Depressive symptoms and alcohol correlates among Brazilians aged 14 years and older: a cross-sectional study

Substance Abuse Treatment, Prevention, and Policy

José Alexandre S Crippa³  Raul Caetano¹  Marcos Zaleski²  Ilana Pinsky⁴  Jair L F Santos⁵  Ronaldo R Laranjeira⁴  Cassiano L S Coelho⁴ 

[1] Dallas Regional Campus, University of Texas, School of Public Health, 5323 Harry Hines Blvd., TX 75390 Dallas, Texas, USA;Departamento de Clínica Médica, Universidade Federal de Santa Catarina (UFSC), Centro de Ciências da Saúde, Campus Universitário, Trindade, CEP 88040-900 Florianópolis, SC, Brazil;INCT Translational Medicine, Sao Paulo, Brazil;Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), R. Felício Antônio Siqueira, 2068, Higienópolis, CEP 15085-420, São José do Rio Preto, SP, Brazil;Department of Social Medicine of the Ribeirão Preto Medical School, Universidade de São Paulo (FMRP-USP), Av. Dos Bandeirantes, 3900, Monte Alegre, CEP 14049-900 Ribeirão Preto, SP, Brazil

关键词: Comorbidity;    Survey;    Epidemiology;    Alcohol dependence;    Depressive symptoms;   

Others  :  1139671
DOI  :  10.1186/1747-597X-9-29

 received in 2014-01-31, accepted in 2014-07-03,  发布年份 2014

【 摘 要 】

Background

The associations between depressive symptoms and alcohol-related disorders, drinking patterns and other characteristics of alcohol use are important public health issues worldwide. This study aims to study these associations in an upper middle-income country, Brazil, and search for related socio-demographic correlations in men and women.

Methods

A cross-sectional study was conducted between November 2005 and April 2006. The sample of 3,007 participants, selected using a multistage probabilistic sampling method, represents the Brazilian population aged 14 and older. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and alcohol dependence was assessed using the Composite International Diagnostic Interview. Associations assessed using bi-variate analysis were tested using Rao-Scott measures. Gender specific multinomial logistic regression models were developed.

Results

Among the participants with alcohol dependence, 46% had depressive symptoms (17.2% mild/moderate and 28.8% major/severe; p < 0.01); 35.8% (p = 0.08) of those with alcohol abuse and 23.9% (p < 0.01) of those with a binge-drinking pattern also had depressive symptoms. Alcohol abstainers and infrequent drinkers had the highest prevalence of major/severe depressive symptoms, whereas frequent heavy drinkers had the lowest prevalence of major/severe depressive symptoms. In women, alcohol dependence and the presence of one or more problems related to alcohol consumption were associated with higher risks of major/severe depressive symptoms. Among men, alcohol dependence and being ≥45 years old were associated with higher risks of major/severe depressive symptoms.

Conclusions

In Brazil, the prevalence of depressive symptoms is strongly related to alcohol dependence; the strongest association was between major/severe depressive symptoms and alcohol dependence in women. This survey supports the possible association of biopsychosocial distress, alcohol consumption and the prevalence of depressive symptoms in Brazil. Investing in education, social programs, and care for those with alcohol dependence and major/severe depressive symptoms, especially for such women, and the development of alcohol prevention policies may be components of a strategic plan to reduce the prevalence of depression and alcohol problems in Brazil. Such a plan may also promote the socio-economic development of Brazil and other middle-income countries.

