Abstract
BackgroundHarmful effects of alcohol abuse are well documented for drinkers, and adverse effects are also reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. This study evaluates intra-household associations between alcohol abuse in men, and depression and suicidal attempts in women, in community-based settings of Chennai, India.MethodsThis community-based cross-sectional study of chronic disease risk factors and outcomes was conducted in n = 259 households and n = 1053 adults (aged 15 years and above) in rural and urban Chennai. The Alcohol Use Disorder Identification Test (AUDIT) score was used to classify alcohol consumption into ‘low-risk', ‘harmful’, ‘hazardous’ and ‘alcohol dependence’ drinking and the Patient Health Questionnaire (PHQ-9) score to classify depression as ‘mild’, ‘moderate’, ‘moderate-severe’ and ‘severe’. Multivariate logistic regression models estimated the association of depression in women with men’s drinking patterns in the same household.ResultsA significant 2.5-fold increase in any depression (PHQ-9 ≥ 5) was observed in men who were ‘alcohol-dependent’ compared to non-drinkers (OR = 2.53; 95 % CI: 1.26, 5.09). However, there was no association between men’s drinking behavior and depression in women of the same household, although suicidal attempts approached a significant dose–response relationship with increasing hazard-level of men’s drinking (p = 0.08).ConclusionNo significant intra-household association was observed between men’s alcohol consumption and women’s depression, though an increasing (non-significant) trend was associated with suicidal attempts. Complex relationships between suicidal attempts and depression in women and male abusive drinking require further exploration, with an emphasis on intra-household mechanisms and pathways.
Highlights
Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings
At the household-level, our findings are similar to those of Schuckit and colleagues [51] who found no association between psychiatric disorders among female spouses of male alcohol abusers, and to other studies in which spouses of male alcohol abusers present with fewer psychiatric symptoms than spouses with lower consumption levels due to certain adaptive activities that provide stability in stressful situations [52, 53]
Studies indicate that the relationship between alcohol use and partner’s depression is influenced by a number of psychosocial risk factors [16] such as spouse’s attitude towards drinking, alcohol-related marital problems, social support, resilience and intimate partner violence (IPV) [54, 55]
Summary
Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. At the family-level, population-based studies have shown a strong relationship between alcoholism in men and the presence of intimate partner violence (IPV) [26,27,28] leading to depression and suicide in spouses, suggesting a potential intra-household mechanism for these outcomes in women [21, 29]. This is borne out through several studies in India, which suggest that husband’s alcohol consumption is a trigger for domestic violence [30, 31,32,33] and may lead to depression and suicide of their spouses and other female family members in India [5, 21, 29, 34]. We conducted this study to evaluate the intra-household associations between hazardous drinking patterns in men with depression and suicidal attempts in female family members from rural and urban communities in Chennai, India
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