Abstract
Alcohol use disorder (AUD) and alcohol misuse are common among adolescents and young adults and are associated with significant personal and societal problems. Similarly, major depressive disorder (MDD) and depressive symptoms are prevalent in this population and when they co-occur with alcohol misuse leads to even more severe consequences. Numerous studies have investigated the association between depressive symptoms, AUD, and various drinking behaviors presenting an unclear picture. In this review, we summarize studies among adolescents and young adults that have examined these relationships. From this review, it emerges that several factors affect results, including study design (cross-sectional vs longitudinal), participants’ age (adolescents vs young adults), severity of problems considered (AUD vs heavy drinking; MDD vs depressive symptoms), and gender. Adolescents with AUD are at higher risk for MDD in particular at a younger age. During adolescence, several drinking behaviors, including weekly alcohol use and heavy drinking, increase the risk for depressive symptoms and MDD, while during young adulthood primarily AUD, but not other drinking behaviors, is associated with increased risk for MDD. Gender may have an effect on the association between depression and drinking behaviors but its role is still unclear. Some evidence suggests that the association between AUD and MDD is bidirectional such that mood problems contribute to the onset of alcohol problems and vice versa. More longitudinal studies are needed to examine these associations in young adults and to clarify the effect of gender on these associations. To date, findings suggest the critical need to reduce any alcohol use at a young age and to treat both depressive symptoms and AUD to prevent the occurrence of comorbid disorders.
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Introduction
Most mental health disorders have their onset during young adulthood [1] (Pedrelli et al. 2015). It has been reported that two thirds of individuals who will experience a mental health disorder experience their first onset by age 25 [2]. Two of the most common conditions present among adolescents and young adults are problematic alcohol use and depressive symptoms.
Problematic alcohol use increases progressively during adolescence and young adulthood [3]. In 2014, 2.7 % of 12–17-year-old adolescents and 12.3 % of young adults 18–25 years old met criteria for an alcohol use disorder (AUD) in the previous year [3]. Heavy episodic drinking has been defined as consuming four standard drinks for women and five for men [4], and “binge drinking” constitutes this level of consumption within a 2-h period [5]. In 2014, 6.1 % of adolescents 12 to 17 years old and approximately 37 % of young adults 18–25 years old engaged in past month heavy episodic drinking [3]. Heavy alcohol consumption in youth is associated with severe problems including suicide, motor vehicle accidents, accidental injuries, sexual-transmitted diseases, sexual assaults, as well as impairments in prefrontal cortex functions such as memory and attention [6–9]. Furthermore, many adolescents and young adults who are heavy drinkers continue to exhibit alcohol-related problems in adulthood [10, 11] and later develop an AUD [12]. Underage drinking costs $27 billion per year, and a significant portion of these costs are due to lost productivity, youth violence (suicide, homicide, aggravated assault), and premature death [13].
Major depressive disorder (MDD) is a common, recurrent, and debilitating disorder that impacts individuals and society as a whole [14–16]. MDD is the fourth leading cause of disability and premature death worldwide [17] and leads to greater impairment and work functioning than any other individual chronic medical conditions [18]. The 1-year prevalence rates of depression are relatively low in childhood but dramatically surge, as much as sixfold, from early to late adolescence [16, 19]. Over half of all cases of depression have a first onset during childhood, adolescence, or young adulthood [20]. In 2014, approximately 11.7 % of adolescents between 12 and 17 years old and approximately 10 % of young adults between 18 and 25 years old had a major depressive episode in the previous year [3]. Moreover, approximately 30 % of young adults report that at least once in the previous year they felt so sad that they were unable to function [21]. Adolescence is a developmental period with a number of important transitions including puberty, shifting parental and peer support, dating, self-identity, and cognitive maturation [22]. Similarly, young adulthood represents a critical period of role transition and adjustment that is characterized by a new level of independence and increased pressures and responsibilities [23]. The increase in stressful life [24] events may contribute to the high onset of MDD in youth [25, 26].
