Patterns of Alcohol and Other Drug Use Associated with Major Depression Among Gay Men Attending General Practices in Australia

  • Martin Holt
  • Joanne Bryant
  • Christy E. Newman
  • Dana M. Paquette
  • Limin Mao
  • Michael R. Kidd
  • Deborah C. Saltman
  • Susan C. Kippax
Article

Abstract

Our aim was to clarify the role of alcohol and other drug (AOD) use in major depression among gay men attending general medical practices. A secondary analysis was conducted on survey data collected from 531 gay men attending high-HIV-caseload general practices in Adelaide and Sydney, Australia. The survey contained demographic, social, behavioural and AOD variables. Participants were classified into those with (n = 130) and without major depression (n = 401) using the PHQ-9 screening tool. Although rates of drug use were very high in the sample, multivariate logistic regression analysis showed that the majority of variables independently associated with major depression were social and behavioural factors. Only one AOD variable was associated with major depression: the use of three or more drug types in the past 6 months. Attending to specific patterns of AOD use may assist in the identification of gay men most at risk of major depression.

Keywords

Alcohol and other drugs Depression Gay men General practice Social factors 

References

  1. Australian Institute of Health and Welfare. (2008). 2007 National Drug Strategy Household Survey: Detailed findings (Drug Statistics Series No. 22). Canberra: Australian Institute of Health and Welfare.Google Scholar
  2. Banta-Green, C., Goldbaum, G., Kingston, S., Golden, M., Harruff, R., & Logan, B. K. (2005). Epidemiology of MDMA and associated club drugs in the Seattle area. Substance Use and Misuse, 40(9–10), 1295–1315.PubMedCrossRefGoogle Scholar
  3. Berg, M. B., Mimiaga, M. J., & Safren, S. A. (2008). Mental health concerns of gay and bisexual men seeking mental health services. Journal of Homosexuality, 54(3), 293–306.PubMedCrossRefGoogle Scholar
  4. Billings, A. G., & Moos, R. H. (1982). Psychosocial theory and research on depression: An integrative framework and review. Clinical Psychology Review, 2, 213–237.CrossRefGoogle Scholar
  5. Blacker, C. V. R., & Clare, A. W. (1988). The prevalence and treatment of depression in general practice. Psychopharmacology, 95, S14–S17.PubMedGoogle Scholar
  6. Bolding, G., Sherr, L., & Elford, J. (2002). Use of anabolic steroids and associated health risks among gay men attending London gyms. Addiction, 97(2), 195–203.PubMedCrossRefGoogle Scholar
  7. Cochran, S. D., & Mays, V. M. (2009). Burden of psychiatric morbidity among lesbian, gay and bisexual individuals in the California quality of life survey. Journal of Abnormal Psychology, 118(3), 647–658.PubMedCrossRefGoogle Scholar
  8. Cochran, S. D., Ackerman, D., Mays, V. M., & Ross, M. W. (2004). Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction, 99(8), 989–998.PubMedCrossRefGoogle Scholar
  9. Colfax, G., & Shoptaw, S. (2005). The methamphetamine epidemic: Implications for HIV prevention and treatment. Current HIV/AIDS Reports, 2(4), 194–199.PubMedCrossRefGoogle Scholar
  10. Davis, L., Uezato, A., Newell, J. M., & Frazier, E. (2008). Major depression and comorbid substance use disorders. Current Opinion in Psychiatry, 21(1), 14–18.PubMedCrossRefGoogle Scholar
  11. Dew, M. A., Becker, J. T., Sanchez, J., Caldararo, R., Lopez, O. L., Wess, J., et al. (1997). Prevalence and predictors of depressive, anxiety and substance use disorders in HIV-infected and uninfected men: A longitudinal evaluation. Psychological Medicine, 27, 395–409.PubMedCrossRefGoogle Scholar
  12. Drake, R. E., O’Neal, E. L., & Wallach, M. A. (2008). A systematic review of psychosocial research on psychosocial interventions for people with co-occurring severe mental and substance use disorders. Journal of Substance Abuse Treatment, 34, 123–138.PubMedCrossRefGoogle Scholar