【 授权许可】

   
2014 Coelho et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]The Global Burden of Disease: 2004 Update. [http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf webcite]
• [2]Angst J, Gamma A, Gastpar M, Lépine JP, Mendlewicz J, Tylee A: Gender differences in depression: epidemiological findings from the European DEPRES I and II studies. Eur Arch Psychiatry Clin Neurosci 2002, 252:201-209.
• [3]Maier W, Gänsicke M, Gater R, Rezaki M, Tiemens B, Urzúa RF: Gender differences in the prevalence of depression: a survey in primary care. J Affect Disord 1999, 53:241-252.
• [4]Hasin DS, Stinson FS, Ogburn E, Grant BF: Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States — results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 2007, 64:830-842.
• [5]Slopen N, Williams DR, Fitzmaurice GM, Gilman SE: Sex, stressful life events, and adult onset depression and alcohol dependence: are men and women equally vulnerable? Soc Sci Med 2011, 73:615-622.
• [6]Regier D, Farmer M, Rae D, Locke B, Keith S, Judd L, Goodwin F: Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) study. JAMA 1990, 264:2511-2518.
• [7]Marmostein NR: Longitudinal associations between alcohol problems and depressive symptoms: early adolescence through early adulthood. Alcohol Clin Exp Res 2009, 33:49-59.
• [8]Brown SA, Inaba RK, Gillin JC, Schuckit MA, Stewart MA, Irwin MR: Alcoholism and affective disorder: clinical course and depressive symptoms. Am J Psychiatry 1995, 152:45-52.
• [9]Stahl SM: Stahl’s Essential Psychopharmacology. Neuroscientific Basis and Practical Applications. 3rd edition. Cambridge: Cambridge University Press; 2008.
• [10]Fergusson DM, Boden JM, Horwood LJ: Tests of causal links between alcohol abuse or dependence and major depression. Arch Gen Psychiatry 2009, 66:260-266.
• [11]Kuo PH, Gardner CO, Kendler KS, Prescott CA: The temporal relationship of the onsets of alcohol dependence and major depression: using a genetically informative study design. Psychol Med 2006, 36:1153-1162.
• [12]Sullivan LE, Fiellin DA, O'Connor PG: The prevalence and impact of alcohol problems in major depression: a systematic review. Am J Prev Med 2005, 118:330-341.
• [13]Cerdá M, Sagdeo A, Johnson J, Galea S: Genetic and environmental influences on psychiatric comorbidity: a systematic review. J Affect Disord 2010, 126:14-38.
• [14]Schuckit MA, Smith TL, Chacko Y: Evaluation of a depression-related model of alcohol problems in 430 probands from the San Diego prospective study. Drug Alcohol Depend 2006, 82:194-203.
• [15]Rodgers B, Korten AE, Jorm AF, Jacomb PA, Christensen H, Henderseon AS: Non-linear relationships in associations of depression and anxiety with alcohol use. Psychol Med 2000, 30:421-432.
• [16]Graham K, Massak A, Demers A, Rehm J: Does the association between alcohol consumption and depression depend on how they are measured? Alcohol Clin Exp Res 2007, 31:78-88.
• [17]Wang J, Patten SB: A prospective study of sex-specific effects of major depression on alcohol consumption. Can J Psychiatry 2001, 46:422-425.
• [18]Hasin DS, Goodwin RD, Stinson FS, Grant BF: Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry 2005, 62:1097-1106.
• [19]Conner KR, Pinquart M, Gamble SA: Meta-analysis of depression and substance use among individuals with alcohol use disorders. J Subst Abuse Treat 2009, 37:127-137.
• [20]Gilman SE, Abraham HD: A longitudinal study of the order of onset of alcohol dependence and major depression. Drug Alcohol Depend 2001, 63:277-286.
• [21]Pettinati HM, Rukstalis MR, Luck GJ, Volpicelli JR, O’Brien CP: Gender and psychiatric comorbidity: impact on clinical presentation of alcohol dependence. Am J Addict 2000, 9:242-252.
• [22]Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, Pang S, Li X, Zhang Y, Wang Z: Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 2009, 373:2041-2053.
• [23]World Development Indicators 2014. [http://data.worldbank.org/country/brazil webcite]
• [24]Rai D, Zitko P, Jones K, Lynch J, Araya R: Country- and individual-level socioeconomic determinants of depression: multilevel cross-national comparison. Br J Psychiatry 2013, 202:195-203.
• [25]Prado JA, Kerr-Corrêa F, Lima MCP, Aciole GG, Santos JLF: Relations between depression, alcohol and gender in the Metropolitan Region of São Paulo, Brazil. Cien Saude Colet 2012, 17:2425-2434.
• [26]Zinn-Souza LC, Nagai R, Teixeira LR, Latorre MRDO, Roberts R, Cooper SP, Fischer FM: Factors associated with depression symptoms in high school students in São Paulo, Brazil. Rev Saude Publica 2008, 42:34-40.
