摘要：Objectives. We examined the association between moderate alcohol use and depressive mood among young adults before and after adjustment for demographic, health, and socioeconomic factors that may act as confounders. Methods. We analyzed 2 waves of interview data collected from 13892 young adults who participated in the National Longitudinal Study of Adolescent Health to compare frequency of depressive symptoms in moderate drinkers with frequency of symptoms in young adults in other alcohol use categories. Results. With adjustment for health and socioeconomic factors, frequency of depressive symptoms were similar among moderate drinkers, lifetime and long-term abstainers, and heavy/heavier moderate drinkers but remained significantly higher among heavy drinkers. Conclusions. Moderate alcohol use may have no effect on depression in young adults relative to abstinence from alcohol use. A growing number of population-based studies suggest that moderate alcohol use may have beneficial effects on mental health, including lowering levels of depression and anxiety and raising levels of positive mood, sociability, and subjective health. 1– 3 Moderate alcohol use is defined in Nutrition and Your Health: Dietary Guidelines for Americans as no more than 1 standard drink per day for healthy nonpregnant women and no more than 2 standard drinks per day for healthy men. 4 Almost all population-based studies to date have found a U- or J-shaped relationship between level of alcohol use and depression and other mental health indicators, with the lowest levels of depression observed at moderate drinking levels. 1– 3 Results of previous studies on moderate drinking and depression that controlled for subjects’ previous depression and/or other potential confounders (e.g., previous problem drinking, general health status) have consistently found a lower level of depression among moderate drinkers relative to heavy or problem drinkers. 1– 3 However, findings on differences in depression levels between moderate drinkers and abstainers have been inconsistent, 1– 3 leaving questions about whether moderate drinking is more beneficial than abstinence. These inconsistent findings may have resulted from not separating lifetime abstainers from ex-drinkers. For example, in a study on moderate alcohol use and depressive mood among adults who participated in the Los Angeles Catchment Area Study, Lipton 5 classified individuals as abstainers if they reported no alcohol use in the prior 6 months. This definition may have led to misleading results, because ex-drinkers who were classified as abstainers may have experienced previous drinking and mental health problems that led to their decision to stop drinking. Therefore, depression levels may be higher among ex-drinkers relative to lifetime abstainers and moderate drinkers. In addition, different levels of moderate and heavy drinking have not adequately been considered in the majority of previous studies, raising questions about whether heavier moderate alcohol use (e.g., having up to 3 drinks per occasion) or infrequent heavy drinking (e.g., having up to 5 consecutive drinks no more than once per month) may be as beneficial as monthly, weekly, or daily moderate drinking. In addition to inadequate separation of alcohol use levels, previous studies have not adequately considered a number of potential confounders of the apparent association between moderate drinking and lower risk of depression, such as previous depression and problem drinking, general health status, educational attainment, and employment status. Nor have any previous studies addressed this issue with a nationally representative sample. On the basis of a review of 15 studies, Peele and Brodsky 2 concluded that, in lieu of a randomized controlled study, more population-based epidemiological studies are needed with prospective cohort designs and controls for potential confounders, including demographic, health, and socioeconomic factors, to determine whether moderate drinking may have a beneficial effect on mental health. To help address this research question, our study focused on the relationship between moderate alcohol use and depressive mood in a national sample of young adults who participated in the National Longitudinal Study of Adolescent Health (Add Health).
