Alcohol and Depression

Critique #296 – Moderate Alcohol Consumption and Risk of Depression: A Longitudinal Analysis in Community-Dwelling Older Adults – October 2025

Reference: Moderate Alcohol Consumption and Risk of Depression: A Longitudinal Analysis in Community-Dwelling Older Adults. Mohebbi, M., Davoodian, N., Ganjali, S., Beilin, L.J., Berk, M., Forbes, M., McNeil, J.J., Nelson, M.R., Ryan, J., Wolfe, R., Woods, R.L., Lotfaliany, M. Nutrients. 2025 Aug 20;17(16):2688. https://doi.org/10.3390/nu17162688.

This study indicates a lower risk of depression among moderate alcohol drinkers compared to abstainers and those exceeding recommended guidelines. However, it does not definitively establish a protective causal effect of moderate alcohol consumption on depression. This study indicates a lower risk of depression among moderate alcohol drinkers compared to abstainers and those exceeding recommended guidelines. However, it does not definitively establish a protective causal effect of moderate alcohol consumption on depression.

For the detailed critique of this paper by the International Scientific Forum on Alcohol Research, please click here.

Critique 122:  Does moderate wine consumption lower the risk of developing depression? —  3 September 2013

Reference:  Gea A, Beunza JJ, Estruch R, et al (17 authors).  Alcohol intake, wine consumption and the development of depression: the PREDIMED study.  BMC Medicine 2013.  Advanced publication, released 29 August 2013.

There is a large literature relating heavy alcohol consumption to depression: most studies show that heavy drinkers tend to be depressed, and depressed people may self-medicate with large amounts of alcohol.  This large prospective study of subjects at high risk of cardiovascular disease has shown that “moderate” drinkers, especially wine drinkers (the majority of their subjects), were at lower risk of developing depression during 7 years of follow up than were non-drinkers.  An important aspect of this study is indeed that the analyses were based on moderate drinkers, as people exceeding certain amounts of alcohol or testing positive on the CAGE questionnaire (a measure of alcohol misuse) were excluded.

Strengths of the study include it being a large prospective study, with more than 5,000 subjects, aged 55-80 years at baseline, who were followed for up to 7 years for the initial development of clinical depression (which was diagnosed in 443 instances).  Especially important was the ability of the investigators to have repeated assessments of alcohol consumption, every two years.  A rather complete list of potentially confounding variables was available.  The key findings of the study were that subjects reporting  >5-15 grams/day of total alcohol intake, and wine drinkers of 2-7 drinks/week, were at a lower risk of developing depression than were non drinkers.

Some Forum members remained concerned that there may have been residual confounding by other lifestyle habits, and that the results may apply primarily to subjects who are also following a Mediterranean-type diet and lifestyle.  Also, data were not available to evaluate the relation of heavy drinking or alcoholism to depression.  However, the authors provide good scientific support for their conclusions that subjects reporting  >5-15 grams/day of total alcohol intake (from about ½ to 1 ½ of a typical drink), and wine drinkers of 2-7 drinks/week, are at approximately 30% lower risk of developing depression than are abstainers of alcohol.

For the full critique of this paper by members of the International scientific Forum on Alcohol Research, please click here.

Critique 098:  Moderate alcohol consumption may lower the risk of developing depression  —  13 December 2012

Reference: Gea A, Martinez-Gonzalez MA, Toledo E, Sanchez-Villegas A, Bes-Rastrollo M, Nuñez-Cordoba JM, Sayon-Orea C, Beunza JJ.  A longitudinal assessment of alcohol intake and incident depression: the SUN Project.  BMC Public Health 2012, 12:954 doi:10.1186/1471-2458-12-954

Analyses from a prospective study of more than 13,000 adults in Spain related baseline alcohol intake (mainly wine) with the development of depression, with the outcome based on a physician’s diagnosis or on the habitual use of anti-depressant drugs for four or more years.  Reported depression was much higher among women than men.  Among women, the estimated hazard ratios for groups reporting an average alcohol intake of < 5 g/day of alcohol, 5-15 g/day, and > 15 g/day were 0.97, 0.62, and 0.84 (in comparison with subjects reporting no alcohol).  The difference was statistically significant (CI = 0.43-0.89) for the group reporting 5-15 g/day.

Few men reported a diagnosis of depression; among moderately drinking men, the estimated risks of depression were similar to those of women, but none of the differences were statistically different from those of non-drinkers.  The investigators found no differences according to the type of alcoholic beverage consumed.

The merits of this study include that the data were collected prospectively, that there were repeated questionnaires seeking data on depression, and that there were a large number of subjects, all of whom were college graduates.  There were few men reporting depression, and few heavy drinkers, so results apply only to moderately drinking women.  Among these women (those consuming between about ½ drink/day to about 1 or 1 ½ drinks per day) there was evidence of a lower risk of depression during a follow-up period extending up to 10 years.

Forum reviewers thought that this was a well-done analysis, and the use of cut-points for drinking groups according to spline analyses was appropriate. Some reviewers cautioned that moderate drinkers, especially regular wine drinkers, tend to have a large number of other healthy lifestyle habits that could relate to the risk of depression. While many of the recognized potential confounders were included in the Cox regression analysis in this paper, it will be important to determine if future studies support the conclusions of the authors.

For the full critique of this paper by members of the International Scientific Forum on Alcohol Research, please click here.