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Mental and personality disorders and abstinence from alcohol: results from a national household survey

Published online by Cambridge University Press:  21 July 2010

J. C. Skogen
Section of Mental Health Research, Division of Psychiatry, Helse Fonna HF, Norway Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Norway
A. Mykletun
Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Norway Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway
C. P. Ferri
King's College London (Institute of Psychiatry), London, UK
P. Bebbington
Department of Mental Health Sciences, University College London, London, UK
T. Brugha
Department of Health Sciences, University of Leicester, Leicester, UK
J. Coid
Forensic Psychiatry Research Unit, St Bartholomew's Hospital, London, UK
H. Meltzer
Department of Health Sciences, University of Leicester, Leicester, UK
R. Stewart*
King's College London (Institute of Psychiatry), London, UK
*Address for correspondence: R. Stewart, MD, Institute of Psychiatry, Box P060; De Crespigny Park, LondonSE5 8AF, UK. (Email:



The beneficial outcomes associated with moderate compared with low alcohol intake or abstinence may be due to the inclusion of people as ‘low consumers’, who have stopped consumption because of poor health. We investigated the association between alcohol abstinence and symptoms of common mental disorder and personality disorder, distinguishing between lifelong abstinence and abstinence following previous consumption.


Analyses were based on the British National Survey of Psychiatric Morbidity 2000, which sampled 8580 residents aged 16–74 years. Hazardous drinking (Alcohol Use Disorders Identification Test) was excluded. Symptoms of common mental disorder (depression/anxiety) were identified by the Clinical Interview Schedule. The screening questionnaire of the Structured Clinical Interview for Axis II Personality Disorders was used to identify potential personality disorder. Self-reported alcohol abstinence was divided into lifelong abstinence and previous consumption. Previous consumers were asked why they had stopped. Covariates included socio-economic status, social activity and general health status.


After adjustment, alcohol abstinence was associated with both common mental disorder symptoms and any personality disorder, but only for previous consumers, in whom odds ratios were 1.69 (95% CI 1.23–2.32) and 1.45 (95% CI 1.09–1.94). Associations were non-specific, being apparent for most individual mental disorder symptoms and personality disorder categories. More detailed analysis indicated that associations were again limited to previous consumers who reported ceasing alcohol consumption for health reasons.


Worse mental health in low alcohol consumers, particularly those who have previously ceased for health reasons, should be taken into account when interpreting associations between moderate (compared with low) alcohol consumption and beneficial health outcomes.

