Self-medicating low mood with alcohol use: Examining the role of frequency of alcohol use, quantity consumed and context of drinking

Age-period-cohort analysis of different mental wellbeing measures in Scotland from 2008 to 2021: The U-shaped curve of mental wellbeing over the life course

BACKGROUND

Common mental disorders are increasingly recognized as a serious public health concern globally. This study reports an age-period-cohort (APC) analysis of mental wellbeing to help identify high-risk groups.

METHOD

Data from Scottish Health Survey from 2008 to 2021 for adults aged 16+ was used with mental wellbeing measured with three different tools: the General Health Questionnaire-12 (GHQ-12), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and the Revised Clinical Interview Schedule (CIS-R). A graphical analysis was performed using hexamap and Intrinsic Estimator models were employed to estimate the separate effects for age, period and birth cohorts on mental wellbeing.

RESULTS

Age evidenced the most pronounced pattern with a U-shape curve indicative of a deterioration of mental health as individuals enter adulthood, reaching a nadir in their late 50s/ early 60s before gradually improving thereafter. Mental health trends across cohorts were largely stable, although there was a noticeable, albeit non-significant, increase in mental health issues among people born in late 1990s-to mid-2000s. After adjusting for APC effects, better mental health was found for males, people with higher incomes, employed and those currently married. Medium to high level of physical activity were also associated with better mental wellbeing.

CONCLUSION

The study supports arguments for greater attention to mental health among those are working-age adults and for younger generations born after the 1980s. Associations with sex, socio-economic factors may help guide targeting of public health measures while associations with a healthy physical lifestyle support arguments at measures intended to promote a mental health through physical activity.

Rising prevalence of subthreshold and major depressive symptom in South Korea: A trend analysis from 2014 and 2018

INTRODUCTION

Subthreshold depression and major depressive symptoms are prevalent mental health conditions that significantly impact quality of life and contribute to South Korea's high suicide rate. Despite their importance, few studies have examined temporal changes in the occurrence of these disorders in the Korean population.

OBJECTIVE

This study aimed to estimate the prevalence of subthreshold depression and MDD using a large, representative sample of the South Korean population and analyze trends over time.

METHODS

Data were obtained from 10,848 participants aged 19 and above in the Korean National Health and Nutrition Examination Survey (KNHNES) in 2014 and 2018. Depression severity was categorized using cutoff scores of 5-14 for subthreshold symptoms and ≥ 15 for severe symptoms.

RESULTS

The prevalence of subthreshold depression increased from 12.90% in 2014 to 15.20% in 2018, while MDD rose from 4.7% to 7.0% (p < 0.001). Logistic regression analysis revealed that MDD (OR = 8.1, 95% CI = 2.34-11.23), college education (OR = 7.9, 95% CI = 4.23-10.00), and age above 65 years (OR = 8.1, 95% CI = 2.58-12.58) exhibited similar risks for suicide attempts.

CONCLUSION

Since 2014, there has been a sharp and sustained increase in both subthreshold and severe depressive symptoms among the Korean population. This alarming trend underscores the critical need for targeted prevention and intervention strategies.

Investigating the nature of depressive experiences in adults who self-medicate low mood with alcohol

OBJECTIVE

This study sought to explore if individuals who self-medicate with alcohol experience higher levels of depression, and if symptom level experiences are affected by the behaviour of self-medication.

DESIGN

Data was from the Wave I (2001-2002) National Epidemiologic Survey on Alcohol and Related Conditions - NESARC. Only participants who experienced either one or both of the two stem questions which highlight the key symptoms of depression were included (n=13,753).

RESULTS

A one factor model of depression was supported. Experiences of suicidality were more likely to be endorsed by people who self-medicated, compared to those with low mood who do not use alcohol in this way. Typically, more common experiences of depression in the form of appetite difficulties, were less likely to be reported by those who self-medicated, compared to those who do not.

CONCLUSIONS

The findings aid understanding of the drinking patterns and other mental health correlates of those who engage in the behaviour of self-medication. Findings indicate that those who self-medicate are at a higher risk for suicidality, given the same level of depression. These findings highlight the importance of identifying these potentially problematic health behaviours as early as possible, due to these risks.

