participants completed an online questionnaire that consisted of socio-demographic, Beck Depression Inventory-ll. Rosenberg Self-Esteem Scale, and Simple Lifestyle Indicator Questionnaire. Data analyses showed that low self-esteem, diet, high smoking, and stress predicted an increase in the level of depression. Stress was a significant mediator for self-esteem and depression. Findings suggested that those with low self-esteem perceived stress as unmanageable, thereby increasing the level of depression scores.
... Reports regarding a protective effect of moderate alcohol drinking against depression have produced inconsistent results (Bell & Britton, 2015;Bellos et al., 2016;García-Esquinas et al., 2018;Gea et al., 2012;Skogen, Harvey, Henderson, Stordal & Mykletun, 2009). We found moderate drinking to be more likely in those with lower energy levels. ...
Objectives
: To explore how individual depressive symptoms might contribute to different patterns of alcohol consumption in Colombian older adults living in the community.
Methods
: A Secondary analysis from a nationally representative cross-sectional study of more than 23,000 older adults, with data from 19,004 participants. Drinking frequency, and level (moderate or heavy drinking) were used to assess alcohol use and depressive symptoms explored with the 15 items-GDS., using bivariate and multivariate adjusted regression models.
Results
: Lower weekly drinking frequency and a higher number of drinks per serving were associated with total GDS score. For individual symptoms, higher drinking frequency was associated with dropping activities and a preference to stay at home. Lower drinking frequency was associated with low mood, unhappiness, feelings of emptiness, worthlessness, hopelessness, and a lack of vigour. Lower number of drinks per serving was associated with withdrawal/apathy related symptoms; these also related to higher frequency of weekly alcohol consumption.
Higher number of drinks per serving was associated with feelings of emptiness, worthlessness, boredom, helplessness, worthlessness. not wanting to be alive, thinking that that other people are better off in their mood, being afraid that something bad will happen and subjective memory problems. Moderate drinkers had a higher likelihood of reporting lack of vigour.
Conclusion
: There were diverse patterns of alcohol use according to individual depressive symptoms. This has implications for interventions to reduce alcohol related harm in older people across a range of depressive symptoms with different patterns of alcohol use.
... Most ''problem behaviours,'' i.e., smoking, drinking, and antisocial behaviour, start in adolescence. Decades of research have demonstrated that a certain amount of experimentation with such behaviours is more or less normal during adolescence (e.g., Pape & Hammer, 1996;Skogen et al., 2009) and not necessarily related to negative consequences. However, a relatively small percentage of young people who engage in such behaviours develop more severe problems in adulthood, such as mental health disorders (Jessor, 2016). ...
Adolescent gambling is becoming a public health problem. While comorbidities with other externalizing behaviours have been ascertained, few studies focus on adolescents with a multi-problem behaviour pattern, i.e., alcohol and tobacco use, in addition to antisocial behaviour, which includes problem gambling. The purpose of this study was to identify adolescents with multi-problem behaviours, i.e., alcohol abuse, daily smoking, antisocial behaviour, and problem gambling and to investigate the differences in relation to gender. Unlike most studies on this topic, we adopted a person-oriented approach to identify groups of adolescent boys and girls who reported multi-problem risk behaviours, i.e., alcohol abuse, daily smoking, antisocial behaviour, and problem gambling. Moreover , we explored to what extent these adolescents exhibited mental health problems, i.e., depressive, psychosomatic, and ADHD symptoms, as well as sleep problems. The sample consisted of 1,526 adolescents from two age cohorts, 15-to 16-year-olds (n = 711, 47%) and 17-to 18-year-olds (n = 815, 53%). Latent Variable Mixture Modeling (LVMM) revealed one group with low rates of all risk behaviours and three groups with multi-problem behaviours. Among the latter three groups, two reported problem gambling and had higher levels of mental health problems. These results suggest that gambling can be added to the constellation of risk behaviours in adolescence and might be more associated with mental health problems than other externalizing behaviours.
... Consistent with prior evidence (e.g., Alati et al., 2005;Caldwell et al., 2002;Skogen et al., 2009), alcohol use had a nonlinear association with depression symptom severity at the time when the sample was not exposed to psychological treatment. As illustrated in Figure 1, abstainers and harmful drinkers tended to have higher depression severity compared to moderate drinkers. ...
Objectives
To investigate associations between alcohol use, psychological treatment attendance, and clinical outcomes.
Methods
We analysed electronic health records for N = 7,986 patients accessing psychological treatment for common mental disorders. Data were collected for pre‐treatment alcohol use (average units per week) and severity of dependence (SDS), number of therapy contacts attended, pre‐ and post‐treatment anxiety (GAD‐7), and depression (PHQ‐9) symptom severity. Hierarchical regression was used to examine associations between alcohol use/dependence and post‐treatment symptom severity controlling for intake severity and relevant confounders.
Results
After controlling for confounders, alcohol use had significant nonlinear associations with pre‐treatment depression severity (R² = .54, p < .01, cubic trend), and post‐treatment anxiety (R² = .23, p < .01, quadratic trend). Alcohol use was not significantly associated with intake anxiety, post‐treatment depression or treatment duration. SDS was not significantly associated with depression severity, alcohol severity, or total contacts after controlling for confounders.
Conclusion
Alcohol users are just as likely to engage in and benefit from evidence‐based psychological treatments for depression in primary care. A nonlinear association between alcohol use and anxiety treatment outcomes indicates that light‐to‐moderate drinkers have some shared characteristic that favours treatment response.
Practitioner points
Depression and anxiety problems often co‐occur with alcohol use and dependence.
Conventional wisdom in the field suggests that heavy alcohol users may not engage well or benefit from psychological therapies for depression and anxiety.
We found no empirical support for the above assumptions in a large clinical sample.
Alcohol consumption was not significantly associated with treatment attendance or depression treatment outcomes.
A nonlinear association between alcohol use and anxiety outcomes suggests that moderate drinkers may have some shared characteristic that favours treatment response.
... This might be partially explained by the fact that non-drinkers are more likely to be older and in turn suffer from chronic conditions or take medication that require them to abstain from alcohol. 37 Furthermore, non-drinkers are more likely to have a smaller social network 37 , which may in turn increase their depression risk. ...
Background: More recent birth cohorts are at a higher depression risk than cohorts born in the early twentieth century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity and obesity, contribute to these birth cohort variations.
Methods: We analyzed panel data from US adults born 1916-1966 enrolled in the Health and Retirement Study (N=163,760 person-years). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. This allowed us to compare the predicted probability of elevated depressive symptoms (CES-D 8 score ≥3) in the natural course to a counterfactual scenario where all birth cohorts had the health behavior of the 1945 birth cohort. We stratified analyses by sex and race/ethnicity.
Results: Depression risk of the 1916-1949 and 1950-1966 birth cohort would be on average 2% (-2.3 to -1.7) and 0.5% (-0.9 to -0.1) higher had they had the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1% (1.8 to 2.4) higher for the 1916-1940 cohorts and 1.8% (-2.2 to -1.5) lower for the 1950-1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race/ethnicity groups, and the contribution of BMI more pronounced for women than for men.
Conclusion: Increased obesity levels exacerbated depression risk in recent birth cohorts in the US, while drinking patterns only played a minor role.
... Keywords: alcohol consumption, harm to others, manifestations of adverse effects, conjugation index Численними дослідженнями доведено, що алкоголь несприятливо впливає на стан здоров'я та соціального благополуччя питущих 1 * осіб [1][2][3][4][5]. Також встановлено, що від вживання алкоголю страждають не тільки самі його споживачі, а й інші люди [6][7][8]. ...
The purpose of the work is to study individual manifestations of adverse effects of drinking people on adults in their microsocial environment. In four regions of Ukraine (Kharkiv, Luhansk and Zaporizhzhia regions, as well as the city of Kyiv), during 2018—2020, 1742 people were examined, who belonged to three qualitatively different comparison groups: patients with alcohol dependence (393 people); healthy relatives of alcohol-dependent patients (274 people) and representatives of the general population (1075 people). Of these surveyed, respondents were identified who had drinkers in the environment: 481 people among healthy people and 69 people among patients with alcohol dependence. Further research focused on this particular contingent. The main research tool was the questionnaire of the international research consortium GENAHTO (Gender, Alcohol, and Harms to Others). The obtained data were processed by methods of mathematical statistics (variance and correlation analysis) on a computer using Excel 2016 computational tables (with the Data Analysis package). The dependences of the frequency of manifestations of the adverse effects of drinkers on adults in their microsocial environment on the age, gender and attitude to alcohol of the respondents were described, and it was found that the most vulnerable contingent in terms of the adverse effects of drinkers are elderly (> 59 years old) women. The conjugation between the mentioned manifestations was analyzed and the corresponding quantitative measure is proposed — the conjugation index (CI). It has been shown that CI can play the role of a marker of the severity of the situation around respondent, which is in microsocial environment of the drinking person.
