Full length articleBinge drinking and subsequent depressive symptoms in young women in Australia
Introduction
Problematic alcohol use (Bendtsen et al., 2011) and mental health problems (Patel et al., 2007) are major public health issues. In any given year 20% to 25% of adults experience a mental health problem in the United States, England and Australia (Australian Bureau of Statistics, 2008, Kessler and Wang, 2008, National Centre for Social Research, 2009). Problematic alcohol use is a major risk factor for early deaths and disabilities in the world (World Health Organization, 2009) and is estimated as responsible for 4.5% of the global burden of disease (World Health Organization, 2010). Both mental health problems and problematic alcohol consumption are highly prevalent among young people. Specifically, 26% of young adults experience high rates of mental health problems (Australian Bureau of Statistics, 2008) and between 28% and 54% of adolescents and young adults binge drink (five or more drinks on one occasion; Archie et al., 2012, Center for Disease Control and Prevention, 2012, Degenhardt et al., 2013). These issues have wide reaching effects on the families of adolescents and society in general (Archie et al., 2012).
Findings suggest that problematic alcohol use and depressive symptoms frequently co-occur (Bellos et al., 2013, Archie et al., 2012, Theunissen et al., 2011, Timko et al., 2008), although the temporal nature of this relationship is bi-directional, problematic alcohol use can lead to depressive symptoms and depression may lead to problematic alcohol use. The limited longitudinal research that has explored this relationship suggests that binge drinking might increase the risk of subsequent depression (Haynes et al., 2005, Paljarvi et al., 2009, Wang and Patten, 2002). However, the findings have not been consistent, and suggest the effects of alcohol may differ not only by level of binge drinking but also for men and women. While two long-term population studies found no association between depression and at least one binge drinking occasion (Bell and Britton, 2015, Bulloch et al., 2012), a study involving Finnish men and women aged 20–54 found a pattern of binge drinking involving intoxications, hangovers or pass-outs preceded depressive symptoms five years later (Paljarvi et al., 2009). In two waves of the Canadian National Population Health Survey, women who reported binge drinking once a month or more had a higher risk of major depression two years later, but this was not the case for men (Wang and Patten, 2002). Conversely, Haynes et al. (2005) found that while men who had six or more drinks per occasion at least once a month had three times the risk of depression 18 months later, there was no excess risk for female binge drinkers. (Bell and Britton, 2015, Bulloch et al., 2012)
Alcohol use, commonly in the form of binge drinking, often starts during adolescence (Chassin et al., 2002) and increases into the early twenties, but this is not the case for all individuals (Brown et al., 2008). Several studies have identified four or five distinct patterns of binge drinking in early adolescence through to early adulthood (Chassin et al., 2002, Hill et al., 2000, Tucker et al., 2005). Whilst the relationship between problematic alcohol use and poor mental health appears greater in some population subgroups, to date there has been little work examining the effects of different patterns of binge drinking on the mental health of young women. This is an important gap, as not only do young women experience higher rates of mental health problems (Australian Bureau of Statistics, 2008), and binge drink at higher rates than older women (Powers et al., 2015), but the impact of binge drinking may be more problematic at a younger age, given the brain is continuing to develop at this time and alcohol use may impede aspects of this development (Zeigler et al., 2005). Given the dangers and increasing prevalence of binge drinking among young women (Mcpherson et al., 2004), there is need for greater awareness of the potential short and long-term consequences of binge drinking.
This large prospective study of young women examines: 1) any distinct longitudinal trajectories of binge drinking among young women between the ages of 16 and 21; 2) explores the characteristics of women with these binge drinking trajectories; and 3) investigates whether earlier patterns of binge drinking precede depressive symptoms in the short-term and the longer term.
Section snippets
Participants
Recruitment for, and construction of the cohort, has been described in detail elsewhere (Lee et al., 2005). Briefly, women born between 1973 and 1978 completed the first mailed survey of the Australian Longitudinal Study on Women’s Health (ALSWH 1973–78 cohort) in 1996, with a response proportion of 41% (n = 14247). The women were randomly selected from the Medicare (national health insurance) database, which covers all permanent residents of Australia. Women living in rural and remote areas of
Results
Women were included in the analyses if they provided binge drinking data at the 2009 survey (n = 8197). Participants at the 2009 survey were older (47% versus 43%) and more likely to have post-school education (32% versus 26%), and were equally likely to be employed and never married in 1996 than non-respondents. This means that participants still over-represented more educated women but otherwise were broadly representative of the women of the same age in the Census. Participants were less
Summary
This study adds significantly to the evidence base on the impact of binge drinking on the mental health of young women by identifying longitudinal trajectories of binge drinking and the subsequent effects on depressive symptoms in both the short-term and the long-term. Two key findings emerged from this work. Firstly with respect to drinking trajectories, five distinct groups of women were identified: very infrequent bingers, infrequent bingers (binged rarely with some fluctuation to heavier
Role of funding source
The Australian Longitudinal Study on Women’s Health is supported by grants from the Australian Government Department of Health. This work was supported by a grant from the New South Wales Department of Health Drug and Alcohol Council Research Grants Program. The funders had no role in the study design, data collection, analysis and interpretation of the data, preparation of the manuscript or decision to publish this manuscript. JP had full access to all the data and takes responsibility for the
Conflict of interest
No conflict declared.
Contributors
JP and DL conceived and designed the study. JP analysed the data. JP, DL and LD drafted the manuscript. JP, DL, LD and LB provided important intellectual content and contributed to the revision of the manuscript. All authors saw the final manuscript and agreed to submit the manuscript for publication.
Acknowledgements
The Australian Longitudinal Study on Women’s Health is conducted by a team of researchers at the University of Newcastle and the University of Queensland. This work was supported by grants from the Australian Government Department of Health and the NSW Department of Health Drug and Alcohol Council Research Grants Program. We are grateful to the women who participate. The authors gratefully acknowledge the valuable contributions of all staff, students, and colleagues who have been associated
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