Given the high prevalence of mood disturbances and alcohol use during adolescence (12–17) and young adulthood (18–25), these conditions often co-occur in this population and it has been hypothesized that they may be associated [27]. While numerous studies have been conducted in this area, the nature of their association is still unclear. Here, we will briefly summarize findings on the relationship between mood and drinking behaviors among adolescents and young adults, and we will differentiate the types of condition examined as it may have an effect on outcome (i.e., MDD vs depressive symptoms, AUD vs heavy drinking) and the design used (longitudinal vs cross-sectional). Gender may also have an effect on the relationship between mood and drinking behaviors. Higher numbers of adolescent and young adult men meet criteria for AUD, and engage in heavy drinking [28, 29]. Furthermore, women and men metabolize alcohol differently, which may influence the degree of intoxication (e.g., blood alcohol content) resulting from consuming the same amount of alcohol [30]. However, more women experience depressive symptoms than men [27, 31]. By age 14, girls experience depression at two and three times the rate of boys [32]. Thus, we will also summarize studies that examined the effect of gender on the association between mood and drinking behaviors.
Depression and Drinking Behaviors
Prospective Studies of Alcohol or AUD Predicting MDD or Depressive Symptoms
One longitudinal study that focused only on the adolescent years found that higher frequency of alcohol use during early adolescence was associated with MDD during late adolescence [33]. Several studies including assessments from adolescence until young adulthood have consistently shown that AUD and subthreshold AUD during adolescence predicts MDD during adolescence and during early adulthood [34•, 35, 36, 37•]. Specifically, adolescents with AUD are twice as likely as those with sub-threshold AUD and non-problematic alcohol use to have a mood disorder during young adulthood. Adolescents with subthreshold AUD are 1.5 more likely to have a mood disorder than those with non-problematic alcohol use [37•]. Moreover, adolescents with subthreshold AUD are also at higher risk for subthreshold MDD during young adulthood [37•].
There is minimal support for an increased risk for MDD in the presence of heavy drinking. One longitudinal study spanning from adolescence to young adulthood found heavy drinking at age 16 to predict the presence of MDD during young adulthood [38]. However, the size of the association was small, and heavy drinking at 18 did not predict MDD during young adulthood. Similarly, another longitudinal study did not find that a heavy drinking trajectory from adolescence to young adulthood predicted MDD during young adulthood [39]. Thus, further studies are needed to evaluate the increased risk for MDD among heavy drinking adolescents.
A recent meta-analysis [40•] summarized most of the longitudinal studies examining the effect of alcohol use and of the frequency of alcohol use on depressive symptoms and MDD during adolescence and young adulthood. A small but significant mean effect size was found for the association between more frequent alcohol use and higher levels of depression. High heterogeneity among studies and greater mean effect size for senior adolescents (16–18 years) relative to junior adolescents (12–15 years) were also found. Higher alcohol consumption was also associated with higher levels of depression with a small but significant mean effect size. Consistently, another study that was not included in the meta-analyses found a small effect size for an increased risk for depressive symptoms during adolescence and young adulthood among those who consumed alcohol during adolescence [41]. Thus, higher alcohol consumption and alcohol frequency increase the risk for the occurrence of depression, although the increased risk may be small in magnitude. Moreover, heterogeneity among studies suggests the existence of moderators including age.
Prospective Studies of MDD or Depressive Symptoms Predicting AUD or Drinking
While limited information is available about the risk for developing AUD among adolescents with MDD, several longitudinal studies following participants from childhood or adolescence to young adulthood have examined depressive symptoms and a number of drinking behaviors. One prospective study found that childhood depression did not predict earlier development of alcohol abuse during young adulthood and that depression during adolescence was not associated with later alcohol use during young adulthood [42]. Conversely, several longitudinal studies show that depressed mood during childhood and adolescence is associated with a number of drinking behaviors. For example, depressive symptoms during adolescence are prospectively associated with higher and more frequent alcohol use during adolescence [41, 43, 44] and with hazardous alcohol use during young adulthood [34•]. Moreover, children and adolescents with worse depressive symptoms are at higher risk to report alcohol intoxication during adolescence and have a twofold increase in risk of alcohol dependence in young adulthood [42]. Thus, depressive symptoms during childhood or adolescence increase the risk for alcohol dependence and for earlier onset of alcohol use and higher alcohol consumptions.
Cross-Sectional Studies on MDD, Depressive Symptoms, AUD, and Drinking During Adolescence
Several cross-sectional studies have examined the associations among MDD, depressive symptoms, AUD, and drinking during adolescence. One study found that in adolescents, MDD and AUD are correlated [35] and a number of studies suggest an association between depressive symptoms and drinking behaviors including higher alcohol consumption and higher frequency of alcohol use and binge drinking [45–47]. Some of these studies have found differences across genders that we will illustrate in a later section.
