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The role of drug and alcohol abuse in recent increases in depression in the US

Published online by Cambridge University Press:  09 July 2009

G. L. Klerman ,
A. C. Leon ,
P. Wickramaratne ,
M. G. Warshaw ,
T. I. Mueller ,
M. M. Weissman  and
H. Akiskal
G. L. Klerman
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
A. C. Leon*
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
P. Wickramaratne
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
M. G. Warshaw
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
T. I. Mueller
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
M. M. Weissman
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
H. Akiskal
Affiliation:
Department of Psychiatry, Cornell University Medical College, Department of Psychiatry and Human Behavior, Brown Universityand Department of Psychiatry, College of Physicians and Surgeons of Columbia Universityand Department of General and Genetic Epidemiology, New York State Psychiatric Institute, New York; and Office of the Director, National Institute of Mental Health, Rockville, MD, USA
*
1Address for correspondence: Dr Andrew C. Leon, Cornell University Medical College, Department of Psychiatry, Box 147, 525 East 68th Street, New York, NY 10021, USA.
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Synopsis

Previous studies have reported an increase in depression among recent birth cohorts. Concurrent with the increase in rates of depression, there have been increases in rates of drug and alcohol abuse and dependence. This study sought to determine if the recent increase in rates of depression could be attributed to co-morbid alcohol and drug abuse. The data derived from two studies: (1) a sample of relatives of probands with affective disorder; and (2) a community survey of the US population. The piecewise exponential statistical model was applied to evaluate the association of gender, age, period and birth cohort with rates of major depressive disorder (MDD) separately for those with, and without, diagnoses of alcohol or drug abuse.

Elevated rates of MDD occurred among those with co-morbid drug and alcohol abuse in both the family and community samples. However, there were also temporal increases in rates of MDD in those with no such co-morbidity. Specifically there were effects of age and gender for both studies; in addition, there was a period effect in the family study and a birth cohort effect in the community sample. The recent increases in depression in the US cannot be accounted for solely by concurrent increases in co-morbid drug and alcohol abuse. Temporal (period and cohort) effects on rates of depression occur in addition to the contribution of co-morbid drug and alcohol abuse or dependence.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 2 , March 1996 , pp. 343 - 351
Copyright
Copyright © Cambridge University Press 1996

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