Helsinki Institute for Social Sciences and Humanities, University of Helsinki, Vuorikatu 3, 00014, Finland; Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, P.O. Box 18, 00014, Finland.
Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, P.O. Box 18, 00014, Finland; Helsinki Institute for Urban and Regional Studies (URBARIA), University of Helsinki, Yliopistonkatu 3, 00100 Helsinki, Finland.
Drug Alcohol Depend. 2022 Sep 1;238:109547. doi: 10.1016/j.drugalcdep.2022.109547. Epub 2022 Jun 30.
Alcohol-related deaths may be among the most important reasons for the shorter life expectancy of people with depression, yet no study has quantified their contribution. We quantify the contribution of alcohol-related deaths to the life-expectancy gap in depression in four European countries with differing levels of alcohol-related mortality.
We used cohort data linking population registers with health-care and death records from Denmark, Finland, Sweden and Turin, Italy, in 1993-2007 (210,412,097 person years, 3046,754 deaths). We identified psychiatric inpatients with depression from hospital discharge registers in Denmark, Finland, and Sweden and outpatients with antidepressant prescriptions from prescription registers in Finland and Turin. We assessed alcohol-related and non-alcohol-related deaths using both underlying and contributory causes of death, stratified by sex, age and depression status. We quantified the contribution of alcohol-related deaths by cause-of-death decomposition of the life-expectancy gap at age 25 between people with and without depression.
The gap in life expectancy was 13.1-18.6 years between people with and without inpatient treatment for depression and 6.7-9.1 years between those with and without antidepressant treatment. The contribution of alcohol-related deaths to the life-expectancy gap was larger in Denmark (33.6%) and Finland (18.1-30.5%) - i.e., countries with high overall alcohol-related mortality - than in Sweden (11.9%) and Turin (3.2%), and larger among men in all countries. The life-expectancy gap due to other than alcohol-related deaths varied little across countries.
Alcohol contributes heavily to the lower life expectancy in depression particularly among men and in countries with high overall alcohol-related mortality.
与酒精相关的死亡可能是导致抑郁症患者预期寿命缩短的最重要原因之一，但尚无研究对其进行量化。我们在四个具有不同酒精相关死亡率的欧洲国家中，对与酒精相关的死亡对抑郁症预期寿命差距的贡献进行了量化。
我们使用队列数据，将丹麦、芬兰、瑞典和意大利都灵的人口登记处与医疗保健和死亡记录相链接，时间跨度为 1993 年至 2007 年（210412097 人年，3046754 人死亡）。我们从丹麦、芬兰和瑞典的住院病人出院记录中确定了患有抑郁症的住院病人，从芬兰和都灵的处方登记处确定了服用抗抑郁药物的门诊病人。我们通过对性别、年龄和抑郁症状况进行分层，根据根本死因和促成死因，对与酒精相关和非酒精相关的死亡进行了评估。我们通过对 25 岁人群的预期寿命差距的死因分解，对与酒精相关的死亡对预期寿命差距的贡献进行了量化。
与未接受住院治疗的抑郁症患者相比，接受住院治疗的抑郁症患者的预期寿命差距为 13.1-18.6 年，与未接受抗抑郁药物治疗的患者相比，接受抗抑郁药物治疗的患者的预期寿命差距为 6.7-9.1 年。在丹麦（33.6%）和芬兰（18.1-30.5%），即酒精相关死亡率较高的国家，与酒精相关的死亡对预期寿命差距的贡献大于瑞典（11.9%）和都灵（3.2%），而且在所有国家中，男性的贡献更大。其他非酒精相关死因导致的预期寿命差距在各国之间变化不大。
酒精在很大程度上导致了抑郁症患者的预期寿命降低，特别是在男性和酒精相关死亡率较高的国家。