Cross-Sectional Studies on MDD, Depressive Symptoms, AUD, and Drinking During Young Adulthood
Cross-sectional studies examining MDD and AUD among young adults present mixed findings. One study found a correlation between MDD and AUD among young adults [35]. Similarly, another study found an association between past year MDD and AUD in young adults not attending college but not among those in college [48]. However, one study based on a large national sample did not find a cross-sectional association between past month MDD and AUD during young adulthood [49]. The mixed findings may be due to the fact that the three studies varied in sample size, participants’ characteristics (college students vs general population), and age considered (different ages during young adulthood).
The association between MDD and heavy drinking among young adults needs to be further examined. A study on college students found that MDD was associated with less frequent heavy drinking and that the effect was driven by males, as they found that the risk for heavy drinking among those with MDD was significantly lower for males compared to females [50]. However, the study included both graduate and undergraduate students, and while most people in college are young adults, it is not known whether participants were all young adults and the inclusion of graduate students who tend to drink heavily less may have affected the results.
Cross-sectional studies among young adults that have examined the association between depressive symptoms and drinking behaviors not classified as AUD have included primarily college students and present a complex picture. In this population, depressive symptoms have been found to be associated with ever engaging in binge drinking [51], problematic alcohol use [52], and higher daily alcohol use in male but not in female young adults [53]. Conversely, associations have not been found between depressive symptoms and past month drinking days [54], drinks per month [55], weekly drinks [56], and frequent binge drinking [54, 57]. The studies with positive results have tended to include large sample sizes [50, 52], while those with negative results had small sample sizes [54–56]. Positive studies have found associations of small magnitude between depressive symptoms and drinking behaviors, and, thus, studies with small samples may not have the power to identify them. Moreover, the effect of gender was not systematically examined which may have contribute to the mixed findings.
Inconsistent findings may be also due to the fact that as adolescents enter young adulthood, a stage where alcohol use is highly prevalent, they may consume alcohol for reasons other than negative mood. Thus, the contribution of mood on drinking may become smaller, in particular with regard to drinking behaviors such as daily alcohol use and binge drinking. Consistently, the association between mood and drinking behaviors in youth changes over time. Several studies have observed that while depressive symptoms effects alcohol use and frequency during adolescence, its effect lessens over time [44, 58].
Gender and the Relationship Between MDD, Depressive Symptoms, AUD, and Drinking
Inconsistent gender differences in the relationship between depressive symptoms and drinking behaviors have been reported. For example, a number of studies found stronger associations between drinking behaviors in females relative to males and that depression predicted alcohol use even when controlling for other variables in females but not in males. A longitudinal study found that the association between depression during early adolescence and hazardous alcohol use (i.e., higher scores on the Alcohol Use Disorders Identification Test [59]) during young adulthood [34•] was stronger in females than in males and that in males, the association was reduced substantially in a multivariate analysis including conduct disorders and cannabis use [34•]. A large cross-sectional study found that depression was more prevalent among adolescents with high alcohol consumption than among those with no alcohol use [46]. However, in a multivariate analyses including substance use, the association between high alcohol use and depression continued to be present in females but not in males. In a longitudinal study, worse depressive symptoms during adolescence were associated with later higher frequency of alcohol use among female but not male adolescents. However, the latter study did not include variables on substance use in the analyses. Conversely, one prospective study showed that the association between depressed mood during early adolescence and higher alcohol use during late adolescence was stronger in boys than girls [41], and a cross-sectional study found that depressive symptoms were associated with higher daily alcohol use in male but not in female young adults in college [53]. However, these latter two studies did not examine substance use.
Gender differences in the associations between depressive symptoms and drinking behaviors may be due to differences among studies in participants’ age, instruments used to assess depression and alcohol use, sample size, and study design (cross-sectional vs longitudinal; inclusion in the analyses of substance use or conduct disorders). Preliminary information suggests that in male youths, co-occurring substance use may influence the association between drinking behaviors and depression. However, given that the co-occurrence among alcohol use and substance use is more prevalent in male than female youth [60] and that depression is less prevalent in men than women [27, 31], future studies should further clarify these associations.
