Background: Alcohol use-related problems and depressive symptoms are clearly associated with each other, but results regarding the nature of this association have been inconsistent. In addition, the possible moderating effects of age and gender have not been comprehensively examined. The goals of this study were to clarify: (i) how depressive symptoms affect the levels and trajectory of alcohol use-related problems, (ii) how alcohol use-related problems affect the levels and trajectory of depressive symptoms, and (iii) whether there are differences in these associations at different points in development or between males and females.
Methods: Participants for this study were drawn from the National Longitudinal Study of Adolescent Health (AddHealth) data set, a community-based sample of 20,728 adolescents followed from adolescence through early adulthood. Multilevel models were used to assess how each problem affected the level and rate of change in the other problem over time; gender was considered as a possible moderator of these associations.
Results: The results indicated that alcohol use-related problems and depressive symptoms had reciprocal, positive associations with each other during the period from early adolescence through early adulthood; however, these effects differed somewhat by gender and age. High levels of depressive symptoms were associated with higher initial levels of alcohol problems (particularly among females), as well as faster increases in alcohol problems over time among males. High levels of alcohol problems were associated with higher initial levels of depressive symptoms (particularly among females), as well as less curvature in the slope of depressive symptoms so that although there was a large difference between people with high and low depressive symptoms in early adolescence, by early adulthood the difference was smaller (particularly among females).
Conclusions: These results highlight the importance of examining gender and age in studies on the associations between affective disorders and substance use disorders.