title: Gender Differences in the Relationships Among Major Depressive Disorder, Heavy Alcohol Use, and Mental Health Treatment Engagement Among College Students.
abstract: Although major depressive disorder (MDD) and heavy episodic drinking (HED, 4+/5+ drinks in a single sitting for women/men) are common among young adults in college, the relationship between the two remains unclear. This study examined the association between MDD and HED in this population, the effect of gender on this association, and whether comorbid MDD and heavy alcohol use are associated with higher rates of mental health treatment engagement.
  
  
  
  The study comprised 61,561 (65.3% female) undergraduate students who answered an online survey on depression, alcohol use, and treatment engagement in the past year. Hierarchical linear regressions examined the association between MDD and alcohol use (HED and peak blood alcohol concentration [pBAC]) and whether gender moderated these associations. Logistic regressions were then conducted to examine the influence of MDD, heavy alcohol use, and gender on treatment engagement.
  
  
  
  Students with MDD reported more frequent HED and higher pBAC than did students without MDD; this was especially true for female students. Rates of treatment engagement were higher among women than men, among students with MDD than students without MDD, and among female students with HED than women without HED.
  
  
  
  The presence of an association between MDD and heavy alcohol use suggests the need for systematic screenings of both conditions. Low rates of treatment engagement in college students with MDD and heavy alcohol use calls for the development of strategies to engage this high-risk group in treatment.
authors.affiliation: Depression Clinical Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Paola
authors.initials: P
authors.lastname: Pedrelli
authors.affiliation: San Francisco Veteran Affairs Medical Center, San Francisco, California.|Department of Psychiatry, University of California-San Francisco, San Francisco, California.
authors.forename: Brian
authors.initials: B
authors.lastname: Borsari
authors.affiliation: Center for the Study of Higher and Postsecondary Education, School of Education, University of Michigan, Ann Arbor, Michigan.|Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Sarah Ketchen
authors.initials: SK
authors.lastname: Lipson
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Justin E
authors.initials: JE
authors.lastname: Heinze
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.|Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Daniel
authors.initials: D
authors.lastname: Eisenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D063425:Binge Drinking / Q000523:psychology*; D000067401:Blood Alcohol Content; D003865:Major Depressive Disorder / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D005783:Gender Identity; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
chemical_list: D000067401:Blood Alcohol Content