Direction of the Association Between AUD and MDD
Most studies have examined whether depressive symptoms predict alcohol problems or vice versa, but it is also critical to determine which condition is most likely to occur first and whether the association between these problems is bidirectional. One longitudinal study with data spanning from adolescence to young adulthood compared three models: one where MDD led to AUD, one where AUD led to MDD, and one including a bidirectional relationship between the two disorders. Results showed that the best fitting model was one in which there was a unidirectional association between AUD to MDD but not a reverse effect from MDD to AUD [61]. Another study examined the prospective associations between MDD and AUD from adolescence to young adulthood and found that the presence of AUD during adolescence predicted early adulthood MDD, and early adulthood MDD predicted adult AUD suggesting a bidirectional influence [34•]. Moreover, they examined temporal ordering of MDD and AUD in individuals with cumulative comorbidity by age 30 and noted that MDD occurred before AUD in 57 % of individuals; AUD occurred first in 41 % of cases, suggesting that MDD tends to occur before AUD. A third study examined retrospectively correlates of MDD among 424 college students and noted that in their sample, alcohol abuse developed subsequent to the onset of MDD [62]. Finally, a prospective study of depressive symptoms and heavy episodic drinking over 4 weeks documented that depressive symptoms increased the risk for heavy episodic drinking, but heavy episodic drinking did not predict depressive symptoms [63]. In aggregate, these findings suggest an association between MDD and AUD and that in many cases, MDD precedes AUD.
Conclusion
Together, these findings suggest the presence, among adolescents and young adults, of a relationship between alcohol use and depression that depends on various factors including severity of the problems examined (AUD, alcohol consumption, heavy drinking, MDD, depressive symptoms) and participants’ developmental phase (adolescence vs young adulthood) and gender. Among adolescents with AUD, there is a strong support for a higher risk for developing MDD during adolescence or young adulthood. Similarly, alcohol use and alcohol frequency increases the risk for MDD and depressive symptoms prospectively, although the effect sizes are small. Less clear is whether adolescents with MDD are at higher risk to develop AUD during young adulthood. Moreover, among young adults with AUD, the risk for a co-occurring MDD may be higher among those not in college than among those in college. Similarly, heavy drinking may not increase the risk for MDD among young adults. Mixed findings on the effect of gender on the association between depressive symptoms and drinking behaviors underline the importance to continue to examine gender differences.
The direction of the association between mood and alcohol problems is unclear. It has not been determined if in adolescence and young adulthood mood disorders lead to AUD, if AUD leads to mood disorders, or if the two conditions have a bi-directional association. Current knowledge suggests that all three scenarios may be true. The presence of a bidirectional association where both MDD and AUD may trigger a cycle of co-occurring problems is concerning. While it has been found retrospectively that MDD is reported to occur prior to an AUD episode, there is limited longitudinal support for MDD increasing the risk for the onset of AUD.
The association between MDD and AUD may be explained by both environmental and biological causes. The presence of AUD or drinking in general at an early age may lead to environmental stressors (i.e., poor academic performance, poor relationship with parents, and legal problems) [64, 65], which in turn may lead to MDD. Moreover, AUD and drinking may lead to biological changes that may lead to increased vulnerability to MDD [66]. Adolescents may be vulnerable to developing mood disorders when they engage in a variety of drinking behaviors, even without an AUD, both because their brain is still developing [67] and because of a higher risk for environmental stressors associated with consuming alcohol at a young age. Alcohol use may have a stronger effect on the brain of adolescents [67–69] than on that of adults, thus increasing the risk for mood problems. As such, evidence is accumulating that heavy drinking during youth has a negative effect on the brain [70]. Alternatively, the presence of MDD following AUD or of depressive symptoms and alcohol could be explained by drinking to cope with negative mood or “self-medication” [71].
An important developmental finding to highlight is that the association between mood and drinking behaviors changes over time. As such, different patterns of findings were found among adolescents and young adults. Longitudinal studies ought to further examine the association between mood and alcohol at different developmental stages and consider the effect of gender on these associations. This brief summary suggests that AUD and any alcohol use may put this population at higher risk for developing mood problems. Thus, prevention programs should address and reduce any alcohol involvement among adolescents. Moreover, prevention programs ought to carefully screen adolescents and young adults to identify mood problems that should be treated promptly.
