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Effects of alcohol consumption on health in early adulthood and the psychological characteristics of abstainers and alcohol consumers
by Dr Philip Norrie M.B. B.S. M.Sc. M.Soc.Sc.(Hons)
Most alcohol and health research papers have concentrated on the effects of alcohol on middle aged & older people.Three researchers have recently had their research letter 'U shaped relation for alcohol consumption and health in early adulthood and implications for mortality' published in The Lancet (vol 352 Sept 12, 1998) where they were looking at associations between alcohol consumption and factors which could predict mortality in young adults.

Dr Chris Power PhD is an epidemiologist from The Institute of Child Health in London, Dr Bryan Rodgers PhD is an epidemiologist and physhologist from the Psychiatric Epidemiology Research Centre,Australian National University in Canberra and Steven Hope MSc is a psychologist and statistician. Due to their psychological background, the researchers were also interested in the overall characteristics and differences between drinkers and abstainers.

The population studied were all the people born in England, Scotland and Wales from 3/3/58 to 9/3/58. These 9,605 individuals (known as the 1958 birth cohort) were followed up at 23 years and 33 years and their alcohol consumption was recorded along with results of psychological distress, health(either poor, fair, good or excellent) and finally any limiting longstanding illnesses.

The researchers found that alcohol consumption was significantly associated with each of the health measures ( see fig 1), in both men and women, by the 33 year survey.

The results yielded the classic U shaped curve, where there were higher rates of ill health among non drinkers and heavy drinkers, compared to moderate drinkers (classified as 6-20 units per week for women and 11-35 units per week for men). This U shape relationship persisted even when making allowances for the possibility that higher rates of illness amogst abstainers was abstinence induced by ill health.

Four different explanations for the results were offered, namely:

1) Moderate consumption of alcohol may have a causal protecting effect on health.

2) Poor health may lead to abstinence or heavy drinking.

3) Abstainers and heavy drinkers may share common risk factors for a particular health outcome.

4) Non-drinkers and heavy drinkers are at an increased health risk (but risk factors may be diferent).

These results imply that underlying causal mechanisms for ill health commence much earlier in life, in order to be statistically evident by the age of 33, than had previously been exposed by research. The poorer health of non drinkers was also shown not to be attributed to past heavy drinkers giving up alcohol.


Dr Rodgers replicated these results in his study in Australia's capital Canberra. The characteristics of abstainers were also analysed closely. His full research findings and paper will be published in early 1999, but the key results were recently presented at The Australasian Society for Psychiatric Research Conference.The co-morbidity of alcohol abuse with mood and anxiety disorders has been shown in previous studies, little is known though, about the nature of this relationship across the full spectrum of drinking behaviour, namely abstinence to abuse/dependence. This is what Dr Rodgers has set out to examine.

The Canberra study involved 2,725 people aged 18 to 80 years old completing the Alcohol Use Disorders Identification Test and five measures of negative affect (two depression scales, two anxiety scales and the neuroticism inventory).

The research findings showed that there is a U shaped relationship between depression scores and level of alcohol consumption by different sex and age groups; thus illustrating that abstainers, as well as heavy drinkers, are at an increased risk of mood and anxiety disorders.

Further work needs to be done to show the varied characteristics of abstainers as it is apparent that moderate consumers of alcohol are the more mentally balanced group, not the abstainers, despite their belief that they hold the moral high ground in the alcohol debate.

From: Chris Power, Bryan Rodgers and Steven Hope'U shaped relation for alcohol consumption and health in early adulthood and implications for mortality' in The Lancet Vol 352,1998. Reproduced by kind permission of Dr Power and The Lancet.

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