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

  • L. Boschloo (a1) (a2), W. van den Brink (a3), B. W. J. H. Penninx (a1) (a2), M. M. Wall (a4) (a5) and D. S. Hasin (a4) (a5) (a6)
  • DOI:
  • Published online: 26 August 2011

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.


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.


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.


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.

Corresponding author
*Address for correspondence: D. S. Hasin, PhD, Columbia University, College of Physicians & Surgeons, 1051 Riverside Drive #123, New York, New York 10032, USA. (Email:
Linked references
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CL Beseler , DS Hasin (2010). Cannabis dimensionality: dependence, abuse and consumption. Addictive Behaviors 35, 961969.

L Burns , M Teesson , K O'Neill (2005). The impact of comorbid anxiety and depression on alcohol treatment outcomes. Addiction 100, 787796.

S Chatterji , JB Saunders , R Vrasti , BF Grant , D Hasin , D Mager (1997). Reliability of the alcohol and drug modules of the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Alcohol/Drug-Revised (AUDADIS-ADR): an international comparison. Drug and Alcohol Dependence 47, 171185.

P Cohen , J Cohen (1984). The clinician's illusion. Archives of General Psychiatry 41, 11781182.

LB Cottler , BF Grant , J Blaine , V Mavreas , C Pull , DS Hasin , WM Compton , M Rubio-Stipec , D Mager (1997). Concordance of DSM-IV alcohol and drug use disorder criteria and diagnoses as measured by AUDADIS-ADR, CIDI and SCAN. Drug and Alcohol Dependence 47, 195205.

DA Dawson , BF Grant (2010). Should symptom frequency be factored into scalar measures of alcohol use disorder severity? Addiction 105, 15681579.

DA Dawson , TD Saha , BF Grant (2010). A multidimensional assessment of the validity and utility of alcohol use disorder severity as determined by item response theory models. Drug and Alcohol Dependence 107, 3138.

R de Graaf , RV Bijl , A Ravelli , F Smit , WAM Vollebergh (2002). Predictors of first incidence of DSM-III-R psychiatric disorders in the general population: findings from the Netherlands Mental Health Survey and Incidence Study. Acta Psychiatrica Scandinavica 106, 303313.

DM Fergusson , JM Boden , LJ Horwood (2009). Tests of causal links between alcohol abuse or dependence and major depression. Archives of General Psychiatry 66, 260266.

BF Grant , DA Dawson , FS Stinson , PS Chou , W Kay , R Pickering (2003). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence 71, 7–16.

BF Grant , RB Goldstein , SP Chou , B Huang , FS Stinson , DA Dawson , TD Saha , SM Smith , AJ Pulay , RP Pickering , WJ Ruan , WM Compton (2009). Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Molecular Psychiatry 14, 10511066.

BF Grant , TC Harford , DA Dawson , PS Chou , RP Pickering (1995). The Alcohol Use Disorder and Associated Disabilities Interview schedule (AUDADIS): reliability of alcohol and drug modules in a general population sample. Drug and Alcohol Dependence 39, 3744.

DS Hasin , CL Beseler (2009). Dimensionality of lifetime alcohol abuse, dependence and binge drinking. Drug and Alcohol Dependence 101, 5361.

DS Hasin , KM Carpenter , S McCloud , M Smith , BF Grant (1997 a). The alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability of alcohol and drug modules in a clinical sample. Drug and Alcohol Dependence 44, 133141.

DS Hasin , RD Goodwin , FS Stinson , BF Grant (2005). Epidemiology of Major Depressive Disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of General Psychiatry 62, 10971106.

DS Hasin , BF Grant (2002). Major depression in 6050 former drinkers. Archives of General Psychiatry 59, 794800.

DS Hasin , S Samet , E Nunes , J Meydan , K Matseoane , R Waxman (2006 b). Diagnosis of comorbid psychiatric disorders in substance users assessed with the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV. American Journal of Psychiatry 163, 689696.

DS Hasin , FS Stinson , E Ogburn , BF Grant (2007). 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. Archives of General Psychiatry 64, 830842.

DS Hasin , R van Rossem , S McCloud , J Endicott (1997 b). Alcohol dependence and abuse diagnoses: validity in community sample heavy drinkers. Alcoholism: Clinical and Experimental Research 21, 213219.

CW Kahler , DR Strong (2006). A Rasch model analysis of DSM-IV alcohol abuse and dependence items in the National Epidemiological Survey on Alcohol and Related Conditions. Alcoholism: Clinical and Experimental Research 30, 11651175.

KS Kendler , AC Heath , MC Neale , RC Kessler , LJ Eaves (1993). Alcoholism and major depression in women: a twin study of the causes of comorbidity. Archives of General Psychiatry 50, 690698.

RC Kessler , RM Crum , LA Warner , CB Nelson , J Schulenberg , JC Anthony (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of General Psychiatry 54, 313321.

MT Lynskey (1998). The comorbidity of alcohol dependence and affective disorders: treatment implications. Drug and Alcohol Dependence 52, 201209.

NR Marmorstein , WG Iacono , SM Malone (2010). Longitudinal associations between depression and substance dependence from adolescence through early adulthood. Drug and Alcohol Dependence 107, 154160.

CS Martin , T Chung , L Kirisci , JW Langenburcher (2006). Item response theory analysis of diagnostic criteria for alcohol and cannabis use disorders in adolescents: implications for DSM-V. Journal of Abnormal Psychology 115, 807814.

CA Prescott , SH Aggen , KS Kendler (2000). Sex-specific genetic influences on the comorbidity of alcoholism and major depression in a population-based sample of US twins. Archives of General Psychiatry 57, 803811.

CB Pull , JB Saunders , V Mavreas , LB Cottler , BF Grant , DS Hasin , J Blaine , D Mager , BT Ustun (1997). Concordance between ICD-10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study. Drug and Alcohol Dependence 47, 207216.

P Rohde , PM Lewinsohn , CW Kahkler , JR Seeley , RA Brown (2001). Natural course of alcohol use disorders from adolescence to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry 40, 8390.

HE Ross (1995). DSM-III-R alcohol abuse and dependence and psychiatric comorbidity in Ontario: results from the Mental Health Supplement to the Ontario Health Survey. Drug and Alcohol Dependence 39, 111128.

D Shmulewitz , K Keyes , C Beseler , E Aharonovic , C Aivadyan , B Spivak , D Hasin (2010). The dimensionality of alcohol use disorders: results from Israel. Drug and Alcohol Dependence 111, 146154.

JD Swendsen , KR Merikangas (2000). The comorbidity of depression and substance use disorders. Clinical Psychological Review 20, 173189.

J Wang , SB Patten (2002). Prospective study of frequent heavy alcohol use and the risk of major depression in the Canadian general population. Depression and Anxiety 15, 4245.

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Psychological Medicine
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