a1 Section of Mental Health Research, Division of Psychiatry, Helse Fonna HF, Norway
a2 Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
a3 Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Norway
a4 Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway
a5 King's College London (Institute of Psychiatry), London, UK
a6 Department of Mental Health Sciences, University College London, London, UK
a7 Department of Health Sciences, University of Leicester, Leicester, UK
a8 Forensic Psychiatry Research Unit, St Bartholomew's Hospital, London, UK
Background The beneficial outcomes associated with moderate compared with low alcohol intake or abstinence may be due to the inclusion of people as ‘low consumers’, who have stopped consumption because of poor health. We investigated the association between alcohol abstinence and symptoms of common mental disorder and personality disorder, distinguishing between lifelong abstinence and abstinence following previous consumption.
Method Analyses were based on the British National Survey of Psychiatric Morbidity 2000, which sampled 8580 residents aged 16–74 years. Hazardous drinking (Alcohol Use Disorders Identification Test) was excluded. Symptoms of common mental disorder (depression/anxiety) were identified by the Clinical Interview Schedule. The screening questionnaire of the Structured Clinical Interview for Axis II Personality Disorders was used to identify potential personality disorder. Self-reported alcohol abstinence was divided into lifelong abstinence and previous consumption. Previous consumers were asked why they had stopped. Covariates included socio-economic status, social activity and general health status.
Results After adjustment, alcohol abstinence was associated with both common mental disorder symptoms and any personality disorder, but only for previous consumers, in whom odds ratios were 1.69 (95% CI 1.23–2.32) and 1.45 (95% CI 1.09–1.94). Associations were non-specific, being apparent for most individual mental disorder symptoms and personality disorder categories. More detailed analysis indicated that associations were again limited to previous consumers who reported ceasing alcohol consumption for health reasons.
Conclusions Worse mental health in low alcohol consumers, particularly those who have previously ceased for health reasons, should be taken into account when interpreting associations between moderate (compared with low) alcohol consumption and beneficial health outcomes.
(Received December 20 2009)
(Revised April 19 2010)
(Accepted June 12 2010)
(Online publication July 21 2010)