Department of Epidemiology, Brown University School of Public Health, 121 S Main Street, Box G-S121-2, Providence, RI 02912, United States; Department of Health Science, College of Health & Wellness, Johnson & Wales University, United States.
Department of Epidemiology, Brown University School of Public Health, 121 S Main Street, Box G-S121-2, Providence, RI 02912, United States; Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States.
Addict Behav. 2018 Oct;85:70-76. doi: 10.1016/j.addbeh.2018.05.021. Epub 2018 May 25.
Alcohol use and its consequences have often been associated with depression, particularly among female college students. Interpretation of this association has been challenging due to potential reverse causation. The current study sought to clarify the temporality of these relationships. We examined: (1) the association between alcohol consumption and onset depression among female college students, and (2) the association between drinking consequences and onset depression among drinkers only. We used a prospective longitudinal design. Participants were first-year female college students who completed a baseline survey at study entry, and monthly assessments of alcohol consumption, drinking consequences, and depression symptoms. Cox proportional hazards regression with time-varying covariates were constructed among the full sample (N = 412) and the drinkers only sample (N = 335). Adjusted hazard ratios accounted for known risk factors for depression such as race/ethnicity, academic challenge, not getting along with one's roommate, sexual victimization prior to college, marijuana use, and socioeconomic status. For each additional average drink per week, adjusting for all covariates, there was no (95% CI: -4%, +4%) increased risk of onset depression. For each additional alcohol consequence, adjusting for all covariates, there was a 19% (95% CI: 5%, 34%) increased risk of onset depression. This significant relationship remained after adjusting for quantity of alcohol consumption. Quantity of alcohol consumed did not predict incident depression. However, experiencing alcohol consequences, regardless of consumption, did increase the risk of incident depression. College substance use and mental health interventions should aim to reduce not only alcohol consumption, but also alcohol-related consequences.
饮酒及其后果通常与抑郁症有关，尤其是在女大学生中。由于潜在的反向因果关系，对这种关联的解释一直具有挑战性。本研究旨在阐明这些关系的时间顺序。我们检查了：（1）饮酒与女大学生抑郁发作之间的关系，以及（2）饮酒后果与仅饮酒者抑郁发作之间的关系。我们使用前瞻性纵向设计。参与者为一年级女大学生，在研究开始时完成基线调查，并每月评估饮酒量、饮酒后果和抑郁症状。在全样本（N=412）和仅饮酒者样本（N=335）中，构建了具有时变协变量的 Cox 比例风险回归。调整后的危害比考虑了抑郁的已知风险因素，如种族/民族、学业挑战、与室友相处不融洽、上大学前遭受性侵犯、大麻使用和社会经济地位。对于每周每增加一个平均饮酒量，在调整所有协变量后，抑郁发作的风险没有增加（95%CI：-4%，+4%）。对于每增加一个酒精后果，在调整所有协变量后，抑郁发作的风险增加了 19%（95%CI：5%，34%）。在调整饮酒量后，这种显著的关系仍然存在。饮酒量并不预示着抑郁的发生。然而，无论饮酒量如何，经历酒精后果都会增加抑郁发作的风险。大学物质使用和心理健康干预措施的目标不仅应减少饮酒量，还应减少与酒精相关的后果。
