A comparison of alcohol measures as predictors of psychological distress in the New Zealand population

Aims: To compare measures of alcohol consumption and alcohol problems as predictors of current psychological distress. Design: Logistic regression models investigated the association between alcohol measures and high psychological distress overall and separately for women and men. Setting: Cross-sectional data from a New Zealand household population sample. Participants: 12,488 participants aged 15 and over. Measures: The Alcohol Use Disorders Identification Test (AUDIT) and its component factors representing consumption (AUDIT-C) and alcohol problems (the remaining items). High psychological distress was defined as a K10 score of 12 or more. Findings: The overall prevalence of high distress was 6.5%. High distress was present in 10.1% of abstainers, 3.4% of moderate drinkers and 35.1% of those with AUDIT scores 20+. There was some evidence for gender differences in the association between drinking and mental health, but a relative excess of distress among male abstainers mainly accounted for this. Gender differences were less clear for heavy drinkers. Substantially elevated levels of high distress were only apparent in a small group of people with very high consumption levels (AUDIT-C = 10) or multiple problems. Alcohol problems appeared to be slightly better than consumption as a predictor of high distress. Conclusions: Firstly, there is some evidence that the association between alcohol use and psychological distress varies according to gender. Secondly, although alcohol use is clearly associated with poor mental health, an excess of mental health problems is largely confined to male abstainers and a relatively small group with very heavy consumption or multiple alcohol problems.