Reconsidering the associations between self-reported alcohol use disorder and mental health problems in the light of co-occurring addictions in young Swiss men

• Published in: PloS one 2019-09, Vol.14 (9), p.e0222806
• Main Authors: Marmet, Simon, Studer, Joseph, Lemoine, Mélissa, Grazioli, Véronique S, Bertholet, Nicolas, Gmel, Gerhard
• Format: Article
• Language: English
• Subjects: Addiction; Addictions; Addictive behaviors; Adolescent; Adult; Alcohol use; Alcoholic beverages; Alcoholism; Alcoholism - epidemiology; Alcoholism - physiopathology; Alcoholism - psychology; Anxiety; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - physiopathology; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Behavior, Addictive - epidemiology; Behavior, Addictive - physiopathology; Behavior, Addictive - psychology; Biology and Life Sciences; Bipolar disorder; Bipolar Disorder - epidemiology; Bipolar Disorder - physiopathology; Bipolar Disorder - psychology; Cannabis; Care and treatment; Comorbidity; Computer and Information Sciences; Confidence intervals; Cross-Sectional Studies; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - physiopathology; Depressive Disorder, Major - psychology; Disorders; Drinking (Alcoholic beverages); Gambling; Health aspects; Health problems; Humans; Hyperactivity; Informed consent; Internet; Logistic Models; Major depressive disorder; Male; Marijuana; Marijuana Abuse - epidemiology; Marijuana Abuse - physiopathology; Marijuana Abuse - psychology; Medical research; Medicine and Health Sciences; Mental depression; Mental disorders; Mental health; Mental Health - statistics & numerical data; Odds Ratio; Phobia, Social - epidemiology; Phobia, Social - physiopathology; Phobia, Social - psychology; Questionnaires; Risk factors; Self Report; Smartphones; Social phobia; Social Sciences; Substance abuse; Substance use; Surveys and Questionnaires; Switzerland - epidemiology; Tobacco; Tobacco Smoking - epidemiology; Tobacco Smoking - physiopathology; Tobacco Smoking - psychology; Young men
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0222806

Alcohol use disorder (AUD) is known to co-occur with other addictions, as well as with mental health problems. However, the effects of other addictions co-occurring with AUD on mental health problems were rarely studied and not considering them may bias estimates of the association between AUD and mental health problems. This study investigated which role co-occurring addictions play for the cross-sectional associations between self-reported AUD and mental health problems. Participants were 5516 young Swiss men (73.0% of those that gave written informed consent) who completed a self-report questionnaire. Using short screening questionnaires, we assessed three substance use disorders (alcohol, cannabis and tobacco), seven behavioural addictions (internet, gaming, smartphone, internet sex, gambling, work, exercise) and four mental health problems (major depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD) and social anxiety disorder). Differences in the proportions of mental health problems were tested using logistic regressions between (1) participants with no AUD and AUD, (2) participants with no AUD and AUD alone and (3) participants with no AUD and AUD plus at least one co-occurring addiction. Overall, (1) participants with AUD had higher proportions of major depression (Odds ratio (OR [95% confidence interval]) = 3.51 [2.73, 4.52]; ADHD (OR = 3.12 [2.41, 4.03]); bipolar disorder (OR = 4.94 [3.38, 7.21]) and social anxiety (OR = 2.21 [1.79, 2.73])) compared to participants with no AUD. Considering only participants with AUD alone compared to participants with no AUD (2), differences in proportions were no longer significant for major depression (OR = 0.83 [0.42, 1.64]), bipolar disorder (OR = 1.69 [0.67, 4.22]), social anxiety (OR = 1.15 [0.77, 1.73]) and ADHD (OR = 1.65 [1.00, 2.72]) compared to participants with no AUD. In contrast, (3) proportions of mental health problems were considerably higher for participants with AUD plus at least one other addiction when compared to participants with no AUD, with OR's ranging from 2.90 [2.27, 3.70] for social anxiety, 4.03 [3.02, 5.38] for ADHD, 5.29 [4.02, 6.97] for major depression to 6.64 [4.44, 9.94] for bipolar disorder. AUD was associated with all four measured mental health problems. However, these associations were mainly due to the high proportions of these mental health problems in participants with AUD plus at least one co-occurring addiction and only to a lesser degree due t