... It is suggested by the literature that the likelihood of developing major depression increases in proportion to the higher amount of alcohol that a person consumes [23]. The findings from a previous study of a large sample population of 38,390 people in Norway indicated that there is a higher risk of anxiety and depression for both those who abstain from alcohol as well as for people who are excessive drinkers [24]. ...
Depression is becoming a major mental health problem globally. Thailand is known as the accepting society for transgender but the available study on transgender women dealing with depression is scarce. This study aims to describe the prevalence of depression among Thai transgender women in Bangkok and to explore the associated factors. A cross-sectional study was conducted among 108 Thai transgender women in Bangkok, Thailand from January 2019 to April 2019. Data were collected through self-administered. Depression was assessed by using The Center for Epidemiological Studies-Depression Scale (CES-D). Multivariate regression analysis was conducted to explore the associated factors of depression. The prevalence of depression among transgender women in this study was 54.6%. Factors associated with depression in the crude analysis were: sex reassignment surgery (OR=2.45, 95%CI=0.96-6.24), illness history (OR=1.79, 95%CI=0.72-4.50). In multivariate logistic regression analysis, depression was significantly associated with drinking alcohol >1 time/month in the past 12months (adjusted OR=0.33, 95%CI=0.12-0.91). Transgender tend to experience higher rates of mental health issues than the general population. This study suggested that alcohol drinking was only significantly
associated with depression in Thai transgender women. For further study, we need to find other associations with depression
in transgender community
... Alcohol consumption proved to be one factor favoring earlier RTW. Studies have described a J-or U-curve effect, in which nondrinkers were at greater risk of mental disorders 18,19 and related absenteeism 20 than those who drank little. A review by Gragnano et al 6 found little evidence of this habit's affecting RTW. ...
Objective:
This study aims to analyse factors that influence return to work (RTW) among workers on sickness absence due to mental disorders.
Methods:
A longitudinal study conducted between 2014-2017 in São Paulo, Brazil. The 385 participants answered a questionnaire including sociodemographics, habits/lifestyle, job characteristics and clinical information. Survival analysis were performed to identify factors influencing the RTW.
Results:
Most of participants were females (74.5%), worked in jobs dealing with public (44.2%) and were depressed (52.4%). RTW occurred for 68.3% participants over 1-year follow-up. Mean duration of absence was 163.83 days. The risk profile for remaining absent was heavy smokers, be abstainer, obese, deal with the public, perceived great effort at work and low self-efficacy.
Conclusions:
These findings can contribute in discussion about disability prevention and interventions to assure mental health care for workers.
... Massin & Kopp (2011) found "a hump-shaped relationship" between life satisfaction and alcohol use and even a positive relationship between life satisfaction and alcohol consumption. Even though according to Diulio et al. (2014), low life satisfaction can be related to alcohol abuse in college students, there is actually no direct evidence of a relationship between life satisfaction and alcohol consumption (Murphy et al., 2005), but only different nonlinear relationships (Alati et al., 2005;Skogen, Harvey, Henderson, Stordal, & Mykletun, 2009). ...
... Alcohol is well known to reduce psychological stress (Cooper et al., 1988;Kuntsche et al., 2005). Numerous studies indicate that moderate alcohol consumption is associated with stress-reducing lifestyle, more close friendships, and more family support than total abstinence (Peele and Brodsky, 2000;Rodgers et al., 2000;Skogen et al., 2009). The pharmacological base for this effect is well-known. ...
Background
Alcohol can be instrumentalized to achieve goals that without the drug would either not be achievable or would be so only with considerably more workload. While an understanding of the neurobiological mechanisms of alcohol instrumentalization is emerging, little information is available concerning instrumentalization goals in controlled consumers and how these goals change during the development of an alcohol use disorder (AUD).
Methods
We surveyed instrumentalization goals in 103 male and 78 female inpatients with AUD (before / after onset of the disorder) and compared them with the goals of 124 male and 96 female age‐matched non‐addicted controls. We also investigated whether instrumentalization goals predict 24‐month alcohol‐related hospital readmissions in the patients using a false discovery rate (FDR) approach.
Results
Separately for both sexes, the most frequently (>25%) self‐reported alcohol instrumentalization goals in patients were “stress coping,” “craving for alcohol,” and “reduction of anxiety and / or depressive mood” and in controls “facilitation of social interaction.” Relative to controls, and in a sex‐dependent manner, patients with AUD reported the goals “facilitation of social interaction” and “search for a partner” significantly less frequently and “reduction of anxiety and / or depressive mood,” “stress coping,” “improvement of sexual activity,” “improvement of concentration,” “euphoria,” and “craving for alcohol” more frequently. During the transition to addiction, many of the instrumentalization goals changed significantly, some in a sex‐dependent manner. In female AUD patients, a goal of “euphoria” nominally predicted a lower risk of alcohol‐related readmission, although not significantly when FDR corrected.
Conclusions
We identified cross‐sectional and intra‐individual differences in instrumentalization goals that support the assumption that the onset of an AUD coincides with a shift in instrumentalization goals from prosocial instrumentalization toward the self‐management of aversive mental states.
... On one hand, indeed, consuming alcohol is seen as a pleasure activity. People usually drink in moderation without harmful effects (Plant & Plant, 2006;Staddon, 2015), enjoying positive psychophysical and social benefits (Peele & Brodsky, 2000), so thatparadoxicallyin societies in which drinking alcohol is the norm, being abstainers is associated with depression and anxiety (Skogen et al., 2009). Furthermore, especially among adolescents, alcohol represents a 'social lubricant' with positive connotations that characterize people as sociable, sexy, 'cool', and mature (Martinic & Measham, 2008;Plant & Plant, 2006). ...
Balanced levels of Psychological Well-Being (PWB) can represent protective factors for human functioning. PWB has not been investigated among young adolescents who practice binge drinking (BD), a popular pattern of alcohol intake, defined as the consumption of five or more alcoholic units in one session. The negative impact of BD on psychophysical health has been extensively studied, but there is scarcity of studies investigating the influence of psychological variables on BD in early adolescence. The main aim of this study was to fill the gap in the literature, focusing on PWB as a new possible target of preventive interventions. One thousand six hundred and eighty-seven Italian adolescents completed questionnaires assessing BD, cannabis use, lifestyle, allostatic overload, subclinical psychological distress, problem-solving, and PWB. Binge drinkers represented 9% of the sample. Among them, 71%, 26%, and 3% binge drank monthly, weekly, and daily, respectively. Stress (higher frequency of stressful life events), psychological distress (higher hostility), and PWB dimensions (higher scores on positive relations and lower on purpose in life) were associated with BD. These new findings on unbalanced levels of PWB could represent the potential target of longitudinal studies aimed to implement specific preventive interventions among young adolescents. Implications for research and prevention are discussed.
... Some studies have indicated no direct relationship with light, moderate and heavy drinkers [42] who have associated with depression and anxiety. Some studies found that alcohol abstainers may develop higher levels of anxiety and depression compared to those who are not alcohol abstainers [43]. However, it is difficult to elucidate these results to sustain the beneficial impacts of moderate alcohol consumption. ...
Purpose:
Risk behaviors are significantly impacting physical and psychological health among adolescents, resulting in a tremendous public health issue. The aim of this study is to examine the association of clustered risk behaviors with mental health and physical activity, and identify to what extent the clustering of various risk behaviors is associated with psychological health and physical activity in Chinese adolescents.
Methods:
Students aged 16-18 years, male 16.2 ± 1.03, female 16.3 ± 1.56, were recruited from 30 high schools to complete an online questionnaire in fall semester 2017. A structured questionnaire, 2017 state and local youth risk behavior survey was revised, modified, and translated into Chinese. Five questions were designed to assess physical activity times of the last 7 days. Symptom checklist 90 (SCL-90) was used to investigate the mental health status of the participants. Statistical analyses were done employing chi-square tests, two step cluster analysis, logistic regression.
Result:
Results illustrate that girls report a significantly higher mean of being bullied in school, electronically bullied, feeling sad or hopeless, and trying cigarette smoking. Two-step cluster analysis and regression analysis find that alcohol use, smoking and sedentary behavior have significant effect on adolescent health. Logic regression demonstrated that risk behaviors have significantly associated with mental health and physical activity in specific cluster.