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry. 2015;39(5):503–11.
Kessler RC et al. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359–64.
Center for Behavioral Health Statistics and Quality. Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15–4927, NSDUH Series H-50). 2015. Retrieved from http://www.samhsa.gov/data/.
Wechsler H, Davenport A, Dowdall G, Moeykens B, Castillo S. Health and behavioral consequences of binge drinking in college: a national survey of students at 140 campuses. J Am Med Assoc. 1994;272:1672–7.
Alcoholism, N.I.o.A.A.a., Moderate & binge drinking, 2013.
Glasheen C, Pemberton MR, Lipari R, Copello EA, Mattson ME. Binge drinking and the risk of suicidal thoughts, plans, and attempts. Addict Behav. 2015;43:42–9.
Baliunas D, Rehm J, Irving H, Shuper P. Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis. Int J Public Health. 2010;55(3):159–66.
Marlatt GA et al. Screening and brief intervention for high-risk college student drinkers: results from a 2-year follow-up assessment. J Consult Clin Psychol. 1998;66(4):604–15.
Hingson RW, Edwards EM, Heeren T, Rosenbloom D. Age of drinking onset and injuries, motor vehicle crashes, and physical fights after drinking and when not drinking. Alcohol Clin Exp Res. 2009;33(5):783–90.
Jackson KM et al. Transitioning into and out of large-effect drinking in young adulthood. J Abnorm Psychol. 2001;110(3):378–91.
Johnston LD. Monitoring the future national results on adolescent drug use-overview of key findings 2006, vol. 2006. Bethesda: National Institute on Drug Abuse; 2007. NIH Publication No 07–6202.
Jennison KM. The short-term effects and unintended long-term consequences of binge drinking in college: a 10-year follow-up study. Am J Drug Alcohol Abuse. 2004;30(3):659–84.
Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the U.S., 2006. Am J Prev Med. 2011;41(5):516–24.
Cassano P, Fava M. Depression and public health: an overview. J Psychosom Res. 2002;52:849–57.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.
Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the national comorbidity survey replication (NCS-R). J Am Med Assoc. 2003;289:3095–105.
Murray CJL, Lopez AD, editors. The global burden of disease. A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge: Harvard University Presss; 1996.
Druss BG, Rosenheck RA, Sledge WH. Health and disability costs of depressive illness in a major U.S. corporation. Am J Psychiatry. 2000;157:1274–8.
Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE. Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol. 1998;107:128–40.
Zisook S et al. Effect of age at onset on the course of major depressive disorder. Am J Psychiatry. 2007;164(10):1539–46.
American College Health Association. American College Health Association-National College Health Assessment II: reference group executive summary fall 2011. Hanover: American College Health Association; 2012.
Steinberg L, Morris AS. Adolescent development. Annu Rev Psychol. 2001;52:83–110.
Arnett JJ, Ramos KD, Jensen LA. Ideologies in emerging adulthood: balancing the ethics of autonomy and community. J Adult Dev. 2001;8:69–79.
Ge X, Lorenz FO, Conger RD, Elder Jr GH, Simons RL. Trajectory of stressful life events and depressive symptoms during adolescence. Dev Psychol. 1994;30:467–83.
Mazure CM. Life stressors as risk factors in depression. Clin Psychol Sci Pract. 1998;5:291–313.
Abela JRZ, Skitch SA. Dysfunctional attitudes, self-esteem, and hassles: cognitive vulnerability to depression in children of affectively ill parents. Behav Res Ther. 2006;45:1127–40.
Cooper ML, Frone MR, Russell M, Mudar P. Drinking to regulate positive and negative emotions: a motivational model of alcohol use. J Pers Soc Psychol. 1995;69(5):990–1005.
Harford TC, Yi HY, Hilton ME. Alcohol abuse and dependence in college and noncollege samples: a ten-year prospective follow-up in a national survey. J Stud Alcohol Drugs. 2006;67(6):803–9.
White HR, Xie M, Thompson W, Loeber R, Stouthamer-Loeber M. Psychopathology as a predictor of adolescent drug use trajectories. Psychol Addict Behav. 2001;15(3):210–8.
Thomasson HR. Gender differences in alcohol metabolism. Recent Dev Alcohol. 1995;12:163–79.
