Abstract
Depressive symptoms and alcohol misuse contribute substantially to the global health burden. These phenotypes often manifest, and frequently co-occur, during adolescence. However, few studies have examined whether both baseline levels of depressive symptoms and change in symptoms are associated with alcohol outcomes. In addition, inconsistent findings could be due to sex differences or the use of different alcohol outcomes. Using data from a prospective population-based cohort in the UK, we estimated trajectories of depressive symptoms from 12 years 10 months to 17 years 10 months, separately for male and female participants. We assessed whether baseline and change in depressive symptoms were associated with use and harmful use of alcohol at 18 years 8 months. Among females, increasing depressive symptoms were associated with increased alcohol use; whilst for males, there was little evidence of this. When examining harmful levels of alcohol use, baseline levels of depressive symptoms in males were weakly related to later harmful alcohol use but this association was attenuated substantially through adjustment for confounders. In contrast, both baseline symptoms and increase in symptoms were associated with later harmful alcohol use in females and these associations were not diminished by confounder adjustment. Elevated depressive symptoms during adolescence are positively associated with increases in both use and harmful use of alcohol at 18 years 8 months. These findings differ between the sexes. Further research is needed to examine the mechanisms underlying the link between depressive symptoms and harmful alcohol use to identify potentially modifiable factors for intervention.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-014-0600-5) contains supplementary material, which is available to authorized users.
Highlights
Alcohol misuse and depressive symptoms both contribute substantially to the global disease burden and adolescence is considered a high-risk period for the onset of these problems [1]
Few studies have examined whether both baseline levels of depressive symptoms and change in symptoms are associated with alcohol outcomes
Using a method similar to growth curve modelling, Marmorstein [3] examined a populationbased sample of adolescents and young adults, and found that subclinical depressive symptoms and alcohol problems had reciprocal effects on one another during this period, with some differences across the sexes
Summary
Alcohol misuse and depressive symptoms both contribute substantially to the global disease burden and adolescence is considered a high-risk period for the onset of these problems [1]. There is evidence, that a positive relationship between depressive symptoms and alcohol use/misuse becomes evident earlier in life, and extends to subclinical levels of problems. Using a method similar to growth curve modelling, Marmorstein [3] examined a populationbased sample of adolescents and young adults, and found that subclinical depressive symptoms and alcohol problems had reciprocal effects on one another during this period, with some differences across the sexes. A study of younger adolescents, using an auto-regressive cross-lag model across four waves of data, suggested that depressive symptoms were positively associated with later alcohol use [7]. Many previous studies [8,9,10,11] of the association between depressive symptoms and alcohol use rely on cross-sectional data or include only two time points. Similar to Needham, Clark and colleagues [13] found that, while baseline depressive symptoms were positively associated with later alcohol use, linear growth in depressive symptoms was inversely related to later alcohol use among a large sample of young adolescents
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