• [27]Souza LDM, Silva RS, Godoy RV, Cruzeiro ALS, Faria AD, Pinheiro RT, Horta BL, Silva RA: Depressive symptomatology in early adolescents – population-based study. J Bras Psiquiatr 2008, 57:261-266.
• [28]I Levantamento Nacional sobre os Padrões de Consumo de Álcool na População Brasileira (PCBA) 2007. [http://www.obid.senad.gov.br/portais/OBID/biblioteca/documentos/Dados_Estatisticos/populacao_brasileira/Padroes_consumo_alcool_populacao_brasileira/327716.pdf webcite]
• [29]Caetano R, Ramisetty-Mikler S, Rodriguez LA: The Hispanic Americans Baseline Alcohol Survey (HABLAS): the association between birthplace, acculturation and alcohol abuse and dependence across Hispanic national groups. Drug Alcohol Depend 2009, 99:215-221.
• [30]Questionário do I Levantamento Nacional sobre os Padrões de Consumo de Álcool na População Brasileira. [http://www.uniad.org.br/v2/master/imgAlbum/Questionario%20final%20do%20levantamento%20nacional.pdf webcite]
• [31]Cahalan D, Cisin IH: American drinking practices: summary of findings from a national probability sample. Q J Stud Alcohol 1968, 29:130-151.
• [32]Cottler LB, Robins LN, Helzer JE: The reliability of the CIDI-SAM: a comprehensive substance abuse interview. Br J Addict 1989, 84:801-814.
• [33]Radloff L: The CES-D Scale: A self-report depression scale for research in the general population. Appl Psych Meas 1977, 1:385-401.
• [34]Ensel WM: Measuring Depression: The CES-D Scale. New York: Academic Press; 1986.
• [35]Schestatsky G: Desempenho de uma Escala de Rastreamento de Depressão (CES-D) em Usuários de um Serviço de Cuidados Primários de Saúde de Porto Alegre. In Masters Thesis. Porto Alegre: Universidade Federal do Rio Grande do Sul, Departamento de Clínica Médica; 2002.
• [36]Silveira DX, Jorge MR: Propriedades psicométricas da escala de rastreamento populacional para depressão CES-D em população clínica e não-clínica de adolescentes e adultos jovens. Rev Psiq Clin 1998, 25:251-261.
• [37]Salle E: Estudo da Sintomatologia Depressiva em Adolescentes de 15 a 17 Anos de uma Escola de 2º Grau de Porto Alegre Através das Escalas Autoaplicáveis BDI, CRS, e CES-D. In Masters Thesis. Porto Alegre: Universidade Federal do Rio Grande do Sul, Departamento de Clínica Médica; 1999.
• [38]Radloff LS, Locke BZ: The community mental health assessment survey and the CES-D scale. In Community Surveys of Psychiatric Disorders. Edited by Weissman MM, Myers JK, Ross CE. New Brunswick, NJ: Rutgers University Press; 1986:177-189.
• [39]Weissman MM, Sholomskas D, Pottenger M, Prusoff V, Locke B: Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 1977, 106:203-214.
• [40]Censo Demográfico 2000. [http://www.ibge.gov.br/home/estatistica/populacao/censo2000/populacao/censo2000_populacao.pdf webcite]
• [41]StataCorp: Stata Statistical Software: Release 12. College Station, Texas: Statacorp LP; 2011.
• [42]Rao JNK, Scott AJ: On Chi-squared tests for multiway contingency tables with cell proportions estimated from survey data. Ann Statist 1984, 12:46-60.
• [43]Carvalho JAM, Wong LIR: A transição da estrutura etária da população brasileira na primeira metade da século XXI. Cad Saude Publica 2008, 24:597-605.
• [44]Síntese de Indicadores Sociais. Uma Análise das Condições de Vida da População Brasileira. [http://www.ibge.gov.br/home/estatistica/populacao/condicaodevida/indicadoresminimos/sinteseindicsociais2009/indic_sociais2009.pdf webcite]
• [45]Bromet EJ, Gluzman SF, Paniotto VI, Webb CP, Tintle NL, Zakhozha V, Havenaar JM, Gutkovich Z, Kostyuchenko S, Schwartz JE: Epidemiology of psychiatric and alcohol disorders in Ukraine: findings from the Ukraine World Mental Health survey. Soc Psychiatry Psychiatr Epidemiol 2005, 40:681-690.
• [46]Crum RM, Green KM, Storr CL, Chan YF, Ialongo N, Stuart EA, Anthony JC: Depressed mood in childhood and subsequent alcohol use through adolescence and young adulthood. Arch Gen Psychiatry 2008, 65:702-712.
• [47]Caldwell TM, Rodgers B, Jorm AF, Christensen H, Jacomb PA, Korten AE, Lynskey MT: Patterns of association between alcohol consumption and symptoms of depression and anxiety in young adults. Addiction 2002, 97:583-594.
• [48]Cooper LM, Frone MR, Russell M, Mudar P: Drinking to regulate positive and negative emotions: a motivational model of alcohol use. J Pers Soc Psychol 1995, 69:990-1005.
• [49]Manninen L, Poikolainen K, Vartiainen E, Laatikainen T: Heavy drinking occasions and depression. Alcohol Alcohol 2006, 41:293-299.