Weitzman ER. Poor mental health, depression, and associations with alcohol consumption, harm, and abuse in a national sample of young adults in college. J Nerv Ment Dis. 2004;192(4):269–77.
Wade TJ, Cairney J, Pevalin DJ. Emergence of gender differences in depression during adolescence: national panel results from three countries. J Am Acad Child Adolesc Psychiatry. 2002;41(2):190–8.
Edwards A, Heron J, Dick D, Hickman M, Lewis G, Macleod J, et al. Adolescent alcohol use is positively associated with later depression in a population-based U.K. Cohort. J Stud Alcohol Drugs. 2014;75(5):758–65.
Edwards AC, Joinson C, Dick DM, Kendler KS, Macleod J, Munafò M, et al. The association between depressive symptoms from early to late adolescence and later use and harmful use of alcohol. Eur Child Adolesc Psychiatry. 2014;23(12):1219–30. Longitudinal study on direction of the association between MDD and AUD.
Brière F, Rohde P, Seeley J, Klein D, Lewinsohn P. Comorbidity between major depression and alcohol use disorder from adolescence to adulthood. Compr Psychiatry. 2014;55(3):526–33.
Rohde P, Lewinsohn PM, Kahler CW, Seeley JR, Brown RA. Natural course of alcohol use disorders from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry. 2001;40(1):83–90.
Fergusson D, Boden J, Horwood L. Alcohol misuse and psychosocial outcomes in young adulthood: results from a longitudinal birth cohort studied to age 30. Drug Alcohol Depend. 2013;133(2):513–9. Longitudinal study outlining an association between alcohol misuse and MDD in youth.
Mason W, Kosterman R, Haggerty K, Hawkins J, Redmond C, Spoth R, et al. Dimensions of adolescent alcohol involvement as predictors of young-adult major depression. J Stud Alcohol Drugs. 2008;69(2):275–85.
Hill K, White H, Chung I, Hawkins J, Catalano R. Early adult outcomes of adolescent binge drinking: person- and variable-centered analyses of binge drinking trajectories. Alcohol Clin Exp Res. 2000;24(6):892–901.
Cairns KE, Yap MB, Pilkington PD, Jorm AF. Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies. J Affect Disord. 2014;169:61–75. Meta-analyses including information on the association between alcohol use and depressive symptoms.
Repetto P, Zimmerman M, Caldwell C. A longitudinal study of the relationship between depressive symptoms and alcohol use in a sample of inner-city black youth. J Stud Alcohol. 2004;65(2):169–78.
Crum R, Green K, Storr C, Chan Y, Ialongo N, Stuart E, et al. Depressed mood in childhood and subsequent alcohol use through adolescence and young adulthood. Arch Gen Psychiatry. 2008;65(6):702.
Owens T, Shippee N, Hensel D. Emotional distress, drinking, and academic achievement across the adolescent life course. J Youth Adolesc. 2008;37(10):1242–56.
White AM, Kraus CL, Swartzwelder HS. Many college freshmen drink at levels far beyond the binge threshold. Alcohol Clin Exp Res. 2006;30(6):1006–10.
Fleming C, Mason W, Mazza J, Abbott R, Catalano R. Latent growth modeling of the relationship between depressive symptoms and substance use during adolescence. Psychol Addict Behav. 2008;22(2):186–97.
Poulin C, Hand D, Boudreau B, Santor D. Gender differences in the association between substance use and elevated depressive symptoms in a general adolescent population. Addiction. 2005;100(4):525–35.
Schwinn T, Schinke S, Trent D. Substance use among late adolescent urban youths: mental health and gender influences. Addict Behav. 2010;35(1):30–4.
Dawson D, Grant B, Stinson F, Chou P. Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug Alcohol Depend. 2005;77(2):139–50.
McCarty CA, Kosterman R, Mason WA, McCauley E, Hawkins JD, Herrenkohl TI, et al. Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood. Gen Hosp Psychiatry. 2009;31(5):442–50.
Cranford J, Eisenberg D, Serras A. Substance use behaviors, mental health problems, and use of mental health services in a probability sample of college students. Addict Behav. 2009;34(2):134–45.
Valentiner D, Mounts N, Deacon B. Panic attacks, depression and anxiety symptoms, and substance use behaviors during late adolescence. J Anxiety Disord. 2004;18(5):573–85.
