title: Intra-household evaluations of alcohol abuse in men with depression and suicide in women: A cross-sectional community-based study in Chennai, India.
abstract: BACKGROUND
  Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are also reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. This study evaluates intra-household associations between alcohol abuse in men, and depression and suicidal attempts in women, in community-based settings of Chennai, India.
  
  
  METHODS
  This community-based cross-sectional study of chronic disease risk factors and outcomes was conducted in n = 259 households and n = 1053 adults (aged 15 years and above) in rural and urban Chennai. The Alcohol Use Disorder Identification Test (AUDIT) score was used to classify alcohol consumption into 'low-risk', 'harmful', 'hazardous' and 'alcohol dependence' drinking and the Patient Health Questionnaire (PHQ-9) score to classify depression as 'mild', 'moderate', 'moderate-severe' and 'severe'. Multivariate logistic regression models estimated the association of depression in women with men's drinking patterns in the same household.
  
  
  RESULTS
  A significant 2.5-fold increase in any depression (PHQ-9 ≥ 5) was observed in men who were 'alcohol-dependent' compared to non-drinkers (OR = 2.53; 95% CI: 1.26, 5.09). However, there was no association between men's drinking behavior and depression in women of the same household, although suicidal attempts approached a significant dose-response relationship with increasing hazard-level of men's drinking (p = 0.08).
  
  
  CONCLUSIONS
  No significant intra-household association was observed between men's alcohol consumption and women's depression, though an increasing (non-significant) trend was associated with suicidal attempts. Complex relationships between suicidal attempts and depression in women and male abusive drinking require further exploration, with an emphasis on intra-household mechanisms and pathways.
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India. adyyagupta@gmail.com.
authors.forename: Adyya
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Voluntary Health Services, Chennai, India. vpriya_1308@yahoo.in.
authors.forename: Bavani
authors.initials: B
authors.lastname: Priya
authors.affiliation: Voluntary Health Services, Chennai, India. jdw.hfa@gmail.com.
authors.forename: Joseph
authors.initials: J
authors.lastname: Williams
authors.affiliation: Centre for Mental Health, Public Health Foundation of India, National Capital Region, India. mona.sharma@phfi.org.|Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India. mona.sharma@phfi.org.
authors.forename: Mona
authors.initials: M
authors.lastname: Sharma
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India. ruby.gupta@phfi.org.|Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India. ruby.gupta@phfi.org.
authors.forename: Ruby
authors.initials: R
authors.lastname: Gupta
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India. dilip.kumar@phfi.org.|Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India. dilip.kumar@phfi.org.
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Jha
authors.affiliation: Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. shah.ebrahim@lshtm.ac.uk.
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India. preet.dhillon@phfi.org.|Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India. preet.dhillon@phfi.org.
authors.forename: Preet K
authors.initials: PK
authors.lastname: Dhillon
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*