Conclusion:
This study finds that a specific behavior cluster has significant impact on mental health and physical activity among adolescents. Integrating risk behaviors cluster with factors can be employed to target high-risk adolescents who have poor physical and psychosocial health. The research suggest that more effective and feasible school intervention programs can be designed to promote adolescent health-related behavior in terms of those pathways.
... 28 Therefore, rate ratios and ORs were calculated to a reference level of the alcohol use measures, which was chosen according to the lowest predicted depressive symptom severity or odds of major depression, respectively. 4 Within the multiple-adjusted models, the two-way interaction with gender and age was tested for each alcohol use measure. 29 Significant interactions (p value of <0.05 according to the likelihood ratio test) were then graphically displayed as mean predicted depressive symptom severity and probability of major depression by gender and age percentiles. ...
Objective
To predict depressive symptom severity and presence of major depression along the full alcohol use continuum.
Design
Cross-sectional study.
Setting
Ambulatory practices and general hospitals from three sites in Germany.
Participants
Consecutive patients aged 18–64 years were proactively approached for an anonymous health screening (participation rate=87%, N=12 828). Four continuous alcohol use measures were derived from an expanded Alcohol Use Disorder Identification Test (AUDIT): alcohol consumption in grams per day and occasion, excessive consumption in days per months and the AUDIT sum score. Depressive symptoms were assessed for the worst 2-week period in the last 12 months using the Patient Health Questionnaire (PHQ-8). Negative binomial and logistic regression analyses were used to predict depressive symptom severity (PHQ-8 sum score) and presence of major depression (PHQ-8 sum score≥10) by the alcohol use measures.
Results
Analyses revealed that depressive symptom severity and presence of major depression were significantly predicted by all alcohol use measures after controlling for sociodemographics and health behaviours (p<0.05). The relationships were curvilinear: lowest depressive symptom severity and odds of major depression were found for alcohol consumptions of 1.1 g/day, 10.5 g/occasion, 1 excessive consumption day/month, and those with an AUDIT score of 2. Higher depressive symptom severity and odds of major depression were found for both abstinence from and higher levels of alcohol consumption. Interaction analyses revealed steeper risk increases in women and younger individuals for most alcohol use measures.
Conclusion
Findings indicate that alcohol use and depression in medical care patients are associated in a curvilinear manner and that moderation by gender and age is present.
... Another finding worth our attention is how the direction of the association between internalising domain and alcohol use behaviours flipped across the subtypes of alcohol outcomes, especially for INT. One possible explanation for this might be the U or J shaped association reported in cross-sectional studies [98][99][100]. Studies that reported negative association between INT and alcohol consumption were either large sample-size studies or measured alcohol consumption in mid-adulthood [21,66,68]. ...
This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.
Objective
The aim of this research was to examine the association between alcohol consumption and depressive symptoms in the Wa ethnic minority of China, a population where this relationship has been insufficiently explored.
Methods
A cross-sectional analysis was conducted on a sample of 317 current drinkers from the Wa ethnic minority, a “direct fast-forward” group in Cangyuan County, between December 1, 2022, and February 28, 2023. Utilizing a multi-stage cluster sampling approach, participants were selected, each of whom exhibited an Alcohol Use Disorder Identification Test (AUDIT) score exceeding 0. Data were collected via face-to-face interviews employing a uniform questionnaire. Quantification of alcohol use was achieved through the application of the AUDIT, while the Patient Health Questionnaire (PHQ)-9 was employed to gauge depressive symptoms. The relationship between the severity of alcohol consumption and depressive symptoms was evaluated using a multivariable logistic regression model. Subsequently, potential non-linear associations were scrutinized through the application of a smoothing plot.
Results
The study included 317 current drinkers (196 males [61.83%]; mean age 41.78 ± 12.91 years), of which 94 (29.65%) exhibited comorbid depressive symptoms. Multivariable logistic regression analysis, adjusting for confounders, revealed that higher AUDIT scores were significantly associated with an increased probability of depressive symptoms (OR = 1.09, 95% CI: 1.02–1.18, p = 0.008). The risk of depressive symptoms was notably greater in the group with alcohol dependent range in contrast the group at low-risk range (OR = 7.01, 95% CI: 1.66–29.62, p = 0.008). The smoothing plot indicated a J-shaped non-linear relationship with an inflection point at an AUDIT score of 15. To the left of this inflection point, no significant relationship was observed, whereas to the right, a positive correlation emerged (OR = 1.39, 95% CI: 1.11–1.74, p < 0.001).
Conclusion
The findings reveal a non-linear relationship between alcohol consumption and the probability of depressive symptoms within the Wa ethnic minority in China, with implications for the development of nuanced and effective treatment strategies tailored to this population.
Background
Alcohol use and depression often co-occur; however, little is known about this association with specific ethnic groups. This study aimed to explore the relationship between alcohol use and depression in the Wa ethnic group in China.
Methods
A stage sampling method was utilized to survey respondents from the Wa ethnic group, who have transitioned rapidly from traditional slash-and-burn cultivation to modern societies. The Alcohol Use Disorder Identification Test (AUDIT) and the Patient Health Questionnaire-9 (PHQ-9) to assess their alcohol use and depressive symptoms, respectively. Data were analyzed using generalized additive models and a two-segment logistic regression.
Results
Among the 668 participants, 48.98% (337/668) were current drinkers. Low-risk, high-risk, and probable alcohol-dependence drinkers accounted for 21.4%, 25.4%, and 2.7% of the sample, respectively. Generalized additive models revealed a non-linear association between AUDIT scores and depressive symptoms, with a statistically significant non-linearity (P < 0.001). A-segment logistic regression identified a critical point at an AUDIT of 15. this threshold, each increase in AUDIT score led to a notable 43% increase in the likelihood of experiencing depressive symptoms (OR = 143, 95 CI: 119,1.72, < 0.). while, on the lower end of the threshold, there was no significant association between the AUDIT score and depressive symptoms observed (OR 0.98 95% CI 0.90, 1.05, P = 0.53).
Conclusion
A non-linear relationship between alcohol use and depression was identified in the Wa ethnic group, suggesting a threshold effect. Screening for alcohol use could help identify individuals at risk of depression in ethnic populations.
“Sick quitting”, a phenomenon describing reductions in alcohol consumption following poor health, may explain observations that alcohol appears protective for frailty risk. We examined associations between frailty and reductions in drinking frequency among people with HIV (PWH). At six Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between January 2012 and August 2021, we assessed whether frailty, measured via validated modified frailty phenotype, precedes reductions in drinking frequency. We associated time-updated frailty with quitting and reducing frequency of any drinking and heavy episodic drinking (HED), adjusted for demographic and clinical characteristics in Cox models. Among 5,654 PWH reporting drinking, 60% reported >monthly drinking and 18% reported ≥monthly HED. Over an average of 5.4 years, frail PWH had greater probabilities of quitting (HR:1.56, 95%CI:1.13–2.15) and reducing (HR:1.35, 95%CI:1.13–1.62) drinking frequency, as well as reducing HED frequency (HR:1.58, 95%CI:1.20–2.09) vs. robust PWH. Sick quitting likely confounds the association between alcohol use and frailty risk, requiring investigation for control.
Sick quitting,” a phenomenon describing reductions in alcohol consumption following poor health, may explain observations that alcohol appears protective for frailty risk. We examined associations between frailty and reductions in drinking frequency among people with HIV (PWH). At six Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between January 2012 and August 2021, we assessed whether frailty, measured through validated modified frailty phenotype, precedes reductions in drinking frequency. We associated time-updated frailty with quitting and reducing frequency of any drinking and heavy episodic drinking (HED), adjusted for demographic and clinical characteristics in Cox models. Among 5,654 PWH reporting drinking, 60% reported >monthly drinking and 18% reported ≥monthly HED. Over an average of 5.4 years, frail PWH had greater probabilities of quitting (HR: 1.56, 95% confidence interval [95% CI] [1.13–2.15]) and reducing (HR: 1.35, 95% CI [1.13–1.62]) drinking frequency, as well as reducing HED frequency (HR: 1.58, 95% CI [1.20–2.09]) versus robust PWH. Sick quitting likely confounds the association between alcohol use and frailty risk, requiring investigation for control.
Aims
To test the Triangle of Human Ecology by examining associations between unipolar depression and different measures of human biological factors, health behaviour, and the physical environment.
Methods
Data originate from the third wave of the Nord-Trøndelag Health Study (2006–2008). The survey was based on a random sample of 50,000 Norwegians (response rate: 54%). Logistic regression was performed, using unipolar depression, measured with the Hospital Anxiety and Depression Scale score, as outcome variable and 38 explanatory variables.