Original Articles
Copyright © Cambridge University Press 2010

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Alati, R, Kinner, S, Najman, JM, Fowler, G, Watt, K, Green, D (2004). Gender differences in the relationships between alcohol, tobacco and mental health in patients attending an emergency department. Alcohol & Alcoholism 39, 463469.CrossRefGoogle ScholarPubMed
Alati, R, Lawlor, DA, Najman, JM, Williams, GM, Bor, W, O'Callaghan, M (2005). Is there really ‘J-shaped’ curve in the association between alcohol consumption and symptoms of depression and anxiety? Findings from the Mater-University Study of Pregnancy and its outcomes. Addiction 100, 643651.CrossRefGoogle ScholarPubMed
Babor, TF, de la Fuente, JR, Saunders, J, Grant, M (1992). AUDIT The Alcohol Use Disoders Identification Test: Guidelines for use in Primary Health Care. World Health Organization: Geneva.Google Scholar
Brugha, T, Bebbington, P, Tennant, C, Hurry, J (1985). The list of threatening experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychological Medicine 15, 189194.CrossRefGoogle ScholarPubMed
Cargiulo, T (2007). Understanding the health impact of alcohol dependence. American Journal of Health-System Pharmacy 64, S5–S11.CrossRefGoogle ScholarPubMed
Chen, K, Kandel, DB (1995). The natural history of drug use from adolescence to the mid-thirties in a general population sample. American Journal of Public Health 85, 4147.CrossRefGoogle Scholar
Coid, J, Yang, M, Bebbington, P, Moran, P, Brugha, T, Jenkins, R, Farrell, M, Singleton, N, Ullrich, S (2009). Borderline personality disorder: health service use and social functioning among a national household population. Psychological Medicine 10, 17211731.CrossRefGoogle Scholar
Cook, M, Young, A, Talyor, D, Bedford, AP (1998). Personality correlates of alcohol consumption. Personality and Individual Differences 24, 641647.CrossRefGoogle Scholar
Cooper, C, Bebbington, P, Meltzer, H, Jenkins, R, Brugha, T, Lindesay, JEB, Livingston, G (2009). Alcohol in moderation, premorbid intelligence and cognition in older adults: results from the Psychiatric Morbidity Survey. Journal of Neurology, Neurosurgery and Psychiatry 80, 12361239.CrossRefGoogle ScholarPubMed
Cunningham, JA, Blomqvist, J, Koski-Jännes, A, Cordingley, J (2005). Maturing out of drinking problems: perceptions of natural history as a function of severity. Addiction Research and Theory 13, 7984.CrossRefGoogle Scholar
Dawson, DA, Grant, BF, Li, T-K (2005 a). Quantifying the risks associated with exceeding recommmended drinking limits. Alcoholism: Clinical and Experimental Research 29, 902908.CrossRefGoogle Scholar
Dawson, DA, Grant, BF, Stinson, FS, Chou, PS (2005 b). Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug and Alcohol Dependence 77, 139150.CrossRefGoogle ScholarPubMed
El-Guebaly, N (2007). Investigating the association between moderate drinking and mental health. Annals of Epidemiology 17, S55S62.CrossRefGoogle Scholar
First, MB, Gibbon, M, Spitzer, RL, William, JBW, Benjamin, L (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders. American Psychiatric Press: Washington.Google Scholar
Kloner, RA, Rezkalla, SH (2007). To drink or not to drink? That is the question. Circulation 116, 13061317.CrossRefGoogle ScholarPubMed
Knupfer, G (1972). Ex-problem drinkers. In Life History in Psychopathology (ed. Roff, M., Robins, L. and Pollack, H.). University of Minnesota Press: Minneapolis.Google Scholar
Koppes, LLJ, Twisk, JWR, Snel, J, de Vente, W, Kemper, HCG (2001). Personality characteristics and alcohol consumption: longitudinal analyses in men and women followed from ages 13 to 32. Journal of Studies on Alcohol And Drugs 62, 494500.CrossRefGoogle ScholarPubMed
Lewis, G, Pelosi, A (1990). Manual of the Revised Clinical Interview Schedule (CIS-R). Institute of Psychiatry: London.Google Scholar
Lipton, RI (1994). The effect of moderate alcohol use on the relationship between stress and depression. American Journal of Public Health 84, 19131917.CrossRefGoogle ScholarPubMed
Manninen, L, Poikolainen, K, Vartiainen, E, Laatikainen, T (2006). Heavy drinking occasions and depression. Alcohol & Alcoholism 41, 293299.CrossRefGoogle ScholarPubMed
