Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands.
Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
Epidemiol Psychiatr Sci. 2023 Feb 27;32:e14. doi: 10.1017/S2045796023000070.
There are indications that problematic alcohol use may negatively impact the course of major depressive disorder (MDD). However, most studies on alcohol use and adverse MDD outcomes are conducted amongst MDD populations with (severe) alcohol use disorder in psychiatric treatment settings. Therefore, it remains unclear whether these results can be generalised to the general population. In light of this, we examined the longitudinal relationship between alcohol use and MDD persistence after a 3-year follow-up amongst people with MDD from the general population.
Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric epidemiological prospective study comprising four waves amongst the adult Dutch general population ( = 6.646). The study sample ( = 642) consisted of those with 12-month MDD who participated at the follow-up wave. The outcome was 12-month MDD persistence after the 3-year follow-up, which was assessed via the Composite International Diagnostic Interview version 3.0. Weekly alcohol consumption was operationalised as non-drinking (0 drinks), low-risk drinking (⩽7 drinks; reference), at-risk drinking (women 8-13 drinks, men 8-20 drinks) and high-risk drinking (women ⩾14, men ⩾21 drinks). We performed univariate and multiple logistic regression analyses, which were adjusted for various socio-demographic and health-related factors.
The majority (67.4%) of the MDD sample were female, while the mean age was 47.1 years. Amongst these, 23.8% were non-drinkers, 52.0% were low-risk drinkers and 14.3% and 9.4% were at-risk and high-risk drinkers, respectively. Around one-quarter of the sample (23.6%) met the criteria for a persistent MDD after 3-year follow-up. No statistically significant association was found between alcohol use and MDD persistence, either for the crude model or the adjusted models. In comparison to low-risk drinking, the full adjusted model showed no statistically significant associations between MDD persistence and non-drinking (odds ratio (OR) = 1.15, = 0.620), at-risk drinking (OR = 1.25, = 0.423), or high-risk drinking (OR = 0.74, = 0.501).
Contrary to our expectations, our findings showed that alcohol use was not a predictor of MDD persistence after 3-year follow-up amongst people with MDD from the general population.
有迹象表明，问题性饮酒可能会对重度抑郁症（MDD）的病程产生负面影响。然而，大多数关于饮酒和 MDD 不良结局的研究都是在精神科治疗环境中针对 MDD 人群（有（严重）酒精使用障碍）进行的。因此，目前尚不清楚这些结果是否可以推广到一般人群。鉴于此，我们在为期 3 年的随访后，在一般人群中检查了 MDD 患者的饮酒与 MDD 持续存在之间的纵向关系。
数据来自荷兰精神健康调查和发病率研究-2（NEMESIS-2），这是一项针对成人荷兰一般人群的四个波次的精神流行病学前瞻性研究（n=6646）。研究样本（n=642）由参加随访波次的 12 个月 MDD 患者组成。3 年随访后 12 个月 MDD 持续存在是该研究的结局，通过使用 3.0 版复合国际诊断访谈进行评估。每周饮酒量被定义为不饮酒（0 杯）、低风险饮酒（≤7 杯；参考）、有风险饮酒（女性 8-13 杯，男性 8-20 杯）和高风险饮酒（女性≥14 杯，男性≥21 杯）。我们进行了单变量和多变量逻辑回归分析，这些分析调整了各种社会人口统计学和健康相关因素。
MDD 样本的大多数（67.4%）为女性，平均年龄为 47.1 岁。其中，23.8%为不饮酒者，52.0%为低风险饮酒者，14.3%和 9.4%分别为有风险和高风险饮酒者。在样本中，约四分之一（23.6%）在 3 年随访后符合持续 MDD 的标准。在未调整模型或调整模型中，饮酒与 MDD 持续存在之间均无统计学显著关联。与低风险饮酒相比，在完全调整的模型中，MDD 持续存在与不饮酒（比值比（OR）=1.15，=0.620）、有风险饮酒（OR=1.25，=0.423）或高风险饮酒（OR=0.74，=0.501）之间均无统计学显著关联。
与我们的预期相反，我们的研究结果表明，在一般人群中，MDD 患者的饮酒并不是 3 年随访后 MDD 持续存在的预测因素。