Results
Biological factors including older age and male gender were associated with higher odds of depression, as were behavioural factors including drinking behaviour and having a neurotic personality. Reduced odds were associated with units of alcohol consumed, extrovert personality and physical activity. Social networks were an environmental factor with reduced odds at both personal and neighbourhood levels, as was warmer outdoor temperatures.
Conclusions
Using the Triangle of Human Ecology provides a holistic insight into how behaviour, biology and the environment influence mental health.
Background
Observational studies have shown an association between gastroesophageal reflux disease (GERD) and anxiety disorders/depression. However, these evidences may be influenced by confounding factors. Therefore, our study aimed to determine the causal relationship between GERD and anxiety disorders/depression by conducting a bidirectional Mendelian randomization (MR) study.
Methods
We performed a bidirectional MR analysis using summary statistics from genome-wide association studies (GWAS) in European individuals. The inverse-variance weighted (IVW) method was used as the primary analytical method to assess causality. In addition, five additional MR methods [maximum likelihood, MR-Egger, weighted median, robust adjusted profile score (MR-RAPS), and mode-based estimate (MR-MBE)] were performed to supplement the IVW results. Furthermore, several sensitivity analyses were performed to assess heterogeneity, horizontal pleiotropy, and stability. Finally, a multivariable MR (MVMR) analysis was performed to determine the causal relationship by adjusting for potential confounders.
Results
MR results of the IVW method indicated that GERD significantly increases the risk of anxiety disorders [odds ratio (OR) = 1.35, 95% confidence interval (CI) 1.15–1.59, P = 2.25 × 10–4] and depression (OR = 1.32, 95% CI: 1.15–1.52, P = 1.26 × 10–4). In addition, the MR results of maximum likelihood, MR-Egger, weighted median, MR-RAPS, and MR-MBE remained parallel to the IVW results. Furthermore, sensitivity analysis suggested that the results were robust, with no pleiotropy or heterogeneity detected. Nevertheless, reverse MR analysis showed that anxiety or depression did not increase GERD risk. Finally, MVMR analysis showed that the effect of GERD on increasing the risk of anxiety disorders/depression was independent of confounders.
Conclusion
This MR study supports a causal association between GERD and an increased risk of anxiety disorders and depression. Therefore, complementing symptomatic treatment of GERD with psychological assessment and necessary psychological support therapy may help reduce the risk of future anxiety disorders and depression.
The purpose of the work is to study individual manifestations of adverse effects of drinking people on children in their microsocial environment. In four regions of Ukraine (Kharkiv, Luhansk and Zaporizhzhia regions, as well as the city of Kyiv), during 2018—2020, 1742 people were examined, who belonged to three qualitatively different comparison groups: patients with alcohol dependence (AD) (393 people); healthy relatives of alcohol-dependent patients (274 people) and representatives of the general population (1075 people). Of these surveyed, respondents were identified who had children in the environment: 288 persons among healthy people and 121 persons among patients with AD). Further research focused on this particular contingent. The main research tool was the questionnaire of the international research consortium GENAHTO (Gender, Alcohol, and Harms to Others). The obtained data were processed by methods of mathematical statistics (variance and correlation analysis) on a computer using Excel 2016 spreadsheet program (with the Data Analysis package). The influence of the presence of drinkers in the environment of children on the frequency of manifestations of their distress is described. It has been confirmed that the most common reason for the disadvantage of children is their own drinking parents, as well as other (except for parents and siblings) drinking relatives. It was found that in healthy respondent’s unfavorable behavioral features of relatives and friends of drinkers always directly correlate with indicators of the disadvantage of children in their environment, while in respondents’ dependent on alcohol these correlations have a complex, mosaic nature, which requires further research to establish the causes of this phenomenon. and its use in practical work.
Background
The association of depressive symptoms with moderate and heavy drinking in adolescents have been reported in many studies, but that with light drinking is unclear.
Methods
In a 2012-13 school-based survey, 20951 secondary school students (aged 11-20 years, 51.3% boys) from 44 schools in Hong Kong reported their sociodemographic information, depressive symptoms, drinking patterns and other lifestyle factors. The associations of depressive symptoms with drinking status, drinking frequency and quantity, and the usual type of alcohol beverage consumed were examined using robust Poisson regression accounting for school clustering and covariates.
Results
The prevalence of current drinking and depressive symptoms was 13.6% and 19.0%, respectively. Depressive symptoms were associated with former drinking (adjusted prevalence ratio 1.48, 95% confidence interval 1.30-1.68) and measures of light drinking: experimental drinking (1.29, 1.19-1.39), less-than-monthly drinking (1.40, 1.18-1.67) and consuming half a drink or less (1.33, 1.12-1.58), and such associations were stronger in younger adolescents. Associations were also observed for light drinking patterns of 1-2 drinks less than monthly (1.72, 1.40-2.11) and half a drink monthly (1.51, 1.21-1.88). Consuming fruit wine (1.51, 1.27-1.79) and beer (1.63, 1.42-1.88) with relatively low alcohol contents was also associated with depressive symptoms.
Conclusions
Our study provided first evidence that even light drinking in terms of the amount, frequency and type of alcohol beverages or light drinking patterns such as consuming 1-2 drinks less than monthly and half a drink monthly were associated with depressive symptoms in adolescents. Our results support total alcohol abstinence in adolescents.
The purpose of the work is to determine in the Ukrainian society the scale of harm inflicted by drinkers to other persons, as well as the gender and age characteristics of this harm. In four regions of Ukraine (Kharkiv, Lugansk and Zaporizhzhia regions, Kyiv), during 2018-2020, 1,742 people were examined from three qualitatively different comparison groups: patients with alcohol dependence (393 people); their healthy relatives (274 people) and representatives of the general population (1075 people). The main research tool was the questionnaire of the international research consortium GENAHTO (Gender, Alcohol, and Harms to Others). It was shown that, in general, drinkers are present in the microsocial environment of 27.62 % of the surveyed healthy respondents. Extrapolation of this indicator to the entire population of Ukraine suggests that the total number of people who suffer in one way or another due to the drinkers in their environment is about 11.6 million people. In addition, the drinkers frequency in the environment of respondents can be used to determine the real number of people with alcohol problems in our country. Preliminary calculations indicate that this number is from 1.5 to 2.2 million people. The drinkers frequency in the environment of the respondents significantly depends on the age of the latter. The highest values of this indicator are characteristic of the respondents in the age category 40—59 years old” (31.43 % for men and 41.27 % for women). The subjective perception of harm from drinkers in the environment grows steadily with increasing age of the respondents, while this growth is most pronounced in women.
Objectives:
To validate the Hospital Anxiety and Depression Scale (HADS) and the 10-item Perceived Stress Scale (PSS-10) for use in clinical studies of recurrent aphthous stomatitis (RAS) and to provide cross-sectional assessment of anxiety, depressive, distress symptoms and perceived stress in patients with RAS.
Methods:
Validity and reliability of the HADS and PSS-10 were evaluated in 120 individuals with RAS through confirmatory factor analysis and calculation of Cronbach's alpha and omega coefficients. The prevalence of comorbid anxiety, depression, distress and moderate-to-high perceived stress, as well as their association with demographics and clinical factors, was assessed through cut-off scores of the HADS and PSS-10 and bivariate analyses respectively.
Results:
A bi-factor model, with all items loading onto general factor with two group factors, provides the best fit to the HADS and PSS-10 data of this RAS cohort. While omega values suggested adequate reliability of total score of both scales, relatively low ranges of coefficient omega hierarchical limit utility of their subscale scores. The prevalence of anxiety, depressive, distress symptoms and moderate-to-high perceived stress was 42.5%, 18.33%, 28.33% and 71.67% respectively. Ethnicity, alcohol consumption, disease comorbidities, clinical type of RAS, ulcer size, pain and RAS disease activity were found to be associated with negative psychological symptoms.
Conclusion:
The HADS and PSS-10 are valid and reliable as general scales of psychological distress and stress in patients with RAS. Significant mental burden among RAS patients makes the use of these validated instruments a sensible and prudent practice for psychological assessment of this patient group.
