Alterations in Alcohol Consumption Echo Depression Symptom Changes

Summary: A new study uncovers a correlation between changes in alcohol consumption and the ebb and flow of depression symptoms.

People reporting lower alcohol use simultaneously noted reductions in depressive symptoms, while an increase in alcohol consumption was paired with a rise in depression, irrespective of the drinking levels.

The findings open a new dialogue on the potential value of monitoring alcohol consumption during interventions for depression. This research may also inspire individuals to decrease drinking habits to enhance their mental health.

Key Facts:

The study used data from 200,000 individuals collected between 2016 and 2020, suggesting that changes in alcohol use correlate with changes in depression symptoms.
For all but two subgroups, an increase in drinking risk level significantly heightened the prevalence of positive depression screens. In contrast, the prevalence of positive depression screens dropped by 17% to 49% for subgroups reporting decreased drinking.
The research did not directly identify the causative factors behind the changes in alcohol use and depression symptoms. The simultaneous changes could stem from multiple factors, including the impact of drinking on depression, the effect of depression on drinking habits, or other unknown factors influencing both.

Changes in alcohol consumption tend to accompany changes in symptoms of depression, according to a study published in Alcohol: Clinical and Experimental Research.

Individuals who reported reductions in alcohol use simultaneously reported reductions in depression symptoms, even when their alcohol consumption exceeded healthy levels.

Similarly, those who endorsed increased alcohol use also reported increased depression, whether or not the amount they drank was at a level considered unhealthy.

The findings may motivate individuals to reduce their drinking to improve their mood and suggest that monitoring changes in alcohol consumption may be helpful as part of clinical interventions for depression.

For the study, researchers reviewed responses from 200,000 individuals about drinking behaviors and depression symptoms to people at primary care visits between 2016 and 2020. Participants were adults who completed questionnaires about alcohol use and depression as part of routine health care on two occasions eleven to twenty-four months apart.

About one-quarter reported unhealthy alcohol use, and about thirteen percent screened positive for depression. Three-quarters had no changes in alcohol use from the time of the first questionnaire to the second.

For all but two subgroups with an increase in drinking risk level, there was a significant increase in the prevalence of positive depression screens ranging from 11 percent to 100 percent higher at the time of the second questionnaire compared to the first.

The exceptions were those whose drinking increased from none to a level of drinking not considered unhealthy and those whose drinking increased from high risk to very high risk.

For subgroups reporting decreased drinking, the prevalence of positive depression screens dropped from 17 percent to 49 percent from the time of the first questionnaire to the second.

The only subgroup where a drop in depression prevalence did not accompany a reduction in drinking were those whose drinking dropped from levels not considered unhealthy when completing the first questionnaire to no drinking at the second assessment.

The study did not examine what caused the changes in alcohol use and depression symptoms.

The simultaneous increases or decreases in both depression symptoms and alcohol use could be attributed to increased or decreased drinking causing changes in depression, improved or worsening depression leading to increases or decreases in drinking, or other factors leading to changes in both depression and drinking.

The screening tools used in the study were the AUDIT-C, a validated instrument to identify high-risk alcohol behavior, and PHQ-2, a validated depression screening tool.

The questionnaires on which the study was based may be subject to biases related to self-report and interactions in the health care setting.

Questionnaires were administered in Washington state; the study population was predominantly white, non-Hispanic, older, and insured by commercial insurance or Medicare.

Abstract

Changes in alcohol consumption reported on routine healthcare screenings are associated with changes in depression symptoms

Background

The Alcohol Use Disorders Identification Test-Consumption version (AUDIT-C) has been robustly validated as a point-in-time screen for unhealthy alcohol use, but less is known about the significance of changes in AUDIT-C scores from routine screenings over time. Unhealthy alcohol use and depression commonly co-occur, and changes in drinking often co-occur with changes in depression symptoms. We assess the associations between changes in AUDIT-C scores and changes in depression symptoms reported on brief screens completed in routine care.

Methods

The study sample included 198,335 primary care patients who completed two AUDIT-C screens 11 to 24 months apart and the Patient Health Questionnaire-2 (PHQ-2) depression screen on the same day as each AUDIT-C. Both screening measures were completed as part of routine care within a large health system in Washington state. AUDIT-C scores were categorized to reflect five drinking levels at both time points, resulting in 25 subgroups with different change patterns. For each of the 25 subgroups, within-group changes in the prevalence of positive PHQ-2 depression screens were characterized using risk ratios (RRs) and McNemar’s tests.

Results

Patient subgroups with increases in AUDIT-C risk categories generally experienced increases in the prevalence of positive depression screens (RRs ranging from 0.95 to 2.00). Patient subgroups with decreases in AUDIT-C risk categories generally experienced decreases in the prevalence of positive depression screens (RRs ranging from 0.52 to 1.01). Patient subgroups that did not have changes in AUDIT-C risk categories experienced little or no change in the prevalence of positive depression screens (RRs ranging from 0.98 to 1.15).

Conclusions

As hypothesized, changes in alcohol consumption reported on AUDIT-C screens completed in routine care were associated with changes in depression screening results. Results support the validity and clinical utility of monitoring changes in AUDIT-C scores over time as a meaningful measure of changes in drinking.