Socially accepted alcohol use among women may be associated with major depressive disorder

Toronto, Ont. – Alcohol use among women is associated with major depressive disorder, an illness associated with biochemical imbalances of neurotransmitters in the brain, even at levels consistent with publicly sanctioned low-risk drinking guidelines.

The findings were drawn from a community-based telephone survey during September and October 2004 of 496 subjects (201 men and 295 women) that involved a validated diagnostic interview for depression and a validated alcohol questionnaire. Of the group, 39 men and 81 women were considered to have major depressive disorder. The sample was divided into three groups, based on alcohol consumption: minimal, or less than one alcoholic beverage a week; moderate, or up to 9 and 14 alcoholic beverages per week for women and men respectively; and heavy, defined as exceeding recommended weekly maximums of 9 drinks for women and 14 drinks for men.

Among men, there was no association between drinking group and major depressive disorder prevalence or suicidality (suicidal thinking or behavior). However, among women, the prevalence of depression increased progressively across drinking groups. The lifetime prevalence of depression among the minimal alcohol consumption group was 24.6 per cent; increasing to 30.3 per cent for the moderate group and 44 per cent for the heavy consumption group.

Moreover, the incidence of suicidality was significantly different for women across drinking groups. The rate of suicidal thinking or behavior was 16.3 per cent for women in the minimal alcohol consumption groups; 29.6 per cent for those in the moderate consumption group and 45.4 per cent for those in the heavy consumption group.

“Most previous studies have focused on alcohol abuse or dependence,” says Dr. Benjamin Goldstein, principal investigator of the study and psychiatrist at Sunnybrook Health Sciences Centre. “Given that most people with depression drink minimally or moderately, these findings may have clinical and public health implications.”

Dr. Goldstein, who is also a Population Health Fellow in the Department of Psychiatry at University of Toronto, notes that the study does have limitations. Men were underrepresented in the sample and the participation rate was lower than hoped. “What’s needed are additional studies that evaluate long-term alcohol consumption patterns. And although we know that moderate alcohol use may predispose individuals to major depressive disorder, the direction of causality is uncertain.”

The study is published in the September/October 2006 issue of Comprehensive Psychiatry.