Heavy alcohol consumption, depression, their comorbidity and risk of all-cause and cause-specific mortality

Alcohol consumption and depression commonly co-occur, and most current research has focused on the associations between either alcohol consumption or depression alone with mortality risk. However, the association of the comorbidity of heavy alcohol consumption and depression on the risk of all-cause and cause-specific mortality remains unclear in the US.
Researchers analysed the risks of all-cause and cause-specific mortality in participants who have heavy alcohol consumption alone, depression alone, or both, by conducting a prospective cohort study with a sample in the National Health and Nutrition Examination Survey (NHANES) database.
11,590 US adults aged ≥ 20 years from a nationally representative sample were included in the study. Data on depression and alcohol consumption were extracted from the NHANES conducted between 2005 and 2018, and mortality information was obtained from the NHANES Linked Mortality File through December 31, 2019. Drinking and depression were classified into four groups: only heavy alcohol consumption, only depression, both present, and neither present. By adjusting for confounding factors, the researchers investigated the risk of all-cause mortality associated with alcohol consumption and depressive states, including cardiovascular disease (CVD), cancer, and other causes.
The adjusted HR (aHR) for all-cause mortality, as well as mortality due to CVD, cancer, and other causes, were highest among individuals with comorbid heavy alcohol consumption and depression (HR 2.68[95%CI 1.84,3.91]; 2.64 [95%CI 1.27, 5.48]; 2.55 [95%CI 1.22,5.35]; and 2.78[95%CI 1.64, 4.71]). However, the results of additive and multiplicative interactions indicated that the synergistic effect of heavy alcohol consumption and depression on all-cause and cause-specific mortality did not reach statistical significance.
This research could provide a foundation for further investigations into the mechanisms underlying the comorbidity of heavy alcohol consumption and depression, as well as interventions for depression among heavy alcohol consumers, with significant implications for public health and clinical practice.
Source: Yan, C., Ding, Y., He, H. et al. Heavy alcohol consumption, depression, their comorbidity and risk of all-cause and cause-specific mortality: a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 60, 2441–2454 (2025).