Dvorak R, Lamis D, Malone P. Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students. J Affect Disord. 2013;149(1–3):326–34.
Pedrelli P, Farabaugh A, Zisook S, Tucker D, Rooney K, Katz J, et al. Gender, depressive symptoms and patterns of alcohol use among college students. Psychopathology. 2011;44(1):27–33.
Lamis D, Malone P, Langhinrichsen-Rohling J, Ellis T. Body investment, depression, and alcohol use as risk factors for suicide proneness in college students. Crisis. 2010;31(3):118–27.
Gonzalez V, Reynolds B, Skewes M. Role of impulsivity in the relationship between depression and alcohol problems among emerging adult college drinkers. Exp Clin Psychopharmacol. 2011;19(4):303–13.
Kenney S, Lac A, LaBrie J, Hummer J, Pham A. Mental health, sleep quality, drinking motives, and alcohol-related consequences: a path-analytic model. J Stud Alcohol Drugs. 2013;74(6):841–51.
Vickers K, Patten C, Bronars C, Lane K, Stevens S, Croghan I, et al. Binge drinking in female college students: the association of physical activity, weight concern, and depressive symptoms. J Am Coll Heal. 2004;53(3):133–40.
Owens T, Shippee N. Depressed mood and drinking occasions across high school: comparing the reciprocal causal structures of a panel of boys and girls. J Adolesc. 2009;32(4):763–80.
Babor TF, de la Fuente JR, Saunders J, Grant M. AUDIT: the alcohol use disorders identification test. Guidelines for use in primary health care. Geneva: World Health Organization; 1992.
Falk D, Yi HY, Hiller-Sturmhöfel S. An epidemiologic analysis of co-occurring alcohol and drug use and disorders: findings from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Alcohol Res Health. 2008;31(2):100–10.
Fergusson DM, Boden JM, Horwood LJ. Tests of causal links between alcohol abuse or dependence and major depression. Arch Gen Psychiatry. 2009;66(3):260–6.
Deykin E, Levy J, Wells V. Adolescent depression, alcohol and drug abuse. Am J Public Health. 1987;77(2):178–82.
Mushquash A, Stewart S, Sherry S, Sherry D, Mushquash C, MacKinnon A. Depressive symptoms are a vulnerability factor for heavy episodic drinking: a short-term, four-wave longitudinal study of undergraduate women. Addict Behav. 2013;38(5):2180–6.
Schöne C, Tandler SS, Stiensmeier-Pelster J. Contingent self-esteem and vulnerability to depression: academic contingent self-esteem predicts depressive symptoms in students. Front Psychol. 2015;20(6):1573.
Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev. 2015.
Rao U, Hammen CL, Poland RE. Mechanisms underlying the comorbidity between depressive and addictive disorders in adolescents: interactions between stress and HPA activity. Am J Psychiatry. 2009;166(3):361–9.
Lisdahl KM, Gilbart ER, Wright NE, Shollenbarger S. Dare to delay? The impacts of adolescent alcohol and marijuana use onset on cognition, brain structure, and function. Front Psychol. 2013;1(4):53.
Demir B, Ulug B, Lay Ergun E, Erbas B. Regional cerebral blood flow and neuropsychological functioning in early and late onset alcoholism. Psychiatry Res. 2002;115:115–25.
Jacobus J, Tapert SF. Neurotoxic effects of alcohol in adolescence. Annu Rev Clin Psychol. 2013;9:703–21.
Squeglia LM, Tapert SF, Sullivan EV, Jacobus J, Meloy MJ, Rohlfing T, et al. Brain development in heavy-drinking adolescents. Am J Psychiatry. 2015;172(6):531–42.
Khantzian EJ. The self-medication hypothesis revisited: the dually diagnosed patient. Primary Psychiatry. 2003;10(9):47–54.
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This study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (K23AA020064) to P. Pedrelli.
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Pedrelli, P., Shapero, B., Archibald, A. et al. Alcohol use and Depression During Adolescence and Young Adulthood: a Summary and Interpretation of Mixed Findings. Curr Addict Rep 3, 91–97 (2016). https://doi.org/10.1007/s40429-016-0084-0
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DOI: https://doi.org/10.1007/s40429-016-0084-0