The second Nord-Trøndelag Health Study in 1995-97 (HUNT 2) was partly a follow-up study of HUNT 1, conducted in 1984-86. HUNT 2 comprised, however, a larger scientific program. The large amount of information collected from each participant, and the large number of participants in a wide age range covering an entire county population, make HUNT one of the largest health studies ever performed. This paper describes the survey covering persons aged 20 years and older. In total, 66.7% of men (n=30,860) and 75.5% of women (n=35,280) participated, the highest participation was in age group 60-69 and the lowest among the young and the elderly. Data collected from several questionnaires and with blood and urine samples and various clinical measurements, some of them in sub-samples of the study population, comprise a huge database for research. All data for each person are linked, and data are also linked to various health registries; all data handling being supervised by The Data Inspectorate and The Regional Ethical Committee. Procedures for data access are established, and more than 100 researchers are currently working on HUNT data. A large number of scientific papers in various disciplines are published, among them 15 doctoral theses (June 2003). The research potential of the HUNT biobank is still not fully exploi- ted, but initiatives are taken. In line with other population based studies both in Norway and abroad, there was a decline in participation rate from HUNT 1 to HUNT 2 (16.9%). This has raised concern about the validity of future population based health studies. However, the good local and national network and the support from the population, make up a good platform also for future health studies in Nord-Trøndelag.
We have explored how age at first intoxication with alcohol relates to mental health, social integration and adjustment to the adult role. The data stem from a longitudinal representative study of 2000 Norwegians. The sample was assessed at ages 19–22, 21–24 and 25–28. Among females, only early intoxication was related to young adult symptoms of poor mental health. A U-shaped association between intoxication debut and psychological problems was revealed among males, implying that both early and late beginners had more such problems than those who had followed the mainstream. These associations persisted without change over time. However, males who remained abstainers in adulthood were psychologically healthy, but they showed indications of a delayed entry into the adult role. Male late beginners were also somewhat reluctant to adopt adult role-behaviors. Thus, getting drunk for the first time in mid-adolescence seems to be an ingredient in the normal developmental process in young males.
We have explored how age at first intoxication with alcohol relates to mental health, social integration and adjustment to the adult role. The data stem from a longitudinal representative study of 2000 Norwegians. The sample was assessed at ages 19-22, 21-24 and 25-28. Among females, only early intoxication was related to young adult symptoms of poor mental health. A U-shaped association between intoxication debut and psychological problems was revealed among males, implying that both early and late beginners had more such problems than those who had followed the mainstream. These associations persisted without change over time. However, males who remained abstainers in adulthood were psychologically healthy, but they showed indications of a delayed entry into the adult role. Male late beginners were also somewhat reluctant to adopt adult role-behaviors. Thus, getting drunk for the first time in mid-adolescence seems to be an ingredient in the normal developmental process in young males.
To analyse the relation between self reported hazardous drinking on the one hand and high sickness absence and/or disability pensions in both sexes on the other hand.
The study is based on data from a health survey, Stockholm Health of the Population Study, conducted in 1984. The mailed questionnaire covered alcohol consumption. Three different measures of alcohol habits were used: usual alcohol consumption, consumption during the previous week, and answers to the four CAGE questions on problem drinking. Information from the health survey and data from a subsequent health examination were related to information from the National Swedish Social Insurance Board for the year 1984 and the years 1986 to 1991 concerning sick leave and disability pensioning.
Four primary health care districts in Stockholm County.
The study group included persons who were aged 20 to 52 years in 1984, who answered the questionnaire (by mail or by telephone), and who participated in the health examination. The study group comprised 985 women and 870 men fulfilling the criteria for inclusion out of 6217 subjects aged 18 years and over randomly drawn.
In both sexes, a consistent pattern of increased sickness absence was seen for high consumers and for those with indications of problem drinking. In most comparisons, a clearly increased relative risk, although not always statistically significant, for an average of at least 60 sick days per year or for a disability pension during follow up was found. In multivariate analysis, controlling for age, socioeconomic group, smoking habits, and self reported health, a small reduction in the relative risks was found, suggesting that these factors could explain only a small part of the relative risks. The risks for abstainers were higher than for low and moderate consumers.
The effects of alcohol on subsequent high levels of sickness absence five to seven years after baseline as well as on the occurrence of disability pensions suggested that there is an effect on working incapacity independent of baseline health status, smoking, and socioeconomic group.
Many studies have demonstrated co-morbidity of alcohol abuse/dependence with mood and anxiety disorders but relatively little is known about anxiety and depression across the full continua of alcohol consumption and problems associated with drinking.
Participants from a general population sample (N = 2725) aged 18-80 years completed the Alcohol Use Disorders Identification Test (AUDIT) and four measures of negative affect (two depression and two anxiety symptom scales) included in a self-completion questionnaire.
High consumption, AUDIT total score, and AUDIT problems score were associated with high negative affect scores in participants under 60 years old (ORs in the range 1.80-2.83). Graphical and statistical analyses using continuous measures of alcohol use/problems and negative affect identified non-linear relationships where abstainers and occasional drinkers, as well as heavy and problem drinkers, were at risk of high anxiety and depression levels. This pattern, however, was not found in those aged > or = 60 years. The U-shaped relationship was not an artefact of abstainers being typical of the general population in their distribution of negative affect.
Studies of co-morbidity should acknowledge the possibility of non-linear associations and employ both continuous and discrete measures. Abstainers, as well as heavy drinkers, are at increased risk of symptoms of depression and anxiety disorders. Psychosocial factors may play a role in the U-shaped relationship between alcohol consumption and mortality.
To examine the relation between alcohol and main alcoholic beverage consumption and subjective health in Spain.
Logistic regression analysis using a cross sectional survey based on self reported data on alcohol and alcoholic beverage consumption, subjective health and the principal confounding factors (age, sex, civil status, educational level, job status, social support, region of residence, size of town or city, tobacco consumption, physical activity during leisure time and work hours, and chronic disease).
The 1993 Spanish National Health Survey.
A 19 573 person sample, representative of the non-institutionalised Spanish population aged 16 years and over.
Among Spaniards, 31.4% reported their health as suboptimal (fair, poor or very poor) and 56.9% consumed alcohol regularly, with the majority having a preference for wine. Light (1-2 drinks per day) or moderate consumption (3-4 drinks per day) was the most frequent pattern. After adjusting for confounding factors, a negative dose-response relation was observed between consumption of total alcohol, wine and beer, and prevalence of suboptimal health (linear trend: p<0.001 for total alcohol, p=0.023 for wine, and p=0.030 for beer). In contrast, for consumption of spirits the prevalence of ill health in moderate drinkers was lower than in non-drinkers, with no clear relation at higher consumption. While persons reporting a preference for wine had a lower frequency of suboptimal health than did abstainers, they showed no difference in frequency of subjective ill health with respect to persons with preference for other types of drink or no preference whatsoever.
The higher the consumption of total alcohol, wine and beer, the lower the prevalence of suboptimal health. These results differ from those obtained in several Nordic countries, where a "J shaped" relation has been observed for total alcohol and wine, and suggest that the relation between alcohol consumption and subjective health may be different in Mediterranean countries.
There is evidence of a non-linear relationship between alcohol consumption and mental health status, and of an association between tobacco use and poor mental health. This paper examines the nature of the association between usual alcohol consumption, tobacco use and symptoms of anxiety and depression in Emergency Department patients in Queensland, Australia.
A cross sectional survey of patients aged 16-84 presenting for treatment over a 14 day period to Gold Coast Hospital Emergency Department using socio-demographic items, the Alcohol Use Disorders Identification Test (AUDIT) to measure moderate, hazardous and harmful alcohol consumption, and the Hospital Anxiety and Depression Scale (HADS) to measure state anxiety and depression.
812 patients were interviewed. Gender differences in results were evident. For men, there was a U-shaped relationship between alcohol consumption and anxiety/depression, and a linear association between smoking and anxiety. For women, alcohol consumption and anxiety/depression showed a more linear relationship, but there was no significant relationship between tobacco use and anxiety/depression.
There may be important gender differences in the relationships between alcohol consumption, tobacco use and mental health status. This study supports previous evidence that mental health status of non-drinkers is worse than that of moderate drinkers, but only among males.
Based on a systematic literature search and an expert survey, publications after 1990 on prevalence of alcohol use disorders (AUD) in EU countries and Norway were reviewed. The search was restricted to studies using the DSM-IIIR or DSM-IV, or ICD-10, plus validated instruments to assess AUD. Using only representative general population surveys, the weighted median estimates for 12-month prevalence rates for dependence alone are 6.1% for males (arithmetic mean 5.0%; interquartile range 0.4% to 7.5%) and 1.1% for females (arithmetic mean 1.4%; interquartile range 0.1% to 2.1%). Results thus showed, that AUD constitute a high burden of disease in Europe, but there was high variability of prevalence. Men have higher prevalence rates of AUD than women. No clear pictures emerged with respect to age and AUD prevalence, or with respect to urban vs. rural and AUD prevalence. The discussion highlights potential explanations for the high variability of prevalence between countries, and the fact, that AUD constitute only a small part of all alcohol-related harm.
