Background

The role of alcohol use in the development of depression is unclear. We aimed to investigate whether alcohol dependence, but not high frequency or quantity of consumption, during adolescence increased the risk of depression in young adulthood.

Methods

In this prospective cohort study, we included adolescents who were born to women recruited to the Avon Longitudinal Study of Parents and Children in Avon, UK, with delivery dates between April 1, 1991, and Dec 31, 1992. Alcohol dependence and consumption were measured at about age 16 years, 18 years, 19 years, 21 years, and 23 years using the self-reported Alcohol Use Disorders Identification Test, and at about age 18 years, 21 years, and 23 years using items corresponding to DSM-IV symptoms. The primary outcome was depression at age 24 years, assessed using the Clinical Interview Schedule Revised. Analyses were probit regressions between growth factors for alcohol dependence and consumption and depression, before and after adjustments for confounders: sex, housing tenure, maternal education, maternal depressive symptoms, parents' alcohol use, conduct problems at age 4 years, being bullied from age 12–16 years, and frequency of smoking cigarettes or cannabis. Adolescents were included in analyses if they had data from at least one timepoint for alcohol use and confounders.

Findings

We included 3902 adolescents (2264 [58·0%] female; 1638 [42·0%] male) in our analysis, and 3727 (96·7%) of 3853 participants with data on ethnicity were White. After adjustments, we found a positive association between alcohol dependence at 18 years of age (latent intercept) and depression at 24 years of age (probit coefficient 0·13 [95% CI 0·02 to 0·25]; p=0·019), but no association between rate of change (linear slope) and depression (0·10 [–0·82 to 1·01]; p=0·84). There was no evidence of an association between alcohol consumption and depression (latent intercept probit coefficient –0·01 [–0·06 to 0·03]; p=0·60; linear slope 0·01 [–0·40 to 0·42]; p=0·96) after adjustments.

Interpretation

Psychosocial or behavioural interventions that reduce the risk of alcohol dependence during adolescence could contribute to preventing depression in young adulthood.

Funding

UK Medical Research Council and Alcohol Research UK (grant number MR/L022206/1).

中文翻译：

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英国青春期酒精依赖和消费与成年早期抑郁症的关联：一项前瞻性队列研究

背景

饮酒在抑郁症发展中的作用尚不清楚。我们的目的是调查青春期期间的酒精依赖（而不是高频率或大量饮酒）是否会增加成年早期患抑郁症的风险。

方法

在这项前瞻性队列研究中，我们纳入了英国雅芳父母和儿童纵向研究中招募的女性所生的青少年，分娩日期在1991年4月1日至1992年12月31日之间。测量了酒精依赖和饮酒量在大约 16 岁、18 岁、19 岁、21 岁​​和 23 岁时使用自我报告的酒精使用障碍识别测试，并且在大约 18 岁、21 岁​​和 23 岁时使用与 DSM-IV 症状相对应的项目。主要结局是 24 岁时抑郁症，使用修订版临床访谈时间表进行评估。分析是酒精依赖、消费和抑郁的增长因素之间的概率回归，调整混杂因素之前和之后：性别、住房保有权、母亲教育、母亲抑郁症状、父母饮酒、4岁时的行为问题、自年龄起被欺负12-16 岁，吸烟或吸大麻的频率。如果青少年有至少一个时间点的饮酒和混杂因素的数据，那么他们就被纳入分析。

发现

我们的分析中纳入了 3902 名青少年（2264 [58·0%] 女性；1638 [42·0%] 男性），3853 名有种族数据的参与者中有 3727 名 (96·7%) 是白人。经过调整，我们发现 18 岁时的酒精依赖（潜在截距）与 24 岁时的抑郁症之间存在正相关（概率系数 0·13 [95% CI 0·02 至 0·25]；p=0· 019），但变化率（线性斜率）与抑郁症之间没有关联（0·10 [–0·82 至 1·01]；p=0·84）。没有证据表明饮酒与抑郁之间存在关联（潜在截距概率系数 –0·01 [–0·06 至 0·03]；p=0·60；线性斜率 0·01 [–0·40 至 0] ·42]；p=0·96) 调整后。

解释

降低青春期酒精依赖风险的社会心理或行为干预措施可能有助于预防成年早期的抑郁症。

资金

英国医学研究委员会和英国酒精研究中心（拨款号 MR/L022206/1）。