Use this URL to cite or link to this record in EThOS:
Title: Associations between common mental health difficulties and alcohol use in an adult population
Author: Hunt, V. J.
ISNI:       0000 0004 9358 1990
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2020
Availability of Full Text:
Access from EThOS:
Access from Institution:
Alcohol use and common mental health problems (i.e. anxiety and depression) often co-occur as a dual diagnosis (DD). However, there is a lack of services providing integrated interventions for DD. Psychological therapists often perceive people with DD who are dependent on substances as less likely to benefit from and engage with psychological treatment when compared to those who have a single diagnosis. Some literature has supported this belief; however, the actual evidence is mixed. Despite a lack of clear evidence, some services will exclude clients due to their DD. A review of the existing literature was undertaken to investigate associations between alcohol use and depression severity. 12 articles, using 11 independent samples, met the inclusion criteria and were combined in a meta-analysis. There was a small positive correlation between alcohol use and depression severity, therefore as depression severity increases, alcohol use increases. Moderator analyses were carried out to investigate other variables that might affect this association. Results indicated that the measures used to quantify alcohol use and risk of bias ratings moderated this association. A sensitivity analysis was carried out, systematically removing articles depending on their characteristics, and the results were mainly congruent with the primary meta-analysis, except for gender. Overall, results should be interpreted with caution due to the heterogeneity and publication bias. To investigate the association between common mental health difficulties and alcohol use further, clinical data from n=7,986 participants, aged between 16-89 years old (n=2,760 male) were analysed using a hierarchical regression model. The analysis examined linear and curvilinear associations between alcohol use or severity of dependence (SD) with depression severity, anxiety severity, and number of psychological therapy contacts attended. The SD was investigated in a subsample (n=195 participants). Participants were recruited from a primary care mental health service and provided consent for their data to be analysed for research purposes. Results indicated participants who drank moderately and extremely hazardously had lower baseline depression scores when compared to those who drank at low levels and hazardously. Participants who drank moderately had lower post-treatment anxiety scores when compared to those who drank at low and hazardous levels. Both relationships were controlled by variables; age, baseline anxiety, functional impairment, disability, employment status, expectancy, baseline depression (post-treatment anxiety only), and ethnicity (post-treatment anxiety only). Alcohol use was not associated with baseline anxiety, post treatment depression or contacts attended after controlling for independent variables. SDS was not associated with any variables after controlling for independent variables. Participants completed self-reporting questionnaires, which could create bias, and data was limited to a primary care mental health service; therefore conclusions should be generalised with caution. Overall, alcohol use and common mental health problems commonly co-occur. It could be beneficial for services to consider comorbidity and integrate this information into treatment plans. It is important for services to discuss the relationship between alcohol use and mental health, taking into account the different factors that influence the relationship (e.g. age, disability, and employment status). Therefore, services could take this into consideration prior to exclusion.
Supervisor: Delgadillo, J. Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available