Mental illness is consistently underrecognized in general health care, which may lead to underestimation of its effects on awards for social security payments. The authors investigated empirically the contribution of psychiatric morbidity to the award of disability pensions, in particular those awarded for physical diagnoses.
Using a historical cohort design, the authors utilized a unique link between a large epidemiological cohort study and a comprehensive national database. Baseline information on mental and physical health was gathered from a 1995-1997 population-based health study of those of working age (20-66 years) in Nord-Trøndelag County, Norway, who were not recipients of disability pension (N=45,782). The outcome assessed was the awarding of disability pensions ascribed to specific ICD-10 diagnoses within 6 to 30 months as registered in the National Insurance Administration.
Anxiety and depression were robust predictors of disability pension awards in general, even when disability pensions awarded for any mental disorder were excluded. These effects were only partly explained by baseline somatic symptoms and diagnoses and were stronger in individuals aged 20-44 than in those aged 45-66. Somatic symptoms accounted for far more disability pension awards than did somatic diagnoses.
The cost of common mental disorders in terms of disability pensions and lost productivity may have been considerably underestimated by official statistics, particularly for younger claimants. The results suggest this might be due both to overuse of physical diagnoses and underrecognition of common mental disorders in primary care.
Objective: Mental illness is consistently underrecognized in general health care, which may lead to underestimation of its effects on awards for social security payments. The authors investigated empirically the contribution of psychiatric morbidity to the award of disability pensions, in particular those awarded for physical diagnoses. Method: Using a historical cohort design, the authors utilized a unique link between a large epidemiological cohort study and a comprehensive national database. Baseline information on mental and physical health was gathered from a 1995-1997 population-based health study of those of working age (20-66 years) in Nord-Trøndelag County, Norway, who were not recipients of disability pension (N=45,782). The outcome assessed was the awarding of disability pensions ascribed to specific ICD-10 diagnoses within 6 to 30 months as registered in the National Insurance Administration. Results: Anxiety and depression were robust predictors of disability pension awards in general, even when disability pensions awarded for any mental disorder were excluded. These effects were only partly explained by baseline somatic symptoms and diagnoses and were stronger in individuals aged 20-44 than in those aged 45-66. Somatic symptoms accounted for far more disability pension awards than did somatic diagnoses. Conclusions: The cost of common mental disorders in terms of disability pensions and lost productivity may have been considerably underestimated by official statistics, particularly for younger claimants. The results suggest this might be due both to overuse of physical diagnoses and underrecognition of common mental disorders in primary care.
In an attempt to relate “moderate drinking” to “mental health,” inadequacies of definition for both terms become apparent. Moderate drinking can be variously defined by a certain number of drinks to “nonintoxicating” to “noninjurious” to “optimal,” whereas mental health definitions range from “the absence of psychopathology” to “positive psychology” to “subjective well-being.” Nevertheless, we evaluated the relation by conducting an electronic search of the literature from 1980 onwards using the terms “moderate drinking,” “moderate alcohol consumption,” “mental health,” and “quality of life.”
Most studies report a “J-shaped curve,” with positive self-reports of subjective mental health associated with moderate drinking but not with heavier drinking. The relevance of expectancies has been unevenly acknowledged, and studies on the cultural differences among expectancies are largely lacking. The potential role of moderate drinking in stress reduction and studies of social integration have yielded inconsistent results as previous levels of drinking, age, social isolation, and other factors have often not been adequately controlled. Future anthropological, epidemiological, and pharmacological interactions preferably must be studied through a prospective design and with better definitions of moderate drinking and mental health.
Aims. To identify risk factors for depression and anxiety that are more prevalent in abstainers than in moderate drinkers and to estimate their contribution to U-shaped relationships of depression and anxiety with alcohol consumption. Design. Cross-sectional general population sample. Setting. Canberra, Australia. Participants. 2725 subjects completed questionnaires, including 1128 men and 1258 women aged 18-59 years. Measurements. Consumption categories from AUDIT quantity/frequency items: (1) non-drinkers (no alcohol in the past year), (2) occasional drinkers (monthly or less), (3) lower-level drinkers (up to 14 standard drinks per week for men and seven for women), (4) higher-level drinkers (up to 28 and 14 standard drinks per week, respectively), and (5) those drinking at hazardous or harmful levels (over 28 and 14 standard drinks per week, respectively). Goldberg and DSSI/sAD depression and anxiety scales. A range of demographic, socio-economic, socio-environmental and personality factors. Findings. Non-drinkers were more likely than lower-level drinkers to have low status occupations, poor education, current financial hardship, poor social support and recent stressful life events, and scored lower on extraversion, fun-seeking and drive. Many of these characteristics also applied to hazardous/harmful drinkers. In multivariate models, these risk factors accounted for a substantial part of the higher depression and anxiety scores of non-drinkers and occasional drinkers relative to lower-level drinkers. Conclusions. Abstainers have a range of characteristics known to be associated with anxiety, depression and other facets of ill health, and these factors may contribute significantly to their elevated levels of depression and anxiety.
The purpose of the study was to determine whether moderate alcohol use mediates or buffers the effect of stress on depression in a group of non-Hispanic White men and women.
Data are from the Los Angeles Epidemiological Catchment Area cohort. Individuals were assessed at two time periods, 1 year apart. Mean depression scores were analyzed for each level of stress and alcohol use.
In the simultaneous presence of both chronic strain and negative life events, a U-shaped pattern was observed in which abstainers and light and heavy drinkers had higher depression scores at the second time period than did light-moderate and moderate alcohol users. The U-shaped relationship remained when the effects of sex, age, and physical health status were controlled.
Light-moderate and moderate drinkers had less depression in the presence of stress than persons in other more extreme drinking categories. Moderate alcohol use may serve as a proxy for a spectrum of generally moderate behaviors that either attenuate the effect of stress on depression or suppress the effects of stress.
Heavy drinkers and abstainers have higher mortality rates than moderate drinkers. Explanations for the relation include a protective effect of moderate drinking, the presence of people who abstain because of illness, and other unidentified risk factors for mortality in abstainers. Studies of alcohol and mortality typically start in mid-life or later, and, therefore, there is little information about the lifetime characteristics of abstainers, including factors that may influence mortality. We investigated, in a large nationally representative sample of young adults in the UK, the association between alcohol consumption and factors predictive of mortality, specifically, psychological distress, self-rated health and limiting illness. 2,3
The association of subjective, self-rated suboptimal (average or poor) health with the intake of beer, wine, and liquor and alcohol intoxication was examined in a general population sample in Finland in 1992. The odds ratios were adjusted for several possible confounders with the use of logistic regression analysis. Compared with subjects who drank no wine, suboptimal health was less frequent among both men and women who imbibed 1-4 drinks of wine, and more common among men who consumed > or = 10 drinks of wine or liquor. Moderate wine drinking seems to be related to good self-rated health.
The aim of this paper is to identify positive psychological concomitants of moderate alcohol consumption. Current research and public-health perspectives on alcohol emphasize harms disproportionately relative to benefits. The major exception is research establishing beneficial effects of moderate drinking on cardiovascular health and overall mortality. In addition, much observational and experiential data suggest the widespread prevalence of positive drinking experiences. This paper is one of the first attempts since 1985 to codify such benefits in epidemiological terms. Methodological difficulties in accomplishing this include defining moderate drinking, controlling for confounding variables, and establishing causality. Nonetheless, evidence of psychological benefits has been found in experimental, observational, interview, self-report, correlational, and some prospective research. These positive findings are in the areas of subjective health, mood enhancement, stress reduction, sociability, social integration, mental health, long-term cognitive functioning, and work income/disability. Problem drinkers and alcoholics also seek mood and other benefits from alcohol, but are more likely to drink to counteract negative feelings and to support their egos than are social drinkers. It is as yet impossible to determine to what extent moderate alcohol consumption causes positive psychological outcomes and to what extent it is part of a complex pattern of mutually reinforcing variables.
To identify risk factors for depression and anxiety that are more prevalent in abstainers than in moderate drinkers and to estimate their contribution to U-shaped relationships of depression and anxiety with alcohol consumption.
Cross-sectional general population sample.
Canberra, Australia.
2725 subjects completed questionnaires, including 1128 men and 1258 women aged 18-59 years.
Consumption categories from AUDIT quantity/frequency items: (1) non-drinkers (no alcohol in the past year), (2) occasional drinkers (monthly or less), (3) lower-level drinkers (up to 14 standard drinks per week for men and seven for women), (4) higher-level drinkers (up to 28 and 14 standard drinks per week, respectively), and (5) those drinking at hazardous or harmful levels (over 28 and 14 standard drinks per week, respectively). Goldberg and DSSI/sAD depression and anxiety scales. A range of demographic, socio-economic, socio-environmental and personality factors.
