Anxiety and depression, as well as alcohol use are widespread among teenagers, and constitute a huge public health burden worldwide.

To study the link between alcohol consumption and emotional distress (anxiety and depression) among adolescents.

We conducted a cross-sectional study in May and June 2016. The sample consisted of 314 pupils from 4 colleges and schools in Sfax (Tunisia). Alcohol Use Disorders Test (AUDIT) was used to evaluate alcohol dependence. Anxiety and depression levels were evaluated using the “Hospital Anxiety and Depression Scale” (HADS).

The mean age was 16 years with a sex ratio of 1.08. Among the participants, 18.9% reported having drunk alcohol at least once and 42.37% of them still consume. The main reasons for alcohol initiation were the search of new experiences (78%) or pleasure and well-being (39%) and the curiosity (49.15%). According to AUDIT, 1.7% of alcohol users presented an alcohol misuse and 20% presented dependence.

The prevalence of anxiety and depression were respectively 56.1% and 23.7%. Anxiety was correlated to alcohol experimentation (P = 0.03) and non-supportive environment (P = 0.003). Depression was correlated to alcohol experimentation (P = 0.001), AUDIT score (P = 0.009), somatic histories (P = 0.02), physical abuse (P = 0.02), non-supportive environment (P = 0.016) and graduating class level (P = 0.005).

Our study highlights the close association between alcohol consumption and emotional distress in adolescence, which seems to be bi-directional. When attempting to reduce the risk of alcohol consumption, we should focus a particular attention on adolescents studying in graduating class, reinforce adolescents’ family support and prevent physical abuse.

The authors have not supplied their declaration of competing interest.