Heavy alcohol use and mental health treatment among adults experiencing depression of different ages Restricted; Files Only

Abstract

Background: This study examined the relationship between heavy alcohol use and mental health treatment utilization among adults who have experienced a major depressive episode in the last year. Additionally, this study examined how this relationship differed based on age group. 

Methods: Data were from adults 18-64 who participated in the 2019 National Survey on Drug Use and Health who met criteria for a major depressive episode in the last year (n=4335). We conducted descriptive bivariate analyses and multivariable logistic regression analyses. 

Results: Among participants with major depressive episodes, the impact of comorbid heavy alcohol use on their odds of receiving mental health treatment in the past year differed significantly by age group. In the multivariable logistic regression model, after adjusting for sociodemographic variables, adults ages 50-64 with no heavy alcohol use had 4.0 times the odds of receiving mental health treatment than those reporting heavy alcohol use. 

Conclusion: Our results show that it is important to consider age when understanding the complex relationship between depression, alcohol use, and mental health treatment. For older adults, comorbid depression and heavy alcohol are associated with lower mental health treatment utilization. Given the number of aging adults in the United States and high levels of heavy alcohol abuse in older adults, it is important to continue to this research in older adults, with a focus on screening, diagnosis, and reducing barriers to treatment. 

Table of Contents

Glossary .......................................................................................................................................... 1 

Chapter I: Introduction .................................................................................................................... 4 

Problem definition: .......................................................................................................................... 4 

Contribution of the current study ...................................................................................................... 6 

Theoretical framework: .................................................................................................................... 7 

Chapter II: Literature Review ............................................................................................................ 9 

Major Depression in the United States ............................................................................................... 9 

Major Depression Differences by Age ................................................................................................ 11 

Treatment for Major Depression ....................................................................................................... 14 

Comorbid Substance Use Disorders and the Need to Focus on Alcohol Use ........................................... 16 

Alcohol Use Across the Ages ............................................................................................................. 20 

Comorbid Depression and Alcohol Use .............................................................................................. 22 

Pathways leading to Comorbidity of Depression and Heavy Alcohol Use .............................................. 24 

Mental Health Treatment for Comorbid Depression and Heavy Alcohol Use ......................................... 27 

Research Question: .......................................................................................................................... 30 

Theoretical framework: .................................................................................................................... 30 

Chapter III: Methodology ................................................................................................................. 36 

Sample............................................................................................................................................ 36 

Measures ......................................................................................................................................... 38 

Data analysis .................................................................................................................................... 39 

Chapter IV: Results ..................................................................................................................... ..... 41 

Demographic Characteristics ...................................................................................................... ...... 41 

Bivariate Results: Those who did receive mental health treatment vs those who did not ........................ 42 

Interaction Analyses......................................................................................................................... 43 

Chapter V: Discussion ....................................................................................................................... 44 

Limitations and Strengths .................................................................................................................. 50 

Implications, Recommendations, Conclusions ...................................................................................... 52 

Table 1 .............................................................................................................................................. 55 

Table 2 .............................................................................................................................................. 60 

References ......................................................................................................................................... 61 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health
Keyword	alcohol use mental health public health mental health treatment depression
Committee Chair / Thesis Advisor	Dr. Regine Haardörfer, Emory University
Committee Members	Dr. Liz Walker, Emory University

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