title: Drinking pattern, abstention and problem drinking as risk factors for depressive symptoms: evidence from three urban Eastern European populations.
abstract: OBJECTIVE
  To examine whether the frequency and amount of alcohol consumed in binge drinking sessions, total annual volume of alcohol consumed, problem drinking and abstaining from alcohol are associated with depressive symptoms in Eastern Europe.
  
  
  METHODS
  Cross-sectional data from a total of 24,381 participants from general population samples of the Czech Republic (N = 7,601), Russia (N = 6,908) and Poland (N = 9,872) aged 45-69 years in 2002-2005. Depressive symptoms were defined as ≥ 16 points on the Centre for Epidemiological Studies - Depression (CES-D) scale. Several alcohol related measures were derived using responses from the graduated frequency questionnaire. Binge drinking was defined at several sex-specific thresholds (ranging from 60+ to 140+ g of ethanol) and two frequencies (at least monthly or weekly). Total annual alcohol intake in grams was also extracted. Problem drinking was defined as ≥ 2 positive answers on the CAGE questionnaire.
  
  
  RESULTS
  Problem drinking was consistently associated with approximately a 2-fold increase in odds of depressive symptoms across all countries and in both sexes. Abstaining from alcohol was typically associated with increased odds of depressive symptoms. Analyses separating lifelong abstainers and former drinkers in the Russian cohort revealed that this increased odds was driven by former drinkers. Amongst men, heavy frequent binge drinking was associated with increased odds of depressive symptoms in the Czech Republic and Poland. In women, heavy infrequent binge drinking was associated with increased odds of depressive symptoms in Russia and Poland. Only in Polish men was higher annual volume of alcohol intake associated with increased odds of depressive symptoms.
  
  
  CONCLUSIONS
  Abstaining from alcohol and problem drinking were associated with increased odds of depressive symptoms in these Eastern European populations. Annual volume of alcohol intake as well as frequency and amount of alcohol consumed in a binge drinking session were less consistently associated with depressive symptoms.
authors.affiliation: Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Steven
authors.initials: S
authors.lastname: Bell
authors.affiliation: Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Annie
authors.initials: A
authors.lastname: Britton
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: Ruzena
authors.initials: R
authors.lastname: Kubinova
authors.affiliation: Institute of Internal and Preventive Medicine, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia.
authors.forename: Sofia
authors.initials: S
authors.lastname: Malyutina
authors.affiliation: Institute of Public Health, Jagiellonian University, Krakow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
authors.affiliation: Institute of Internal and Preventive Medicine, Novosibirsk, Russia.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Nikitin
authors.affiliation: Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Bobak
mesh_terms: D000368:Aged; D064829:Alcohol Abstinence; D000428:Alcohol Drinking; D000437:Alcoholism; D003430:Cross-Sectional Studies; D018153:Czech Republic; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011044:Poland; D012044:Regression Analysis; D012307:Risk Factors; D012426:Russia; D014505:Urban Population