Non-drinkers were more likely than lower-level drinkers to have low status occupations, poor education, current financial hardship, poor social support and recent stressful life events, and scored lower on extraversion, fun-seeking and drive. Many of these characteristics also applied to hazardous/harmful drinkers. In multivariate models, these risk factors accounted for a substantial part of the higher depression and anxiety scores of non-drinkers and occasional drinkers relative to lower-level drinkers.
Abstainers have a range of characteristics known to be associated with anxiety, depression and other facets of ill health, and these factors may contribute significantly to their elevated levels of depression and anxiety.
The authors developed a methodological basis for investigating how risk factors work together. Better methods are needed for understanding the etiology of disorders, such as psychiatric syndromes, that presumably are the result of complex causal chains.
Approaches from psychology, epidemiology, clinical trials, and basic sciences were synthesized.
The authors define conceptually and operationally five different clinically important ways in which two risk factors may work together to influence an outcome: as proxy, overlapping, and independent risk factors and as mediators and moderators.
Classifying putative risk factors into these qualitatively different types can help identify high-risk individuals in need of preventive interventions and can help inform the content of such interventions. These methods may also help bridge the gaps between theory, the basic and clinical sciences, and clinical and policy applications and thus aid the search for early diagnoses and for highly effective preventive and treatment interventions.
Previous sample studies of depression have shown a higher prevalence of depression in women, and an inconsistent relation to age has been found for both genders. The aim of the present study was to investigate depression in relation to gender and age in the general adult population.
Of the total population of 92,100 individuals aged 20-89 years and living in Nord-Trøndelag county of Norway, 62,344 (67.7%) filled in valid ratings of depression on the Hospital Anxiety and Depression Scale (HADS).
Minimal gender difference was found in dimensional depression scores and in prevalence rates of depression. Both these measures were found to increase continuously with age in both genders.
Our results of this population-based study differ from most sample studies reported, and these discrepancies are discussed with focus on study design, self-rating, and the concept of depression covered by HADS.
The Hospital Anxiety and Depression (HAD) rating scale is a commonly used questionnaire. Former studies have given inconsistent results as to the psychometric properties of the HAD scale.
To examine the psychometric properties of the HAD scale in a large population.
All inhabitants aged 20-89 years (n=92 100) were invited to take part in The Nord-Trøndelag Health Study, Norway. A total of 65 648 subjects participated, and only completed HAD scale forms (n=51 930) formed the basis for the psychometric examinations.
Principal component analysis extracted two factors in the HAD scale that accounted for 57% of the variance. The anxiety and depression sub-scales shared 30% of the variance. Both subscales were found to be internally consistent, with values of Cronbach's coefficient (alpha) being 0.80 and 0.76, respectively.
Based on data from a large population, the basic psychometric properties of the HAD scale as a self-rating instrument should be considered as quite good in terms of factor structure, intercorrelation, homogeneity and internal consistency.
To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS).
A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression?
Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83.
HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.
Recent epidemiological findings indicate that non-drinkers as well as hazardous/harmful drinkers experience higher levels of distress than moderate drinkers. Little is known about the age at which this develops. This paper examines levels of affect, depression and anxiety over the full range of alcohol consumption in young adults.
Cross-sectional findings from the first wave of a prospective, longitudinal study are presented.
The general population sample comprised of 2404 young adults (aged 20-24 years). living in the Canberra region. Measures included: the Goldberg Depression and Anxiety scales, the Positive and Negative Affect Schedule, and the Alcohol Use Disorders Identification Test.
For men, both non/occasional and hazardous/harmful consumption were associated with lower levels of positive affect and higher levels of anxiety and depression. The higher levels of distress evident for male abstainers were related to being less extroverted and less healthy and not to past hazardous/harmful alcohol consumption, current tobacco or marijuana use. For women, only hazardous/harmful drinkers were found to have higher levels of depression and negative affect. Hazardous/harmful consumption was related to using marijuana, tobacco and recent stressful events in both men and women.
Higher levels of distress are already evident in male non-drinkers in early adulthood. The findings counter theories that distress in non-drinkers is due to past hazardous/harmful alcohol consumption, marijuana or tobacco use, or characteristics in common with hazardous/harmful drinkers. Alcohol use disorders and mental health problems are pertinent issues for young adults. However, more understanding is needed of the experiences of non-drinkers in an alcohol consuming culture.
In recent community surveys, abstainers and heavy drinkers of alcohol have reported more mood and anxiety symptoms than moderate drinkers (U-shaped relationship). The present study was aimed at extending this finding by investigating this potential U-shaped relationship using structured diagnostic interviews to assess mood and anxiety disorders.
Data came from two contemporaneous surveys, the National Comorbidity Survey (NCS; N=6780) and the Mental Health Supplement of the Ontario Health Survey (OHS-MHS; N=7001). The University of Michigan Revision of the Composite International Diagnostic Interview (UM-CIDI) was used to make DSM-III-R psychiatric diagnoses in both surveys. Three mutually exclusive lifetime alcohol use categories were compared: (1) Alcohol abstainers-individuals reporting no alcohol use or less than 12 drinks in any year throughout their life. (2) Moderate drinkers-individuals that did not meet criteria for alcohol abstainers or problem drinkers. (3) Problem drinkers-DSM-III-R lifetime alcohol abuse, dependence or hazardous levels of alcohol use.
After controlling for demographic variables, alcohol abstainers were not found to have significantly higher rates of mood and anxiety disorders in comparison with moderate drinkers. However, problem drinking was significantly associated with mood and anxiety disorders.
Across both surveys, there was no evidence of a U-shaped relationship between lifetime alcohol consumption and lifetime mood and anxiety disorders.
This paper examines the associations between past-year drinking status and the prevalence of 15 different past-year anxiety, mood and personality disorders, using a large (n = 43,093) nationally representative sample of the U.S. population. The prevalence of these disorders and their associations with drinking are compared for college students 18-29 years of age, other youth 18-29 years of age, and adults 30 years of age and older. After adjusting for sociodemographic characteristics and past-year tobacco and illicit drug use, only drinkers with alcohol dependence experienced an excess risk of a mood or anxiety disorder among college students 18-29 years of age, OR = 2.4. In contrast, the excess risk of any mood or anxiety disorder associated with drinking status among non-college youth varied from an OR of 1.8 for non-binge drinkers to 4.7 for drinkers with alcohol dependence. Among persons 30 years of age and older, the degree of excess risk was slightly lower but still higher than those for college students, OR = 1.5-3.8. Similarly, the excess odds of any personality disorder associated with drinking varied from 1.6 to 5.0 for the younger, non-college group and from 1.5 to 3.8 for the older adults, with no significant effect observed among college students. Factors that may help explain the weaker association of psychopathology and drinking in the college population include selectivity and greater availability of social and treatment resources that serve as alternatives to self-medicating the symptoms of psychological distress with alcohol.
To determine the nature of the association between alcohol consumption and symptoms of anxiety and depression in women.
Prospective cohort study of women (n = 4527) who received antenatal care at a major public hospital (Mater Misericordiae Hospital) in South Brisbane between 1981 and 1984 and who have follow-up data on alcohol use, depressive and anxiety symptoms over a 14-year period.
At the 5-year follow-up there was a 'J-shaped' association between alcohol consumption and both symptoms of depression and of anxiety. However, at the baseline assessment and the 14-year follow-up alcohol consumption was linearly and positively associated with depressive symptoms with increasing prevalence of symptoms with greater consumption. At the 5-year follow-up the prevalence of depressive and anxiety symptoms among those who were abstainers at both baseline and 5-year follow-up was similar to that among those who had been previous drinkers and then become abstainers (P = 0.67). Similarly, the prevalence of these symptoms was the same at the 14-year follow-up comparing those who had been abstainers at baseline, 5-year and 14-year follow-up to those who had previously consumed alcohol but were then abstainers.
The nature of the association between alcohol consumption and symptoms of depression and anxiety may vary across their life course in women. Previous drinkers who become abstainers do not appear to be at any higher risk of symptoms of depression or anxiety compared to those who always abstained, suggesting that increased symptoms in abstainers at age 30 is not due to 'sick quitters'. The association of high alcohol consumption with symptoms of depression and anxiety may be confounded by low income and smoking.
To assess the risk of depression for subjects with or without heavy drinking occasions after adjusting for the average long-term alcohol consumption, age, gender, marital status, employment status, and chronic diseases.
