Typologies of Alcohol Use in Korean Men and Women

Purpose: Approximately 20.2% of Korean adults are at risk drinkers (>7 drinks for men, >5 drinks for women), and 14.8% are either alcohol abusers or dependents. While there have been various cross-sectional studies that examined alcohol using behaviors of Korean adults, little is known about the dynamic nature of alcohol use within them, let alone gender-specific typologies. Consequently, it is not known whether the number and structure of subgroups of drinkers vary by gender. Besides, while problem drinking tends to co-occur with emotional and/or behavioral problems with the highest prevalence rates, the extent to which the patterns of co-occurring issues varied by gender is also absent from the literature. Using latent class analysis (LCA), this study examined whether different typologies of drinkers exist among Korean men and women and further explored differences among subtypes of drinkers on co-occurring depressive symptoms by gender. 

Method: A total of 14,177 legal aged drinkers including 6,427 men and 7,750 women extracted from the 2006 Korean Welfare Panel study (KOWEPS) were used in the analysis. Alcohol use was measured based on the following six questions regarding respondents’ drinking in the past year: quantity per drinking episode; frequency of drinking per week; and four items measuring alcohol-related problems. LCA was performed to classify subtypes of drinkers by gender who showed similar response patterns in their alcohol use. Additionally explored were possible linkages between the identified subtypes of drinkers, levels of depressive symptoms (the 11-item CES-D, α=.89), and sociodemographic factors (i.e., age, marital status, education attainment, and household income), using multinomial logistic regressions.

Results: Four distinct subtypes of drinkers emerged among Korean men: (a) abstainers (n=1,864, 29.0%); (b) infrequent-light drinkers with low alcohol-related problems (n=2,037, 31.7%); (c) frequent-heavy drinkers with moderate alcohol-related problems (n=1,634, 25.4%); and (d) frequent-heavy drinkers with high alcohol-related problems (n=892, 13.9%). For Korean women, three subtypes of alcohol users emerged from the analysis: (a) abstainers (n=5,366, 69.2%); (b) infrequent-light drinkers with low alcohol-related problems (n=2,133, 27.5%); and (c) frequent-heavy drinkers with moderate alcohol-related problems (n=251, 3.2%). Multinomial logistic regression results, controlling for sociodemographic factors, indicated that, for Korean men, frequent-heavy drinkers with high alcohol-related problems experienced greater levels of depressive symptoms (OR=1.04, p<.001) in reference to the male abstainers. For Korean women, frequent-heavy drinkers with moderate alcohol-related problems presented greater levels of depressive symptoms (OR=1.06, p<.001) than the female abstainers.

Implications: Findings on the distinct subtypes of alcohol users and the association with the levels of depressive symptoms that varied by gender and drinker subtypes provide preliminary evidence that the drinking behavior classifies into a gender-specific typology and that the co-occurring depression can distinguish heavy drinkers from non-drinkers. Specifically, frequent-heavy drinkers whom also presented high (males) or moderate (females) alcohol-related problems were more likely to experience greater levels of depression. These behavioral findings may support the underlying mechanisms of self-medicating needs of drinkers whom also present mental health issues that have not been adequately treated. An efficient integrative care system is suggested for heavy drinkers with comorbid depression.