  13. Dutra, L., Stathopoulou, G., Basdee, S. L., Leyro, T. M., Powers, M. B., & Otto, M. W. (2008). A meta-analytic review of psychosocial interventions for substance use disorders. The American Journal of Psychiatry, 165, 179–187.PubMedCrossRefGoogle Scholar
  14. Halkitis, P. N., Moeller, R. W., Siconolfi, D. E., Jerome, R. C., Rogers, M., & Schillinger, J. (2008). Methamphetamine and poly-substance use among gym-attending men who have sex with men in New York City. Annals of Behavioral Medicine, 35(1), 41–48.PubMedGoogle Scholar
  15. Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Erickson, S. J. (2008). Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men. Health Psychology, 27(4), 455–462.PubMedCrossRefGoogle Scholar
  16. Hickie, I. B., Koschera, A., Davenport, T. A., Naismith, S. L., & Scott, E. M. (2001). Comorbidity of common mental disorders and alcohol or other substance misuse in Australian general practice. Medical Journal of Australia, 175(Suppl), S31–S36.PubMedGoogle Scholar
  17. Jaffe, A., Shoptaw, S., Stein, J. A., Reback, C. J., & Rotheram-Fuller, E. (2007). Depression ratings, reported sexual risk behaviors, and methamphetamine use: Latent growth curve models of positive change among gay and bisexual men in an outpatient treatment program. Experimental and Clinical Psychopharmacology, 15(3), 301–307.PubMedCrossRefGoogle Scholar
  18. Jané-Llopis, E., & Matytsina, I. (2006). Mental health and alcohol, drugs and tobacco: A review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs. Drug and Alcohol Review, 25(6), 515–536.PubMedCrossRefGoogle Scholar
  19. King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., et al. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 70.PubMedCrossRefGoogle Scholar
  20. Knox, S., Kippax, S., Crawford, J., Prestage, G., & Van De Ven, P. (1999). Non-prescription drug use by gay men in Sydney, Melbourne and Brisbane. Drug and Alcohol Review, 18(4), 425–433.CrossRefGoogle Scholar
  21. Körner, H., Newman, C., Mao, L., Kippax, S., Kidd, M.R., & Saltman, D.C. (2008). ‘It’s really a myriad of different signals, not just the textbook’: The complexities of diagnosing depression in gay men and HIV-positive men in general practice. Mental Health in Family Practice, 5, 167–175.Google Scholar
  22. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 609–613.CrossRefGoogle Scholar
  23. Mao, L., Kippax, S. C., Newman, C. E., Andrews, G., Rogers, G., Saltman, D. C., et al. (2008). Rates of depression among men attending high-HIV-caseload general practices in Australia. Mental Health in Family Medicine, 5(2), 79–83.Google Scholar
  24. Mao, L., Newman, C. E., Kidd, M. R., Saltman, D. C., Rogers, G. D., & Kippax, S. C. (2009a). Self-reported sexual difficulties and their association with depression and other factors among gay men attending high HIV-caseload general practices in Australia. Journal of Sexual Medicine, 6(5), 1378–1385.PubMedCrossRefGoogle Scholar
  25. Mao, L., Kidd, M. R., Rogers, G., Andrews, G., Newman, C. E., Booth, A., et al. (2009b). Social factors associated with Major Depressive Disorder in homosexually active, gay men attending general practices in urban Australia. Australian and New Zealand Journal of Public Health, 33, 83–86.PubMedCrossRefGoogle Scholar
  26. Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91(11), 1869–1876.PubMedCrossRefGoogle Scholar
  27. McPherson, T. L., & Hersch, R. K. (2000). Brief substance use screening instruments for primary care settings: A review. Journal of Substance Abuse Treatment, 18, 193–202.PubMedCrossRefGoogle Scholar
  28. Mills, T. C., Paul, J., Stall, R., Pollack, L., Canchola, J., & Chang, Y. J. (2004). Distress and depression in men who have sex with men: The urban men’s health study. The American Journal of Psychiatry, 161(2), 278–285.PubMedCrossRefGoogle Scholar
  29. Munro, I., & Edward, K. L. (2008). Mental illness and substance use: An Australian perspective. International Journal of Mental Health Nursing, 17(4), 255–260.PubMedCrossRefGoogle Scholar
