Depression and alcohol use in the university context

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DEPRESSION AND ALCOHOL USE IN THE UNIVERSITY CONTEXT

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Lisa Outini / 20170955                                                                         Mister Frederic Avesque

INTRODUCTION.

    Alcohol consomation seems to date from the Neolithic. Traces of it can be found in China in 10,000 B.C. and some anthropologists have suggested that the technique of making beer may have preceded that of bread. A certain hypothesis presented by Professors Dustin Stephen and Robert Dudley called "The Drunken Monkey Hypothesis" would even explain the attraction and addiction to the alcohol present in ripe fruit and would have been of evolutionary interest to our hominid ancestors.

    Today, alcohol plays a considerable role in our modern civilizations: food or poisons, substances useful to hygiene and industry or harmful to health, alcoholic liquids are in all hands. For several years now, we have been noticing a rejuvenation of the alcohol-consuming population. Indeed, the number of students consuming this substance is constantly increasing, but at what price ? Certain psychological pathologies such as depression may be the cause or the result of this excessive consumption. In view of the prevalence of mood disorders in the population and the increase in alcohol consumption in the university context, it seems interesting to me to observe the co-morbidities between these two variables. We will therefore examine the links between alcohol consumption and depressive state among students. We are not focusing on the sense of causality between addictive disorder and mood disorder but on the co-morbidity between these disorders.

I. ALCOHOL CONSUMPTION AMONG STUDENTS.

1.1. Definition of alcohol use disorders.

    Alcoholism, as a syndrome, was independently described in 1785 by the American physician Benjamin Rush and the British physician Thomas Trotter. Dependence is a compulsive craving, loss of control over its use, continued use despite negative consequences, and the development of physical dependence. The use of harmful substances that cause dependence is common (J. Garbutt, R. Gwyther , J. Thorpe Jr.). Alcoholism is defined as a complex pathological conduct, which is related to each individual's history but is primarily an addiction. This pathology includes 3 different fields; the biological field, the psychological field and the social field. (P. Hallouët). Beginning to drink alcohol and use drugs in adolescence would significantly increase the risk of presenting, in adulthood, alcohol abuse problems or alcohol dependence disorders (DeWit, 2000).

    It is generally estimated that there are about 5,000,000 people in France with alcohol problems, 2 million of whom are alcohol-dependent. (F.Paille). In 2014, the overall consumption per capita per year in France is 11.5 litres of pure alcohol per inhabitant of over 15 years according to the WHO. (P. Gache).

    With the release of the DSM-5, alcoholic disease becomes the alcohol use disorder, taking into account both dependence and damage according to a gradient of severity (C. Dano, F. Le Geay, Brière). The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) proposes an 11-criteria diagnosis of alcohol use disorder with three levels of severity: mild (at least 2 criteria present out of 11), moderate (at least 4) and severe (at least 6) : recurrent alcohol use resulting in difficulties in fulfilling work or family obligations, recurrent alcohol use resulting in physical endangerment of the subject, persistence of alcohol use despite recurrent or ongoing social or interpersonal problems caused or exacerbated by the effects of alcohol, tolerance, a clear need to increase the quantities of alcohol to reach a state of intoxication or the desired effect a clear decrease in the effect produced if the same quantity of alcohol is used continuously, signs of withdrawal, alcohol is consumed in greater quantities or over a longer period of time than intended, there is a persistent desire or unsuccessful efforts on the part of the subject to stop or control his or her drinking, significant time is spent by the subject on activities aimed at acquiring alcohol to consume or recovering from the effects of drinking, important professional/personal or recreational activities are abandoned in favor of drinking, Alcohol use remains the same despite the awareness of the existence of continuous or recurrent physical or psychological repercussions of consumption and the regular presence of craving or a strong or compulsive desire to consume alcohol. (SRAE)

1.2 Alcohol use among students.

    Alcohol consumption is a complex issue that is influenced by many factors. Three elements and their interactions must therefore be taken into account: the product (its properties, frequency of consumption, method of administration), the individual (history, experience, genetic heritage, motivations for consumption) and the environment (culture, legislation, advertising, surroundings). (Olievenstein).

    In recent years we have noticed a rejuvenation of alcohol consumption, a significant increase in "binge drinking" behaviour (drinking to intoxication, also known as "express drinking") where alcohol becomes the central, or even exclusive, element of the party and polydrinking practices remain important and are sometimes on the increase for certain sections of the population: 35% of 17-year-olds declare using alcohol and cannabis, 10% alcohol and medicines (ESPAD 2005 survey). Excessive drinking is characteristic of young people (Davis, 2006; Demers and Quesnel Vallée, 1998; RISQ, 2005). Alcohol is highly culturally entrenched and valued in France. Its consumption is associated with relaxation, partying and fun. For the vast majority of the population, its consumption is not problematic. It is the most common, accessible and culturally accepted psychotropic drug in our society. (M. de Duve, 2007). For some students, the use of licit and illicit products seems to facilitate social integration (V. Migeot, I. Ingrand, G. Defossez, F. Salardaine, M.F. Lahorgue, Christian Poupin, Daniel Marcelli, A. Texier and P. Ingrand). Alcohol consumption among the students in this study would therefore be part of a socialisation process or festive atmosphere that marks the transition from secondary to tertiary level. The fact that 30% of the students who drank alcohol began their consumption in a bar or discotheque is an argument in favour of this hypothesis. Individuals, and young people in particular, are socially connected. Their behaviour with alcohol is also socially connected. The majority of drinkers started drinking in the company of a friend or family member. Peers and parents thus play an important role in young people's decisions about whether and how to drink. (C. Zedini, J. Sahli, M. El Ghardallou, M. Mellouli, M. Limam, S. Bouhlel, A. Mtiraoui and T. Nabli Ajmi).

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