{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T11:43:42Z","timestamp":1785930222835,"version":"3.56.0"},"posted":{"date-parts":[[2026,8,3]]},"group-title":"Epidemiology","reference-count":62,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["UH3AI133675"],"award-info":[{"award-number":["UH3AI133675"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"award":["RF1MH132360"],"award-info":[{"award-number":["RF1MH132360"]}],"id":[{"id":"https:\/\/ror.org\/04xeg9z08","id-type":"ROR","asserted-by":"publisher"}]},{"name":"National Institute of Child Health and Human Development","award":["P2C HD050924"],"award-info":[{"award-number":["P2C HD050924"]}]},{"id":[{"id":"https:\/\/ror.org\/01xdqrp08","id-type":"ROR","asserted-by":"publisher"}]},{"name":"CUNY Institute for Implementation Science in Population Health"},{"name":"CUNY Graduate School of Public Health and Health Policy Department of Epidemiology and Biostatistics"},{"name":"COVID-19 Grant Program of the CUNY Graduate School of Public Health and Health Policy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Alcohol consumption is a modifiable risk factor linked to anxiety and depression, yet the population-level impact of reducing alcohol use on the prevalence of anxiety and depression symptoms remains unclear. Prior studies are limited by methodological challenges including health-related selection into abstinence, time-varying confounding and reverse causation.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data from 2,813 participants without documented underlying health conditions in a U.S. national longitudinal cohort (September 2021-December 2023) and applied the parametric g-formula within a target trial emulation framework to estimate the effect of a hypothetical intervention reducing alcohol consumption to low-risk levels on the prevalence of moderate-to-severe anxiety (GAD-7 \u226510) and depression (PHQ-8 \u226510) symptoms. The intervention set moderate- and high-risk drinking to low-risk at each follow-up, while leaving abstinent and low-risk drinking unchanged. Models adjusted for time-varying and baseline covariates, with uncertainty estimated using bootstrap resampling.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Under the natural course, the estimated prevalence of moderate-to-severe depressive symptoms was 12.67% (95% CI: 12.17, 13.23), compared to 12.77% (95% CI: 12.26, 13.29) under the intervention (risk difference: 0.10 percentage points; 95% CI: -0.22, 0.50). For anxiety symptoms, prevalence was 10.40% (95% CI: 8.89, 11.89) under the natural course and 10.25% (95% CI: 8.76, 11.98) under the intervention (risk difference: -0.15 percentage points; 95% CI: - 0.68, 0.35).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Under a hypothetical population-wide intervention reducing alcohol consumption to low-risk levels, differences in the prevalence of moderate or severe anxiety and depression symptoms were near null. These findings suggest that reducing alcohol use alone may be insufficient to meaningfully shift the population-wide burden of common mental health disorders.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.07.31.26359417","type":"posted-content","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:45:24Z","timestamp":1785775524000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of anxiety and depression symptoms under population-level alcohol reduction to low-risk drinking: A parametric g-computation analysis in a U.S. nationwide cohort"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3726-3724","authenticated-orcid":false,"given":"Jenna","family":"Sanborn","sequence":"first","affiliation":[{"name":"Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA"},{"name":"Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3280-5386","authenticated-orcid":false,"given":"Denis","family":"Nash","sequence":"additional","affiliation":[{"name":"Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA"},{"name":"Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8426-6572","authenticated-orcid":false,"given":"McKaylee","family":"Robertson","sequence":"additional","affiliation":[{"name":"Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA"},{"name":"Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4321-125X","authenticated-orcid":false,"given":"Angela","family":"Parcesepe","sequence":"additional","affiliation":[{"name":"Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA"},{"name":"Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA"},{"name":"Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8673-6759","authenticated-orcid":false,"given":"Zachary","family":"Shahn","sequence":"additional","affiliation":[{"name":"Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA"},{"name":"Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026080503451181000_2026.07.31.26359417v1.1","unstructured":"Mental Health By the Numbers. 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