Alcohol Use and Mental Health in Middle-aged Women. Women´s Health in Lund Area, a Swedish Population-based Study

Sammanfattning: Alcohol use and mental health of the general population is of public health concern. Few population-based studies have focused on middle-aged women. The aim of this thesis was to increase knowledge about middle-aged women’s alcohol consumption, drinking patterns, mental symptoms and use of psychotropic drugs. A separate analysis focuses on immigrant women. All women aged 50-59 (n=10,766), born between 1935 and 1945, and living in the Lund area of southern Sweden, were invited to participate in a health survey (WHILA). A total of 6,917 women (64.2%) answered a questionnaire and underwent a physical examination that was carried out between 1995 and 2000. This thesis is based on material from the questionnaire. Three out of four middle-aged women drank alcohol weekly. Wine was the dominant beverage. For most women consumption was low, while binge drinking (i.e. heavy occasional drinking) was common. Several differences regarding social situation and physical health were found between those who did not drink alcohol weekly compared to weekly drinkers, all implying a more unfavourable situation for the former. This was more pronounced among abstainers than those who drank alcohol less than weekly. Most associations to poorer health vanished in the multivariate logistic regression analysis, while most associations to poorer social situation remained. Immigrants from Eastern Europe and outside Europe were more often non-drinkers, in particular those who immigrated later in life. This study illustrates poor subjective health among middle-aged women. Mental symptoms were common, and severe (i.e. many) mental symptoms were strongly associated with severe physical symptoms. In women with severe mental symptoms, 15.4% used psychotropic drugs regularly and 4.1% had medical control for mental reasons. Immigrants were not more often troubled by severe mental symptoms than Swedish-born women. Neither level of alcohol consumption nor binge drinking was associated with severity of mental symptoms, use of psychotropic drugs, treatment for a mental disorder, lifelong or previous year suicidal behaviour. However, drinking alcohol to relieve tension, affirmed by 7.2% of the women, was associated with severe mental symptoms as well as binge drinking. In health care, attention should be paid to middle-aged women’s drinking patterns and mental health problems.