In a cross-sectional population survey (N = 3124) carried out in Finland in 1997, long-term average alcohol consumption was assessed by a self-administered quantity-frequency questionnaire. A heavy drinking occasion was defined as six or more drinks for men and four or more drinks for women consumed at one session. The self-administered 21-item Beck Depression Inventory score of > or = 10 was classified as clinically significant depression.
Ex-drinkers and subjects with heavy drinking occasions had more often clinically significant depression compared with lifelong abstainers and individuals without heavy drinking occasions. In addition to the drinking habit, the risk for clinically significant depression increased also with age. Men aged 45-64 years with heavy drinking occasions had 2.3 times higher risk for depression compared with young men (aged 25-34 years) without heavy drinking occasions. The respective risk for old women was 2.2 times higher.
Drinking pattern with heavy drinking occasions is independently associated with clinically significant depression irrespective of average long-term alcohol consumption.
Relatively few studies have investigated associations between volume of alcohol consumption and psychological characteristics in normal samples. A sub-sample, comprising 363 men and 331 women between 29 and 34 years of age, was selected from the Copenhagen Perinatal Cohort on the basis of perinatal records. The sample was divided into four consumption categories: abstainers (including occasional drinkers), light, moderate, and risk drinkers. ANOVA and relevant contrasts were used to test the significance of differences among consumption categories. Both abstaining and risk drinking were associated with low social status family background, low education and intelligence. Abstaining was associated with low disinhibition and social recognition scores, while risk drinking was associated with high neuroticism and, in males, high disinhibition, low social recognition, and low achievement scores. Compared with light drinkers, a more "carefree" life orientation characterized male moderate drinkers, while relatively high scores on anxiety, dysthymia, and somatoform symptom scales characterized female moderate drinkers.
Inconsistent findings regarding the relationship between alcohol consumption and depression, including whether the relationship is J-shaped or U-shaped, may be at least partly due to the types of measures used for both alcohol consumption and depression.
We conducted a general population survey using random digit dialing (RDD) and computer-assisted telephone interviewing (CATI) with 6,009 males and 8,054 females aged 18 to 76 years. The survey included 4 types of alcohol measures (frequency, usual and maximum quantity per occasion, volume, and heavy episodic drinking) covering both the past week and the past year, and 2 types of depression measures (meeting DSM criteria for a clinical diagnosis of major depression, recent depressed affect).
The overall relationship between depression and alcohol consumption did not vary by gender or type of depression measure but did vary significantly by type of alcohol measure, with the strongest relationship found for heavy episodic drinking and high quantity per occasion. There were also significant gender interactions with both depression and alcohol measures, with females showing a stronger relationship than males when depression was measured as meeting the criteria for major depression and when alcohol consumption was measured as quantity per occasion or heavy episodic drinking. There was some evidence of a J-shaped relationship, that is, greater depression among abstainers compared with those who usually drank 1 drink and never drank as much as 5 drinks for both former drinkers and lifetime abstainers when depression was measured as recent symptoms of depression but the J shape was found only for former drinkers when depression was measured as meeting the criteria for major depression and did not reach statistical significance in some analyses.
The results of the present study suggest that measurement and gender are key issues in interpreting findings on the relationship between alcohol and depression. First, depression is primarily related to drinking larger quantities per occasion, less related to volume, and unrelated to drinking frequency, and this effect is stronger for women than for men. Second, the overall relationship between depression and alcohol consumption is stronger for women than for men only when depression is measured as meeting a clinical diagnosis of major depression and not when measured as recent depressed affect. Finally, while there was some evidence that former drinkers had slightly higher rates of major depression and higher scores on recent depressed affect compared with light drinkers, there was no evidence that light drinking was protective for major depression when compared with lifetime abstainers, although light drinkers did report fewer recent symptoms of depressed affect.
To review the effects of alcohol dependence on physical and mental health.
Alcohol dependence is wide-spread among people of all ages and socioeconomic groups. Persons with alcohol dependence face enormous health consequences. Alcohol dependence is a major cause of mortality and is associated with psychiatric conditions, neurologic impairment, cardiovascular disease, liver disease, and malignant neoplasms. Psychiatric conditions associated with alcohol dependence include major depression, dysthymia, mania, hypomania, panic disorder, phobias, generalized anxiety disorder, personality disorders, any drug use disorder, schizophrenia, and suicide. Psychiatric comorbidity, in turn, is associated with alcohol-related symptoms of greater severity. Excessive alcohol consumption causes brain damage, as evidenced by brain imaging, and related neurologic deficits, including impairments in working memory, cognitive processing of emotional signals, executive functions, visuospatial abilities, and gait and balance. Whereas moderate alcohol consumption is cardioprotective, heavy drinking is associated with increased risks of hypertension, coronary heart disease, and ischemic stroke, possibly due to alcohol-induced sympathetic activation. Chronic excessive alcohol consumption is a strong risk factor for various types of cancer, particularly cancers of the aero-respiratory tract, but also cancers of the digestive system, liver, breast, and ovaries. Heavy drinking is associated with various forms of alcoholic liver disease, such as cirrhosis. (People with alcohol dependence die from cirrhosis at a much higher rate than is found in the general population.) Alcohol dependence also increases the risk of injury, possibly due to alcohol-related factors such as diminished coordination and balance, increased reaction time, and impaired attention, perception, and judgment.
Alcohol dependence has numerous and serious ill effects on physical and mental health and represents a major public health burden.
To investigate empirically the association between anxiety/depression and cause-specific mortality with particular attention to the underlying mechanisms and causes of death. Depression reportedly increases general mortality. For cause-specific mortality, there is evidence depression has an effect on cardiovascular disease (CVD) mortality and suicide. Less information is known as to other mortality diagnoses. There is scarce and conflicting literature on anxiety in relation to mortality.
Employing a historical cohort design, we used a link between an epidemiological cohort study and a comprehensive national mortality database. We gathered baseline information on physical and mental health (Hospital Anxiety and Depression Scale, HADS) from the population-based health study (n = 61,349). Causes of death were registered with International Classification of Diagnoses, 10th edition (ICD-10) during mean follow-up of 4.4 years.
Case-level depression increased the mortality rate for all major disease-related causes of death, whereas case-level anxiety and comorbid anxiety/depression did not. The effect of depression was similar for cardiac mortality compared with all other causes combined, and confounding effects were also very similar. Symptom load of anxiety was associated negatively with both CVD and other cause mortality in fully adjusted models. Accidents and suicide were associated primarily with comorbid anxiety/depression.
Depression is a risk factor for all major disease-related causes of death; it is not limited to CVD mortality or suicide. Because the association between depression and cardiac mortality was comparable to the other causes of death combined and confounding and mediating factors were markedly similar, future investigation as to the mechanisms underlying the effect of depression on mortality should not be limited to CVD mortality.
Smoking is reported to be associated with depression and anxiety. The present study (a) examines these associations taking comorbidity into account, (b) investigates possible confounders, (c) examines how former smokers compared to current and never-smokers in terms of anxiety and depression, and if anxiety and depression decline by time since cessation. Participants (66%) aged 20-89 years in a population-based health survey (N=60,814) were screened employing the HADS. (a) The association with smoking was strongest in comorbid anxiety depression, followed by anxiety, and only marginal in depression. Associations were stronger in females and younger participants. (b) Variables partly accounting for the association comprised somatic symptoms, socio-demographics, alcohol problems, and low physical activity. (c) Anxiety and depression were most common in current smokers, followed by quitters, and then never-smokers. No decline in anxiety or depression was found with time since cessation. Previous studies of associations between depression and smoking might have overestimated the association when ignoring comorbid anxiety.
Thevalid-ityof theHospitalAnxietyandDepressionScale:anupdated literature review
- Bjellandi A Dahla
- T Haugt
- Neckelmannd
BjellandI.,DahlA.A.,HaugT.T.,NeckelmannD.Thevalid-ityof theHospitalAnxietyandDepressionScale:anupdated literature review. J Psychosom Res 2002; 52: 69–77
The validity of the Hospital Anxiety and Depression Scale: an updated literature review
- I Bjelland
- A A Dahl
- T T Haug
- D Neckelmann
Bjelland I., Dahl A. A., Haug T. T., Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated
literature review. J Psychosom Res 2002; 52: 69–77.
The validity of the Hospital Anxiety and Depression Scale: an updated literature review
- Bjelland
Påliteligheten av selvrapportert alkoholkonsum: Svalbardstudien 1988–89 [The reliability of self‐reported alcohol consumption: the Svalbard study 1988–89
- Høyer G.