Alcohol-use disorder severity predicts first-incidence of depressive disorders

L Boschloo, W van den Brink, B W J H Penninx, M M Wall, D S Hasin

Research output: Contribution to JournalArticleAcademicpeer-review


BACKGROUND: Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted first-incident depressive disorders, an association that has never been found for the presence or absence of an alcohol use disorder in the general population.

METHOD: In a national sample of persons who had never experienced a major depressive disorder (MDD), dysthymia, manic or hypomanic episode (n=27 571), we examined whether a version of DSM-5 alcohol-use disorder severity (a count of three abuse and all seven dependence criteria) linearly predicted first-incident depressive disorders (MDD or dysthymia) after 3-year follow-up. Wald tests were used to assess whether more complicated models defined the relationship more accurately.

RESULTS: First-incidence of depressive disorders varied across alcohol-use disorder severity and was 4.20% in persons meeting no alcohol-use disorder criteria versus 44.47% in persons meeting all 10 criteria. Alcohol-use disorder severity significantly predicted first-incidence of depressive disorders in a linear fashion (odds ratio 1.14, 95% CI 1.06-1.22), even after adjustment for sociodemographics, smoking status and predisposing factors for depressive disorders, such as general vulnerability factors, psychiatric co-morbidity and subthreshold depressive disorders. This linear model explained the relationship just as well as more complicated models.

CONCLUSIONS: Alcohol-use disorder severity was a significant linear predictor of first-incident depressive disorders after 3-year follow-up and may be useful in identifying a high-risk group for depressive disorders that could be targeted by prevention strategies.

Original languageEnglish
Pages (from-to)695-703
Number of pages9
JournalPsychological Medicine
Issue number4
Early online date26 Aug 2011
Publication statusPublished - Apr 2012


  • Adolescent
  • Adult
  • Alcoholism/epidemiology
  • Depressive Disorder/epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Interview, Psychological
  • Linear Models
  • Male
  • Middle Aged
  • Severity of Illness Index
  • United States/epidemiology
  • Young Adult


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