Posttraumatic stress disorder, drinking to cope, and harmful alcohol use: A multivariate meta-analysis of the self-medication hypothesis

The association between posttraumatic stress disorder (PTSD) and harmful alcohol use has often been explained through the self-medication hypothesis via coping-related drinking motives. However, the magnitude of the indirect effect of PTSD on harmful alcohol use through coping motives is unclear. This study aggregated this indirect effect using a meta-analytic structural equation modeling approach and explored moderators that influenced the indirect effect. We identified articles from PsycINFO, PubMed/MEDLINE, and PROQUEST (through June 22, 2021) containing measures of (a) PTSD symptoms, (b) coping-related drinking, and (c) harmful alcohol use. Thirty-four studies yielding 69 effect sizes were included (mean N = 387.26 participants; median N = 303.5; range = 42-1,896; aggregate sample n = 15,128). Coping motives mediated the relation between PTSD and harmful alcohol use, accounting for 80% of the variance in the total effect. Moderating variables and evidence of publication bias were also found. Findings suggest that coping-related drinking is a strong mediator in the relation between PTSD and harmful alcohol use and that the strength of the indirect effect is meaningfully influenced by measurement approach, sample characteristics, and study design. Additional longitudinal and multivariate studies are needed to establish directionality and account for additional variance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining the alcohol-related consequences of adult drinkers who self-report medicating low mood with alcohol: An analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions survey data

The aim of this paper is to examine the alcohol-related consequences experienced by adults who reported a 2-week period of low mood and identified as a 'self-medicator' compared to those who do not. Our focus is on assessing whether the conceptualization of alcohol use disorder severity differs across adult drinkers who self-medicate with alcohol during a period of low mood, compared to those who do not. This study used secondary data from the NESARC survey. The analytic sample consisted of 5945 participants who answered questions from the alcohol abuse/dependence (alcohol experiences) section, in the last 12 months. The sample was split into four groups by whether they self-medicated with alcohol or not, drank alcohol in the last year, and their drinking class. The findings indicated that a one-factor model was the best fit, and all items were a strong indicator of alcohol use disorder. The two-parameter model had the best fit, indicating that the diagnostic criteria were placed as a good fit along a continuum of severity. It was revealed that the hazardous drinking group who self-medicated, experienced more consequences even at low levels of severity. As the self-medicating hazardous drinking group also showed the highest estimates for alcohol use disorder severity, this may indicate that this group is composed of high-functioning self-medicators who are trying to regulate their drinking, and may not be as clinically high risk as expected, due to their drinking patterns.

Potential causal effect of posttraumatic stress disorder on alcohol use disorder and alcohol consumption in individuals of European descent: A Mendelian Randomization Study

BACKGROUND

Posttraumatic stress disorder (PTSD) often co-occurs with alcohol consumption (AC) and alcohol use disorder (AUD). However, it is unknown whether the same etiologic influences that underlie PTSD co-occurring with AUD are those that underlie PTSD and AC individually.

METHODS

This study used large-scale genome-wide association study (GWAS) data to test whether PTSD and drinks per week [DPW]/AUD are causally related to one another, and, if so, whether PTSD precedes DPW/AUD and/or vice versa. We used Mendelian Randomization methods to analyze European ancestry GWAS summary statistics from the Psychiatric Genomics Consortium (PGC; PTSD), GWAS & Sequencing Consortium of Alcohol and Nicotine Use (GSCAN; DPW), and the Million Veteran Program (MVP; AUD).

RESULTS

PTSD exerted a potentially causal effect on AUD (β = 0.039, SE = 0.014, p = 0.005), but not on DPW (β = 0.002, SE = 0.003, p = 0.414). Additionally, neither DPW (β = 0.019, SE = 0.041, p = 0.637) nor AUD (β = 8.87 × 10-4 , SE = 0.001, p = 0.441) exerted a causal effect on PTSD.

CONCLUSIONS

These findings are consistent with the self-medication model, in which individuals misuse alcohol to cope with aversive trauma-related symptoms. These findings extend latent analysis and molecular findings of shared and correlated risk between PTSD and alcohol phenotypes. Given the health behaviors associated with these phenotypes, these findings are important in that they suggest groups to prioritize for prevention efforts. Further, they provide a rationale for future preclinical and clinical studies examining the biological mechanisms by which PTSD may impact AUD.