Alcohol use disorder tied to higher risk for subsequent depressive symptoms

Takeaway

• Alcohol use disorder (AUD) was associated with an increased risk for subsequent depressive symptoms.
• Heavy drinking (>168 g/week or >48 g/day at least weekly) did not predict occurrence of depressive symptoms after adjusting for confounders.

Why this matters

• Cohort studies have shown inconsistent results for the association between AUD and subsequent depressive symptoms.

Study design

• 42 studies (n=338,426) met eligibility criteria after a search across PubMed, Embase and PsycINFO databases.
• Alcohol intake divided into abstinence, light (0-84 g/week), moderate (85-168 g/week) and heavy drinking (>168 g/week or >48 g/day at least weekly).
• Funding: National Key R&D Program of China.

Key results

• AUD was associated with an increased risk for subsequent depressive symptoms (relative risk [RR], 1.57; 95% CI, 1.41-1.76).
• Compared with non-heavy drinking, heavy drinking was associated with a higher risk for subsequent depressive symptoms (RR, 1.13; 95% CI, 1.05-1.22).
• After adjustment for confounders, the strength of the association between heavy drinking and subsequent depressive symptoms was reduced.
• Alcohol intake levels ranging 0-42 g/day were linked with a decreased risk for depressive symptoms.
• Risk for depression reduced by 23% with alcohol intake of about 10 g/day compared with abstinence.

Limitations

• Heterogeneity among studies.
• Possibility of residual reverse causality.
• Risk for confounding.