Abstract
BACKGROUND: Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted first-incident depressive disorders, an association that has never been found for the presence or absence of an alcohol use disorder in the general population.
METHOD: In a national sample of persons who had never experienced a major depressive disorder (MDD), dysthymia, manic or hypomanic episode (n=27 571), we examined whether a version of DSM-5 alcohol-use disorder severity (a count of three abuse and all seven dependence criteria) linearly predicted first-incident depressive disorders (MDD or dysthymia) after 3-year follow-up. Wald tests were used to assess whether more complicated models defined the relationship more accurately.
RESULTS: First-incidence of depressive disorders varied across alcohol-use disorder severity and was 4.20% in persons meeting no alcohol-use disorder criteria versus 44.47% in persons meeting all 10 criteria. Alcohol-use disorder severity significantly predicted first-incidence of depressive disorders in a linear fashion (odds ratio 1.14, 95% CI 1.06-1.22), even after adjustment for sociodemographics, smoking status and predisposing factors for depressive disorders, such as general vulnerability factors, psychiatric co-morbidity and subthreshold depressive disorders. This linear model explained the relationship just as well as more complicated models.
CONCLUSIONS: Alcohol-use disorder severity was a significant linear predictor of first-incident depressive disorders after 3-year follow-up and may be useful in identifying a high-risk group for depressive disorders that could be targeted by prevention strategies.
Original language | English |
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Pages (from-to) | 695-703 |
Number of pages | 9 |
Journal | Psychological Medicine |
Volume | 42 |
Issue number | 4 |
Early online date | 26 Aug 2011 |
DOIs | |
Publication status | Published - Apr 2012 |
Keywords
- Adolescent
- Adult
- Alcoholism/epidemiology
- Depressive Disorder/epidemiology
- Diagnostic and Statistical Manual of Mental Disorders
- Female
- Follow-Up Studies
- Humans
- Incidence
- Interview, Psychological
- Linear Models
- Male
- Middle Aged
- Severity of Illness Index
- United States/epidemiology
- Young Adult