Major depressive disorder as a moderator of the relationship between heavy-episodic drinking and anxiety symptoms.

Background: Major depressive disorder and heavy-episodic drinking are risk factors for the development of anxiety. However, the interactive effect between these constructs for predicting anxiety symptoms remains understudied.

Aims: This study sought to examine how major depressive disorder moderates the relationship between heavy-episodic drinking frequency and the development of anxiety symptoms in adolescence and emerging adulthood among a sample of justice-involved youth, with expectations that the salience of this relationship may differ based on life-course stage.

Methods: Several waves of the Pathways to Desistance study were analyzed. Poisson regression with robust standard errors was used to test the direct and interactive effects of major depressive disorder and heavy-episodic drinking frequency on anxiety symptoms at follow-up in adolescence and emerging adulthood separately.

Results: Results indicated that there was a significant negative interaction between major depressive disorder and heavy-episodic drinking frequency for predicting anxiety scores in both adolescence and emerging adulthood, though the results for adolescence were more robust.

Conclusions: These results suggest youth without major depressive disorder that engage in heavy-episodic drinking may be a priority population for treating anxiety issues, but that ceiling effects may limit the impact of the behavior on anxiety on youth with major depressive disorder.