rst-incidence of depressive disorders in a linear fashion (OR=1.14, 95% CI=1.06-1.22), even after adjustment for sociodemographics, smoking status and predisposing factors for depressive disorders, such as general vulnerability factors, psychiatric comorbidity

Background | Previous studies suggested that alcohol-use disorder severity, dened by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted rst-incident depressive disorders, an association that has never been found for the presence or absence of an alcohol use disorder in the general population. Methods | In a national sample of persons who had never experienced a major depressive disorder (MDD), dysthymia, manic or hypomanic episode (n=27,571), we examined whether a version of DSM-5 alcohol-use disorder severity (a count of three abuse and all seven dependence criteria) linearly predicted rst-incident depressive disorders (MDD or dysthymia) after 3-year follow-up. Wald tests were used to assess whether more complicated models dened the relationship more accurately. Results | First-incidence of depressive disorders varied across alcohol-use disorder severity and was 4.20% in persons meeting no alcohol-use disorder criteria versus 44.47% in persons meeting all ten criteria. Alcohol-use disorder severity signicantly predicted rst-incidence of depressive disorders in a linear fashion (OR=1.14, 95% CI=1.06-1.22), even after adjustment for sociodemographics, smoking status and predisposing factors for depressive disorders, such as general vulnerability factors, psychiatric comorbidity and subthreshold depressive disorders. This linear model explained the relationship just as well as more complicated models. Conclusions | Alcohol-use disorder severity was a signicant linear predictor of rst-incident depressive disorders after 3-year follow-up, and may be useful in identifying a high-risk group for depressive disorders that could be targeted by prevention strategies.