Miller-Tutzauer, C, Leonard, KE, Windle, M (1991). Marriage and alcohol use: a longitudinal study of ‘Maturing out’. Journal of Studies on Alcohol 52, 434440.CrossRefGoogle ScholarPubMed
Moos, RH, Moos, BS, Kulik, JA (1976). College-student abstainers, moderate drinkers, and heavy drinkers: a comparative analysis. Journal of Youth and Adolescence 5, 349360.CrossRefGoogle ScholarPubMed
Moos, RH, Moos, BS, Kulik, JA (1977). Behavioral and self-concept antecedents and correlates of college-student drinking patterns. Substance Use & Misuse 12, 603615.Google Scholar
Moran, P, Stewart, R, Brugha, T, Bebbington, P, Bhugra, D, Jenkins, R, Coid, JW (2007). Personality disorder and cardiovascular disease: results from a National Household Survey. Journal of Clinical Psychiatry 68, 6974.CrossRefGoogle ScholarPubMed
Mortensen, EL, Jensen, HH, Sanders, SA, Reinisch, JM (2006). Associations between volume of alcohol consumption and social status, intelligence, and personality in a sample of young adult Danes. Scandinavian Journal of Psychology 47, 387398.CrossRefGoogle Scholar
Mykletun, A, Bjerkeset, O, Dewey, M, Prince, M, Øverland, S, Stewart, R (2007). Anxiety, depression and cause-specific mortality. The HUNT study. Psychosomatic Medicine 69, 323331.CrossRefGoogle ScholarPubMed
Nelson, HE (1982). National Adult Reading Test. NFER-Nelson: Windsor.Google Scholar
Pape, H, Hammer, T (1996). Sober adolescence – predictor of psychosocial maladjustment in young adulthood? Scandinavian Journal of Psychology 37, 362–277.CrossRefGoogle ScholarPubMed
Power, C, Rodgers, B, Hope, S (1998). U-shaped relation for alcohol consumption and health in early adulthood and implications for mortality. Lancet 352, 877.CrossRefGoogle ScholarPubMed
Rehm, JT, Bondy, SJ, Sempos, CT, Vuong, CV (1997). Alcohol consumption and coronary heart disease morbidity and mortality. American Journal of Epidemiology 146, 495501.CrossRefGoogle ScholarPubMed
Rodgers, B, Korten, AE, Jorm, AF, Christensen, H, Henderson, S, Jacomb, PA (2000 a). Risk factors for depression and anxiety in abstainers, moderate drinkers and heavy drinkers. Addiction 95, 18331845.CrossRefGoogle ScholarPubMed
Rodgers, B, Korten, AE, Jorm, AF, Jacomb, PA, Christensen, H, Henderson, AS (2000 b). Non-linear relationships in associations of depression and anxiety with alcohol use. Psychological Medicine 30, 421432.CrossRefGoogle ScholarPubMed
Room, R, Babor, T, Rehm, J (2005). Alcohol and public health. Lancet 365, 519530.CrossRefGoogle ScholarPubMed
Ruitenberg, A, van Swieten, JC, Witteman, JCM, Mehta, KM, van Duijn, CM, Hofman, A, Breteler, MMB (2002). Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet 359, 281286.CrossRefGoogle ScholarPubMed
Sareen, J, McWilliams, L, Cox, B, Stein, MB (2004). Does a U-shaped relationship exist between alcohol use and DSM-III-R mood and anxiety disorders? Journal of Affective Disorders 82, 113118.CrossRefGoogle ScholarPubMed
Singleton, N, Lee, A, Meltzer, H (2000). Psychiatric Morbidity Among Adults Living in Private Households, 2000. Technical Report. The Stationery Office: London.Google Scholar
Singleton, N, Lewis, G (2003). Better or Worse: A Longitudinal Study of the Mental Health of Adults Living in Private Households in Great Britain. The Stationery Office: London.Google ScholarPubMed
Singleton, N, Meltzer, H, Gatward, R, Coid, J, Deasy, D (1998). Psychiatric Morbidity Among Prisoners in England and Wales. The Stationery Office: London.Google Scholar
Skogen, JC, Harvey, S, Henderson, M, Stordal, E, Mykletun, A (2009). Anxiety and depression among abstainers and low-level alcohol consumers.The Nord-Trøndelag Health Study. Addiction 104, 15191529.CrossRefGoogle Scholar
StataCorp (2009). Statistical Software: Release 10.1. Stata Corporation: College Station, TX.Google Scholar
Ullrich, S, Deasy, D, Smith, J, Johnson, B, Clarke, M, Broughton, N, Coid, J (2008). Detecting personality disorders in the prison population of England and Wales: comparing case identification using the SCID-II screen and the SCID-II clinical interview. Journal of Forensic Psychiatry & Psychology 19, 301322.CrossRefGoogle Scholar