Does substance use explain social differences in terms of depression? Findings from the Constances cohort.
Depression
Social differences
Substance use
Journal
Comprehensive psychiatry
ISSN: 1532-8384
Titre abrégé: Compr Psychiatry
Pays: United States
ID NLM: 0372612
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
12
03
2020
revised:
20
07
2020
accepted:
11
08
2020
pubmed:
15
9
2020
medline:
22
12
2020
entrez:
14
9
2020
Statut:
ppublish
Résumé
The role of alcohol, tobacco and cannabis use in social differences in terms of depression is poorly understood. We have applied mediation and moderated-mediation models stratified by gender to a population-based sample (N = 37,192) of French men and women from the Constances cohort with baseline and follow-up measures of depressive states. We have examined whether socioeconomic status (SES, measured by education and income) differences in the prevalence of depressive states may be explained by both differences in prevalence of substance use according to SES (mediating effects) and differential effects of substance use on depressive state according to SES (moderating effects). In the mediation models, substance use only explained 5.3% and 2.4% of the association between low education and depressive state in men and women respectively, and was not a significant mediator for income. Moderated mediation models showed robust moderation effects of education and income in both men and women. The association of tobacco use with depressive symptoms, which was the only substance for which a mediation effect remained and for which the moderation effect of SES was the strongest, was significantly higher in participants with low SES. The partially cross-sectional nature of the data restricts the possibility of drawing causality with regards to associations between SES and substance use. Targeting substance use, particularly tobacco, can especially reduce depression risk in individuals of low SES.
Sections du résumé
BACKGROUND
The role of alcohol, tobacco and cannabis use in social differences in terms of depression is poorly understood.
METHOD
We have applied mediation and moderated-mediation models stratified by gender to a population-based sample (N = 37,192) of French men and women from the Constances cohort with baseline and follow-up measures of depressive states. We have examined whether socioeconomic status (SES, measured by education and income) differences in the prevalence of depressive states may be explained by both differences in prevalence of substance use according to SES (mediating effects) and differential effects of substance use on depressive state according to SES (moderating effects).
RESULTS
In the mediation models, substance use only explained 5.3% and 2.4% of the association between low education and depressive state in men and women respectively, and was not a significant mediator for income. Moderated mediation models showed robust moderation effects of education and income in both men and women. The association of tobacco use with depressive symptoms, which was the only substance for which a mediation effect remained and for which the moderation effect of SES was the strongest, was significantly higher in participants with low SES.
LIMITATIONS
The partially cross-sectional nature of the data restricts the possibility of drawing causality with regards to associations between SES and substance use.
CONCLUSION
Targeting substance use, particularly tobacco, can especially reduce depression risk in individuals of low SES.
Identifiants
pubmed: 32927368
pii: S0010-440X(20)30045-6
doi: 10.1016/j.comppsych.2020.152203
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
152203Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Dr. Hoertel has received personal fees and non-financial support from Lundbeck, outside the submitted work. Dr. Limosin reports non-financial support from Otsuka Pharmaceutical, outside the submitted work. Cédric Lemogne has received speaker and consulting fees from Boehringer Ingelheim, Janssen-Cilag, Lundbeck and Otsuka, outside the submitted work. The other authors have nothing to declare.