  30. National Health and Medical Research Council. (2001). Australian alcohol guidelines: Health risks and benefits. Canberra: Commonwealth of Australia.Google Scholar
  31. Newman, C. E., Kippax, S. C., Mao, L., Saltman, D. C., & Kidd, M. R. (2008). GPs understanding of how depression affects gay and HIV positive men. Australian Family Physician, 37(8), 678–680.PubMedGoogle Scholar
  32. Newman, C. E., Kippax, S. C., Mao, L., Rogers, G., Saltman, D. C., & Kidd, M. R. (2009). Features of the management of depression in gay men and men with HIV from the perspective of Australian general practitioners. Family Practice, 26(1), 27–33.PubMedCrossRefGoogle Scholar
  33. Prachakul, W., Grant, J. S., & Keltner, N. L. (2007). Relationships among functional social support, HIV-related stigma, social problem solving, and depressive symptoms in people living with HIV: A pilot study. The Journal of the Association of Nurses in AIDS Care, 18(6), 67–76.PubMedCrossRefGoogle Scholar
  34. Rogers, G., Curry, M., Oddy, J., Pratt, N., Beilby, J., & Wilkinson, D. (2003). Depressive disorders and unprotected casual anal sex among Australian homosexually active men in primary care. HIV Medicine, 4(3), 271–275.PubMedCrossRefGoogle Scholar
  35. Saltman, D. C., Newman, C. E., Mao, L. K., Kippax, S. C., & Kidd, M. R. (2008). Experiences in managing problematic crystal methamphetamine use and associated depression in gay men and HIV positive men: in-depth interviews with general practitioners in Sydney, Australia. BMC Family Practice, 9, 45.PubMedCrossRefGoogle Scholar
  36. Simon, G. E., Fleck, M., Lucas, R., Bushnell, D. M., & LIDO Group. (2004). Prevalence and predictors of depression treatment in an international primary care study. The American Journal of Psychiatry, 161, 1626–1634.CrossRefGoogle Scholar
  37. Stall, R., Paul, J. P., Greenwood, G., Pollack, L. M., Bein, E., & Crosby, G. M. (2001). Alcohol use, drug use and alcohol-related problems among men who have sex with men: The urban men’s health study. Addiction, 96(11), 1589–1601. 1688.PubMedCrossRefGoogle Scholar
  38. Tennant, C. (2002). Life events, stress and depression: A review of recent findings. The Australian and New Zealand Journal of Psychiatry, 36, 173–182.PubMedCrossRefGoogle Scholar
  39. Sullivan, L. E., Fiellin, D. A., & O’Connor, P. G. (2005). The prevalence and impact of alcohol problems in major depression: A systematic review. The American Journal of Medicine, 118(4), 330–341.PubMedCrossRefGoogle Scholar
  40. Wang, J., Häusermann, M., Ajdacic-Gross, V., Aggleton, P., & Weiss, M. G. (2007). High prevalence of mental disorders and comorbidity in the Geneva gay men’s health study. Social Psychiatry and Psychiatric Epidemiology, 42(5), 414–420.PubMedCrossRefGoogle Scholar
  41. Waraich, P., Goldner, E. M., Somers, J. M., & Hsu, L. (2004). Prevalence and incidence studies of mood disorders: A systematic review of the literature. Canadian Journal of Psychiatry, 49(2), 124–138.Google Scholar
  42. Wong, C. F., Kipke, M. D., & Weiss, G. (2008). Risk factors for alcohol use, frequent use, and binge drinking among young men who have sex with men. Addictive Behaviors, 33(8), 1012–1020.PubMedCrossRefGoogle Scholar
  43. Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Martin Holt
    • 1
  • Joanne Bryant
    • 1
  • Christy E. Newman
    • 1
  • Dana M. Paquette
    • 1
  • Limin Mao
    • 1
  • Michael R. Kidd
    • 2
  • Deborah C. Saltman
    • 3
  • Susan C. Kippax
    • 4
  1. 1.National Centre in HIV Social Research, Level 2, Robert Webster buildingThe University of New South WalesSydneyAustralia
  2. 2.Faculty of Health SciencesFlinders UniversityAdelaideAustralia
  3. 3.Faculty of Arts and SciencesSouthern Cross UniversityLismoreAustralia
  4. 4.Social Policy Research CentreThe University of New South WalesSydneyAustralia
  5. 5.National Centre in HIV Social ResearchThe University of New South WalesSydneyAustralia

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