Kaleidoscope - Volume 222 , Issue 5

Tracy, Derek K.; Albertson, Dawn N.; Cordoba, Emmeline Lagunes; Shergill, Sukhwinder S.

Abstract

‘A glass of wine to help my heart!’ is – in the K Team's experience – the most optimistically overused health cry at parties. How strong are the data that suggest moderate alcohol also decreases the risk of depression? A challenge has been the inability to robustly determine causality, with much of the existing research on the topic favouring this risk reduction. Writing in the American Journal of Psychiatry, Visontay et alReference Visontay, Mewton, Slade, Aris and Sunderland1 explored a national longitudinal cohort to contrast abstinence and occasional, moderate and above-guidelines alcohol consumption through adulthood (baseline measurements at ages 29–37 years) and any depression at age 50. Valid data were obtained from over 3500 individuals, and a J-curve relationship emerged. When various confounders were accounted for, marginal structural models for causal inference showed that consistent occasional and moderate drinkers had reduced depression scores and reduced rates of probable depression by age 50 compared with those who abstained completely. Those with consistent above-guidelines consumption had a greater risk of depression, though not at a statistically significant level. There were no differences between genders. The results are fascinating and perhaps contrary to what most of us might have predicted, not least as alcohol use disorders have well-established comorbid links with depression. They show that the previously found J-curve appears to be a true finding when modern statistical methods and careful controlling of confounders are applied. The authors note that moderate alcohol consumption increases brain-derived neurotrophic factor and lowers inflammatory biomarkers, both of which are associated with depression. Perhaps more parsimoniously, modest consumption might reflect better social connections. The clinicians in the room will also instinctively feel the tension of how this could be misinterpreted, not least as increasingly we seem to be moving socially to a ‘no safe limit’ culture.

• Journal Article Type: Editorial
• Acceptance Date: Apr 1, 2023
• Online Publication Date: Apr 17, 2023
• Publication Date: May 1, 2023
• Deposit Date: Jun 21, 2023
• Journal: British Journal of Psychiatry
• Print ISSN: 0007-1250
• Electronic ISSN: 1472-1465
• Publisher: Cambridge University Press (CUP)
• Peer Reviewed: Not Peer Reviewed
• Volume: 222
• Issue: 5
• Pages: 224-225
• DOI: https://doi.org/10.1192/bjp.2023.38
• Public URL: https://uwe-repository.worktribe.com/output/10880294
• Publisher URL: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/kaleidoscope/1D72D7689C2196C1A4F565F088C0BA90