Reciprocal longitudinal relationship between depressive symptoms and problematic alcohol use: a random intercept cross-lagged panel model including a nationwide sample of Korean adults

Abstract

BackgroundProblematic alcohol use and mental health problems co-occur frequently. However, the longitudinal, reciprocal relationship between depressive symptoms and problematic alcohol use is not fully understood. This study examined the bidirectional longitudinal association between depressive symptoms and problematic alcohol use.MethodsA total of 14,569 adults participated in a panel survey, with data collected annually at three time points (2022, 2023, and 2024). Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale (11-item version). Problematic alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT) (10-item version). A random intercept cross-lagged panel model (RI-CLPM) with three time points was used to determine the reciprocal relationship between depressive symptoms and problematic alcohol use.ResultsThe sample consists of 6,406 men and 8,134 women, with a mean (standard deviation) age of 57.7 (19.5) years. At the between-person level, random intercepts of depressive symptoms and problematic alcohol use showed no significant correlations (B = 0.117, P = .566). At the within-person level, depressive symptoms at a given time point were positively associated with problematic alcohol use in the following year (B = 0.050, P = .005). Similarly, problematic alcohol use at a given time point was positively associated with depressive symptoms in the following year (B = 0.062, P = .012). Significant covariance between depressive symptoms and problematic alcohol use were observed across the survey waves.ConclusionThis study found a bidirectional longitudinal relationship between depressive symptoms and problematic alcohol use at the within-individual level. Policy interventions should adopt an integrated approach that addresses mental health issues and problematic alcohol use simultaneously.