Depression syndromes with risk of alcohol dependence in adulthood: A latent class analysis
Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA. Drug and Alcohol Dependence
(Impact Factor: 3.42).
08/2005; 79(1):71-81. DOI: 10.1016/j.drugalcdep.2005.01.001
Using prospectively gathered data, we assessed whether depression is associated a risk for late-onset alcohol dependence, and whether that relationship differed by gender. The baseline interview was completed in 1981 (mean age=41.7 years, standard deviation (S.D.)=17.0, range 18-86) on a probability sample of Baltimore residents as part of the Epidemiologic Catchment Area Program. Between 1993 and 1996, the original cohort was traced (73% of the survivors were re-interviewed, n=1920). Baseline depression items were subjected to gender-specific latent class analyses prior to exploring associations between class membership and two classifications of alcohol dependence: (1) lifetime prevalence, and (2) new onset assessed at follow-up. A depression syndrome class was identified (24% of the females and 20% of the males). The odds of lifetime alcohol dependence among those in the depressive syndrome class was significantly elevated for both sexes, relative to the non-depressed class. However, no appreciable association was found for depressive syndrome with the development of alcohol dependence. In this sample of middle-aged adults, the evidence supports an association for the presence of a depressive syndrome with lifetime alcohol dependence, but not for the new onset of alcohol dependence. Other predictors of alcohol dependence identified in the analyses are discussed.
Available from: Arbi Ben Abdallah
- "Importantly, LCA methods attend to spurious causation in ways that other variable-centered approaches cannot. Although this technique has been applied in studies of conduct problems [Maughan et al., 2000], drug and alcohol use [Collins et al., 1994; Crum et al., 2005], mental health [Eaton et al., 1989], and psychopathology [Bucholz et al., 2000], only a handful of studies have used this approach to clarify typologies of youth delinquency. Below, we briefly mention some of these studies, and then present findings from LCA conducted with a school-based sample of Australian youth. "
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ABSTRACT: This study used latent class analysis to examine subpopulation membership based on self-reports of delinquent behaviors obtained from Australian youth. Three discrete identifiable classes were derived based on 51 indicators of physical violence, property damage, minor infractions, drug use, and social delinquency. One class of youth engaged in primarily rule breaking and norm violations including underage alcohol use, typical of this age period. A second class was more actively delinquent emphasizing drug use, trespassing, and various forms of disobedience. A third class of highly delinquent youth differed from their counterparts by endorsing drug use, thievery that involved stealing money, goods, and cars, property damage, gambling, precocious sexual experiences, involvement with pornographic materials, and fighting. Multinomial logistic regression predicting class membership indicated highly delinquent youth were more likely to be older males, use venting coping strategies, and be fun or novelty seeking compared with rule breakers. Findings are discussed in terms of refining current taxonomic arguments regarding the structure of delinquency and implications for prevention of early-stage antisocial behavior.
Available from: Daniel M Blonigen
- "For the young-adult group, these individuals exhibited higher rates of completing college and being married for a greater number of years, which is consistent with Zucker's descriptions of the developmentally limited alcoholics as entering adult social roles earlier than antisocial alcoholics in their study (Zucker et al., 1995; Zucker and Gomberg, 1986). Findings provided only weak support for the expectation that the late-onset class would be characterized by internalizing features (e.g., the presence of an affective disorder; Crum et al., 2005); that is, although the late-onset class had the highest proportion of individuals with a lifetime diagnosis of major depressive disorder, scores were not signifi cantly different from those in the other classes. On the other hand, the late-onset group had the lowest rate of marriage and fewest years married at time of assessment—noteworthy differences given the impact of marital status and quality of marriage on mortality risk among alcoholics (e.g., Timko et al., 2006). "
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ABSTRACT: Identifying developmental trajectories of alcohol use is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to replicate and generalize our previous finding that had been based on a twin sample drawn from the Vietnam Era Twin Registry. In this study, we made use of a nontwin sample of Vietnam veterans drawn from the Vietnam Era Study--a 25-year follow-up of the Vietnam Drug User Returns project that assessed the long-term medical and psychiatric consequences of substance abuse or dependence in Vietnam.
Alcohol-related behaviors and psychiatric status were assessed in a sample of 839 individuals that comprised 323 veterans who tested positive for drugs (i.e., opiates, barbiturates, or amphetamines) on discharge from Vietnam, 319 veterans who tested negative for drugs at that time, and a nonveteran control sample (n = 197). Individuals with a lifetime diagnosis of alcohol dependence (n = 293) were selected for further analysis. Using detailed life history charts, in-person structured interviews were conducted, which entailed retrospective reports covering the 25 years since the 1972 survey. Measures of alcohol and drug use as well as psychiatric symptoms were obtained by assessing each year of the follow-up interval, beginning with 1972.
Using latent growth mixture modeling, a four-class model was identified with trajectories that were parallel to those identified in our previous studies based on the Vietnam Era Twin Registry: severe chronic alcoholics, severe nonchronic alcoholics, late-onset alcoholics, and young-adult alcoholics.
Present findings provide additional support for the replicability and generalizability of meaningful differences in the course of alcoholism from early adulthood to midlife.
Available from: Natacha Carragher
- "Research efforts to elucidate the heterogeneity in depression have utilised a wide variety of latent variable techniques including factor analysis (Aggen et al., 2005; Muthén, 1989; Simon and von Korff, 2006); discriminant function analysis (Sen, 1987); cluster analysis (Andreasen et al., 1980; Blashfield and Morey, 1979; Cox et al., 2001; Scotte et al., 1997); grade of membership analysis (Blazer et al., 1988, 1989; Davidson et al., 1988); and, more recently, latent class analysis (Chen et al., 2000; Crum et al., 2005; Eaton et al., 1989; Kendler et al., 1996; Sullivan et al., 1998, 2002). Across these typology studies, different assessment instruments have been employed (i.e., self-report checklists, clinician rating scales, and structured psychiatric interviews) and the resultant subtypes have been validated by reference to comorbid psychopathology, demographic variables, familial liability to psychiatric illness, and clinical features, including treatment response and relapse rate. "
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ABSTRACT: Continued research efforts aim to elucidate the heterogeneity in depression. The identification of meaningful and valid subtypes has implications for research and clinical practice. Based on patterns of depressive symptomatology, this study identified a typology of depressive syndromes using data from a large, nationally representative survey.
Analyses were based on a subsample of 12,180 respondents from the 2001-2002 Wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Latent class analysis was applied to the DSM-IV 'A' criteria for major depression to identify homogenous subtypes or classes of depressive syndromes. Associations between the emergent latent classes and demographic and clinical characteristics were assessed.
Three clinically relevant subtypes were identified, in addition to a class who reported few depressive symptoms: severely depressed (40.9%), psychosomatic (30.6%), cognitive-emotional (10.2%) and non-depressed (18.3%). The odds of experiencing negative life events, psychiatric disorders, and having a family background of major depression were significantly higher for the severely depressed, psychosomatic and cognitive-emotional classes, compared to the non-depressed class. Several unique differences between the latent classes also emerged.
Methodological shortcomings included: reliance on lay interviewer-administered structured interviews to determine diagnoses; basing sample selection on the endorsement of screener items; and, using measures of 'any anxiety disorder', 'any mood disorder', and 'any personality disorder' to determine psychiatric disorder prevalence rates.
Significant heterogeneity in depressive symptomatology exists in this U.S. sample. Profiling symptom patterns is potentially useful as a first step in developing tailored intervention and treatment programmes.
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