Major depression in 6050 former drinkers - Association with past alcohol dependence
Major depression in 6050 former drinkers - Association with past alcohol dependence
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DOI：
10.1001/archpsyc.59.9.794
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发表时间：
2002-09-01
影响因子：
--
通讯作者：
Grant, DF
中科院分区：
文献类型：
--
作者：
Hasin, DS;Grant, DF
背景：一般人群中酗酒与重度抑郁症之间的关联已被解释为误诊的酒精中毒和误诊为抑郁综合征的戒断效应。为了调查这是否可以解释整个关系，在不再饮酒或饮酒很少的个体中调查了过去的酒精依赖与当前重度抑郁症（即不重叠的时间范围）的关联。我们使用全国纵向酒精流行病学调查的数据（一个具有代表性的样本）进行了这项研究。方法：过去一年没有吸毒或吸烟的前饮酒者（n = 6050）被分为有和没有过去 DSM-IV 酒精依赖的人。比较这 2 组当前（过去 12 个月）DSM-IV 重度抑郁症的存在情况。在控制其他变量的情况下，通过线性逻辑回归测试既往酒精依赖与当前重度抑郁症之间的关联。结果：既往酒精依赖使当前重度抑郁症的风险增加了 4 倍以上。这种关系并未因控制变量而减弱。大多数患有重度抑郁症的受试者在访谈前两年或两年以上才使用过某种物质，这消除了急性中毒或戒断效应作为其抑郁症的解释。结论：在具有全国代表性的前饮酒者样本中，先前的酒精依赖与当前或最近的重度抑郁症之间存在强烈的、特定的关联，表明这种关联并不完全是误诊的中毒和戒断效应造成的。应寻求更好地了解这两种疾病之间关系的本质，这将具有重要的公共卫生意义。
Background: The association between alcoholism and major depression in the general population has been explained as misdiagnosed alcohol intoxication and withdrawal effects mistaken for depressive syndromes. To investigate whether this could account for the entire relationship, the association of past alcohol dependence with current major depression (ie, nonoverlapping time frames) was investigated in individuals who no longer drink or who drink very little. We conducted the study using data from the National Longitudinal Alcohol Epidemiologic Survey, a representative sample.Methods: Former drinkers who did not use drugs or smoke in the past year (n=6050) were divided into those with and without past DSM-IV alcohol dependence. These 2 groups were compared for the presence of current (last 12 months) DSM-IV major depression. The association between prior alcohol dependence and current major depression was tested with linear logistic regression, controlling for other variables.Results: Prior alcohol dependence increased the risk of current major depressive disorder more than 4-fold. This relationship was not attenuated by control variables. The majority of subjects with major depression last used substances 2 or more years prior to the interview, which eliminates acute intoxication or withdrawal effects as an explanation of their depressions.Conclusions: The strong, specific association between prior alcohol dependence and current or recent major depression in a nationally representative sample of former drinkers indicates that the association is not entirely an artifact of misdiagnosed intoxication and withdrawal effects. A better understanding of the nature of the relationship between the 2 disorders should be sought and will have important public health significance.