Alcohol involvement as a function of co-occurring alcohol use disorders and major depressive episode: Evidence from the National Epidemiologic Survey on Alcohol and Related Conditions

Abstract

Background Co-occurring alcohol use disorder and major depression (C-ALDP) is a major public health problem. Yet, the available evidence is mixed regarding the implications of C-ALDP for alcohol involvement. The purpose of this research was to examine the associations between past 12-month co-occurring AUDs (abuse and dependence) and major depressive episode (MDE) and alcohol involvement in a representative community sample. Design The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is a national household survey of 43,083 adults ages 18 and older. For the NESARC, the target population is the civilian noninstitutionalized population, 18 years of age and older, living in the United States and the District of Columbia. Methods All NESARC interviews were conducted with the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM IV Version (AUDADIS-IV; Grant et al., 2003). Results Prevalence of past 12-month co-occurring AUD (abuse or dependence) and MDE was 1.2%, corresponding to about 2.4 million adults ages 18 and older. Among males with alcohol dependence, comorbid MDE was associated with a greater number of days drinking at home alone. Among females and males with alcohol abuse and dependence, comorbid MDE was associated with higher prevalence of drinking to enhance depressed mood. Comorbid MDE was also associated with lower levels of some drinking behaviors among those with alcohol abuse. Conclusions Co-occurring AUDs and MDE are associated with specific dimensions of alcohol involvement, and this association is more consistent for alcohol dependence than abuse.

Is Major Depression Linked to Alcohol-Impaired Driving?

“…The NESARChas been used to study the bi-directional relationships between AUDs and depressive disorders (Pacek, Martins, & Crum, 2013), early adverse life events and AUDs (Fetzner, McMillan, Sareen, & Asmundson, 2011), self-medication of mood disorders with alcohol (Bolton, Robinson, & Sareen, 2009), depression as a co-morbidity of AUDs(Cranford, Nolen-Hoeksema, & Zucker, 2011), socioeconomic correlates ofdepressive disorders (Rubio et al, 2011), AUD severity as a predictor of depression onset (Boschloo, van den Brink, Penninx, Wall, & Hasin, 2012), and relationships between personality disorders, alcohol use, and alcohol-impaired driving (Maclean &French, 2014). …”

“…NESARC excluded cases in which depressive symptoms stemmed solely from bereavement or physical illness. The definition of major depression used here has been widely used in previous studiesof depression using NESARC data (e.g., Grant & Harford, 1995; Hasin, Goodwin, Stinson, & Grant, 2005; Hasin et al, 2007; Grant et al, 2008; Cranford et al, 2011). …”

Posttraumatic stress disorder and alcohol misuse among women: effects of ethnic minority stressors

“…In each model, sociodemographic factors were retained as a block and the remaining potential confounders were retained in the model if they were independently associated with the outcome (p ≤.10 at entry to allow for only the potentially relevant variables to be included) or if they confounded the exposure-outcome relationship (≥10% change in exposure-outcome HR) [82]. These factors have been associated with PTSD and/or AUD in prior research [83–89,72,90,91]. As previously noted, family history of alcohol misuse (problem drinking/alcoholism) is a well-established risk factor for alcohol use disorders [72].…”

Impacts of Alcoholism in Public Health: A Systematic Review

“…Some studies using clinical samples showed that the co-occurrence of alcoholism and depression (C-ALDP) is associated with worse alcohol-related outcomes, and this relationship appears to be stronger in males than females [136,141]. However, the findings of Beijer, U. and Andréasson, S. with homeless population showed that younger homeless women (18-36-years-old at the baseline) had a higher risk for alcohol disorders than homeless men [137].…”

“…The research of Schuckit et al, 1997 about alcohol use disorders (AUD) had conclusions that among those with an AUD, comorbid depression is associated with an earlier onset of alcohol dependence, higher rates of lifetime drug dependence [138,141]. Besides, in the same study already realized by Beijer, U. and Andréasson, S. the prevalence of schizophrenia in combination with alcohol and drug use disorders was nearly three times higher among the homeless women than among homeless men [137].…”