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Rosa M. Crum, MD, MHS; Kerry M. Green, PhD; Carla L. Storr, ScD; Ya-Fen Chan, PhD; Nicholas Ialongo, PhD; Elizabeth A. Stuart, PhD; James C. Anthony, PhD

Arch Gen Psychiatry. 2008;65(6):702-712.

Context  Despite prior evidence supporting cross-sectional associations of depression and alcohol use disorders, there is relatively little prospective data on the temporal association between depressed mood and maladaptive drinking, particularly across extended intervals.

Objective  To assess the association between depressed mood in childhood and alcohol use during adolescence and young adulthood by mood level and sex and race/ethnicity subgroups.

Design  Cohort study of individuals observed during late childhood, early adolescence, and young adulthood.

Setting  Urban mid-Atlantic region of the United States.

Participants  Two successive cohorts of students from 19 elementary schools have been followed up since entry into first grade (1985, cohort I [n = 1196]; 1986, cohort II [n = 1115]). The students were roughly equally divided by sex (48% female) and were predominantly African American (70%). Between 1989 and 1994, annual assessments were performed on students remaining in the public school system, and between 2000 and 2001, approximately 75% participated in an interview at young adulthood (n = 1692).

Main Outcome Measures  Among participants who reported having used alcohol, Cox and multinomial regression analyses were used to assess the association of childhood mood level, as measured by a depression symptom screener, with each alcohol outcome (incident alcohol intoxication, incident alcohol-related problems, and DSM-IV alcohol abuse and dependence).

Results  In adjusted regression analyses among those who drank alcohol, a high level of childhood depressed mood was associated with an earlier onset and increased risk of alcohol intoxication, alcohol-related problems during late childhood and early adolescence, and development of DSM-IV alcohol dependence in young adulthood.

Conclusions  Early manifestations associated with possible depressive conditions in childhood helped predict and account for subsequent alcohol involvement extending across life stages from childhood through young adulthood.

Author Affiliations: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine (Dr Crum), and Departments of Mental Health (Drs Crum, Storr, Chan, Ialongo, Stuart, and Anthony), Epidemiology (Drs Crum and Anthony), Health, Behavior, and Society (Dr Green), and Biostatistics (Dr Stuart), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Dr Green is now with the Department of the Public and Community Health, University of Maryland College Park School of Public Health, College Park; Dr Storr is now with the Department of Family and Community Health, University of Maryland School of Nursing, Baltimore; Dr Chan is now with Lighthouse Institute, Chestnut Health Systems, Bloomington, Illinois; and Dr Anthony is now with the Department of Epidemiology, Michigan State University, East Lansing.

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