Evaluation of a depression-related model of alcohol problems in 430 probands from the San Diego prospective study

Some individuals might use alcohol to help cope with stress and feelings of depression. Studies of such depression or affect-related models have produced divergent results, which might reflect different definitions of affective disturbances, varying emphasis on excluding substance-induced depressions, and different approaches to defining family histories (FH). This paper describes a prospective study that evaluates a model of the role of depressive episodes in the development of alcohol-related problems, while controlling for substance-induced mood disorders.

Personal interviews were obtained 10 and 15 years after 430 Caucasian subjects entered a study of drinking but not alcohol-dependent 20-year olds. An AMOS Structural Equation Model (SEM) was used to evaluate the development of alcohol problems in the context of the FH of alcoholism and independent (i.e., not substance induced) depressive episodes, personal histories of independent depression, levels of stress, social support, drinking to cope with stress, expectations of the effects of alcohol, and peer drinking.

The SEM explained 51% of the variance for the 15-year outcome, and demonstrated good fitness characteristics. The FH of mood disorders (FHdep) predicted depressive episodes through interactions with higher stress and an FH of alcoholism (FHalc), as well as in the context of lower social support. Depressive episodes contributed to the development of alcohol problems both directly and through drinking to cope.

In this model when independent depressive syndromes developed in individuals with a FH of alcoholism, they modestly enhanced the risk for alcohol-related problems, but FHalc did not by itself increase the risk for independent depressions.