Summary: Adolescents with signs of alcohol dependency are more likely to suffer from depression in their mid-20s.
The research, involving 3,902 participants from the ALSPAC study, examined the correlation between alcohol consumption and dependency at age 18 and depression at age 24.
It found that those dependent on alcohol at age 18 were more likely to be depressed at age 24 than their peers. Interestingly, high levels of alcohol consumption alone, without signs of dependency, did not increase the risk of depression.
- Signs of alcohol dependence in late adolescence may increase the risk of developing depression in adulthood.
- High levels of alcohol consumption alone, without signs of dependency, were not found to increase depression risk.
- The study suggests a possible causal relationship between alcohol dependence and depression, not explained by poor overall mental health in adolescence.
Adolescents who show signs of alcohol dependence are more likely to develop depression by their mid-20s, according to a new study led by UCL (University College London) and University of Bristol researchers.
Drinking large amounts of alcohol regularly, but with no signs of dependency, did not predict depression risk, according to the findings published in The Lancet Psychiatry.
Co-lead author Dr Gemma Lewis (UCL Psychiatry) said: “By using a large, longitudinal dataset, we have found evidence that problematic drinking patterns in late adolescence may increase the risk of developing depression years later.
“Problematic drinking patterns could be a warning sign of future mental health problems, so helping young people to avoid problematic alcohol use could have long-term benefits to their mental health.”
The study involved 3,902 people who are part of the Children of the 90s birth cohort study (Avon Longitudinal Study of Parents and Children – ALSPAC), a longitudinal cohort of parents and their children born in the southwest of England in 1991 and 1992, who have been surveyed at regular intervals.
This paper looked at the association between alcohol consumption and signs of problematic drinking, or dependence, at age 18, and depression six years later at age 24.
Alcohol dependence signs include an inability to stop drinking, failure to meet normal expectations due to drinking, and feeling a need to drink after a heavy session, as well as harmful effects such as drink-related memory loss.
The researchers found that people who appeared to be dependent on alcohol at age 18 (or at any age from 17 to 22) were more likely than their peers to have depression at age 24.
Those with a score of zero on the alcohol dependence scale at age 18 face an 11% probability of depression by age 24, compared to 15% for those with a score of one on the scale (an increase from zero to one on the alcohol dependency scale represents a 28% increase in the probability of not being able to stop drinking once started and a 33% increase in the probability of failing to do what was normally expected of you).
This relationship remained after they adjusted for potential confounding factors such as substance use and depressive symptoms at age 16, suggesting that there may be a causal relationship between alcohol dependence and subsequent depression that is not explained by poor overall mental health in adolescence.
The researchers found that consumption levels alone were not associated with an increased risk of depression, which they say may be partly due to the fact that drinking in late adolescence is often tied with social contact and reflects social norms.
Co-lead author Dr Gemma Hammerton (University of Bristol) said: “While we found that alcohol consumption alone did not appear to increase the probability of depression, heavy drinking can be a precursor to dependence, and can have harmful physical health impacts in the longer term as well.
“High frequency and quantity of alcohol consumption therefore remain important as targets to prevent or reduce during adolescence.
“Public health interventions to prevent depression could target problematic alcohol use (such as if alcohol is having a negative impact on a person’s personal relationships or responsibilities), which is likely to occur before dependence, and involve high frequency and quantity of consumption.”
The study was funded by the Medical Research Council and Alcohol Research UK (now Alcohol Change UK).
Mark Leyshon, Senior Research & Policy Manager at Alcohol Change UK, said: “Alcohol consumption amongst 18 to 24-year-olds has been falling for some time. However, there remains a significant number of young people who use alcohol in a harmful way.
“There were over 40,000 alcohol-related hospital admissions amongst under 24s in 2019, and more than a quarter of these were for mental and behavioural disorders as a result of alcohol.
“The findings from this new study reinforce the importance of protecting young people from alcohol harm, through early intervention and proper funding of youth addictions services so that the right support and treatment is there for everyone who needs it.”
The findings align with the results of another recent UCL-led study in adults, which found that problematic alcohol use – but not level of consumption – is associated with increased odds of suicide attempt or self-harm.
About this depression and neurodevelopment research news
Original Research: Open access.
“The association of alcohol dependence and consumption during adolescence with depression in young adulthood, in England: a prospective cohort study” by Gemma Lewis et al. Lancet Psychiatry
The association of alcohol dependence and consumption during adolescence with depression in young adulthood, in England: a prospective cohort study
The role of alcohol use in the development of depression is unclear. We aimed to investigate whether alcohol dependence, but not high frequency or quantity of consumption, during adolescence increased the risk of depression in young adulthood.
In this prospective cohort study, we included adolescents who were born to women recruited to the Avon Longitudinal Study of Parents and Children in Avon, UK, with delivery dates between April 1, 1991, and Dec 31, 1992. Alcohol dependence and consumption were measured at about age 16 years, 18 years, 19 years, 21 years, and 23 years using the self-reported Alcohol Use Disorders Identification Test, and at about age 18 years, 21 years, and 23 years using items corresponding to DSM-IV symptoms. The primary outcome was depression at age 24 years, assessed using the Clinical Interview Schedule Revised. Analyses were probit regressions between growth factors for alcohol dependence and consumption and depression, before and after adjustments for confounders: sex, housing tenure, maternal education, maternal depressive symptoms, parents’ alcohol use, conduct problems at age 4 years, being bullied from age 12–16 years, and frequency of smoking cigarettes or cannabis. Adolescents were included in analyses if they had data from at least one timepoint for alcohol use and confounders.
We included 3902 adolescents (2264 [58·0%] female; 1638 [42·0%] male) in our analysis, and 3727 (96·7%) of 3853 participants with data on ethnicity were White. After adjustments, we found a positive association between alcohol dependence at 18 years of age (latent intercept) and depression at 24 years of age (probit coefficient 0·13 [95% CI 0·02 to 0·25]; p=0·019), but no association between rate of change (linear slope) and depression (0·10 [–0·82 to 1·01]; p=0·84). There was no evidence of an association between alcohol consumption and depression (latent intercept probit coefficient –0·01 [–0·06 to 0·03]; p=0·60; linear slope 0·01 [–0·40 to 0·42]; p=0·96) after adjustments.
Psychosocial or behavioural interventions that reduce the risk of alcohol dependence during adolescence could contribute to preventing depression in young adulthood.
UK Medical Research Council and Alcohol Research UK (grant number MR/L022206/1).