Does the association between alcohol consumption and depression depend on how they are measured?
Does the association between alcohol consumption and depression depend on how they are measured?
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DOI：
10.1111/j.1530-0277.2006.00274.x
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发表时间：
2007-01-01
影响因子：
3.2
通讯作者：
Rehm, Juergen
中科院分区：
文献类型：
--
作者：
Graham, Kathryn;Massak, Agnes;Rehm, Juergen
背景资料：关于饮酒和抑郁之间关系的不一致发现，包括这种关系是J形还是U形，可能至少部分是由于用于饮酒和抑郁的测量类型。方法：我们使用随机数字拨号（RDD）和计算机辅助电话访谈（CATI）对6，009名男性和8名女性进行了一般人群调查，054名女性，年龄18至76岁。调查包括4种酒精测量（频率、每次通常和最大数量、体积和重度间歇性饮酒），涵盖过去一周和过去一年，以及2种类型的抑郁指标（符合DSM标准的临床诊断为重性抑郁症，最近抑郁的影响）。抑郁症和饮酒之间的总体关系并不因性别或抑郁症类型而异，但因酒精类型而异，其中，重度间歇性饮酒与每次大量饮酒的关系最强。也有显着的性别相互作用与抑郁症和酒精的措施，与女性表现出比男性更强的关系时，抑郁症被测量为满足重度抑郁症的标准，当酒精消费量被测量为每次或重度发作性饮酒的数量。有一些证据表明存在J型关系，也就是说，当抑郁症被测量为抑郁症的近期症状时，戒酒者与那些通常喝1杯酒和从不喝多达5杯酒的人相比，前者和终身戒酒者的抑郁症更大，但当抑郁症被测量为符合重度抑郁症的标准时，仅发现前者的J形，并且没有达到统计学上的显著性差异。结论：本研究的结果表明，测量和性别是解释酒精和抑郁症之间的关系的结果的关键问题。首先，抑郁症主要与每次饮酒量较大有关，与数量关系不大，与饮酒频率无关，这种影响对女性比男性更强。第二，只有当抑郁症被测量为符合重度抑郁症的临床诊断时，而不是当测量为最近的抑郁情绪时，抑郁症和饮酒之间的整体关系才比男性更强。最后，虽然有一些证据表明，与轻度饮酒者相比，以前饮酒的人患重度抑郁症的几率略高，近期抑郁情绪的得分也较高，但与终身戒酒者相比，没有证据表明轻度饮酒对重度抑郁症有保护作用，尽管轻度饮酒者确实报告了较少的近期抑郁情绪症状。
Background: Inconsistent findings regarding the relationship between alcohol consumption and depression, including whether the relationship is J-shaped or U-shaped, may be at least partly due to the types of measures used for both alcohol consumption and depression.Methods: We conducted a general population survey using random digit dialing (RDD) and computer-assisted telephone interviewing (CATI) with 6,009 males and 8,054 females aged 18 to 76 years. The survey included 4 types of alcohol measures (frequency, usual and maximum quantity per occasion, volume, and heavy episodic drinking) covering both the past week and the past year, and 2 types of depression measures (meeting DSM criteria for a clinical diagnosis of major depression, recent depressed affect).Results: The overall relationship between depression and alcohol consumption did not vary by gender or type of depression measure but did vary significantly by type of alcohol measure, with the strongest relationship found for heavy episodic drinking and high quantity per occasion. There were also significant gender interactions with both depression and alcohol measures, with females showing a stronger relationship than males when depression was measured as meeting the criteria for major depression and when alcohol consumption was measured as quantity per occasion or heavy episodic drinking. There was some evidence of a J-shaped relationship, that is, greater depression among abstainers compared with those who usually drank 1 drink and never drank as much as 5 drinks for both former drinkers and lifetime abstainers when depression was measured as recent symptoms of depression but the J shape was found only for former drinkers when depression was measured as meeting the criteria for major depression and did not reach statistical significance in some analyses.Conclusions: The results of the present study suggest that measurement and gender are key issues in interpreting findings on the relationship between alcohol and depression. First, depression is primarily related to drinking larger quantities per occasion, less related to volume, and unrelated to drinking frequency, and this effect is stronger for women than for men. Second, the overall relationship between depression and alcohol consumption is stronger for women than for men only when depression is measured as meeting a clinical diagnosis of major depression and not when measured as recent depressed affect. Finally, while there was some evidence that former drinkers had slightly higher rates of major depression and higher scores on recent depressed affect compared with light drinkers, there was no evidence that light drinking was protective for major depression when compared with lifetime abstainers, although light drinkers did report fewer recent symptoms of depressed affect.