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Alcohol consumption and internalising disorders in young adults of ALSPAC: a population-based study
  1. Gwen Sascha Fernandes1,
  2. Gemma Lewis2,
  3. Gemma Hammerton1,
  4. Kushala Abeysekera1,
  5. Liam Mahedy1,
  6. Alexis Edwards3,
  7. Glyn Lewis2,
  8. Matthew Hickman4,
  9. Jonathan Heron4
  1. 1 Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
  2. 2 UCL Division of Psychiatry, London, UK
  3. 3 Virginia Institute for Psychiatric and Behavior Genetics, Richmond, Virginia, USA
  4. 4 School of Social and Community Medicine, University of Bristol, Bristol, UK
  1. Correspondence to Gwen Sascha Fernandes, Population Health Sciences, Barley House, Oakfield Grove, Bristol BS8 2BN, UK; gwen.fernandes{at}


Introduction Depression and harmful alcohol consumption contribute significantly to the global health burden, but in young adults, this relationship is under-researched and conflicted. The aim of this study was to determine the sex-based prevalence and the association between internalising disorders such as depression and alcohol use disorders.

Method Using the Avon Longitudinal Study of Parents and Children, we assessed the sex-specific prevalence of International Classification of Diseases,Tenth Revision diagnosed generalised anxiety disorder (GAD), depression and fear-based anxieties (FBA) at 24 years (n=3572). We examined the association between internalising disorders and alcohol consumption using the Alcohol Use Disorder Identification Test for Consumption 5+ threshold and Diagnostic and Statistical Manual on Mental Disorders defined criteria for alcohol dependence.

Results Women reported more GAD (11.6% vs 6.5%), depression (13.4% vs 6.9%) and FBA (1.3% vs 0.5%) than men (p<0.001). Harmful drinking, after adjustment for sex and socioeconomic status, was associated with a higher prevalence of depression (OR 1.8, 95% CI 1.3 to 2.4, p<0.001), anxiety (OR 1.4, 95% CI 1.0 to 2.0, p<0.001) and FBA (OR 2.4, 95% CI 1.04 to 5.56, p=0.009) compared with lower-risk drinkers. In contrast, hazardous drinking was associated with a lower prevalence of GAD (OR 0.69, 95% CI 0.54 to 0.88) and depression (OR 0.68, 95% CI 0.54 to 0.86) compared with lower-risk drinkers.

Conclusions Young adults in the UK who drink harmfully are more likely to have depression and other internalising disorders. Further research should test whether there is a J-shaped relationship between alcohol consumption and mental health in young people and whether this varies across the life course.

  • Depression
  • alcohol
  • addictive behaviour/addiction
  • epidemiology

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  • Contributors GH, JH and MH were responsible for the initial study design. GSF performed the statistical analysis and GSF wrote the initial draft of the manuscript. GH and KA corroborated the analysis. JH, LM, AE, Gemma Lewis, GL and MH contributed to and approved the final manuscript.

  • Funding This research was specifically funded by the UK Medical Research Council and Alcohol Research UK Grant (MR/L022206/1). The UK Medical Research Council and Wellcome Trust (Grant Ref: 092731) and the University of Bristol provide core support for ALSPAC. We also acknowledge support from The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UKCRC Public Health Research Centre of Excellence (joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration), the NIHR School of Public Health Research, NIHR Health Protection Research Unit in Evaluation and NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. LM is supported by the Elizabeth Blackwell Institute for Health Research, University of Bristol and the Wellcome Trust Institutional Strategic Support Fund (204813/Z/16/Z). GH is supported by a Sir Henry Wellcome Postdoctoral Fellowship (209138/Z/17/Z).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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