This longitudinal epidemiologic study examined how levels of psychiatric distress over one year may be influenced by both concurrent levels of alcohol use and by prior drinking levels. The study's data were gathered during the 1981-1982 Eastern Baltimore Mental Health Survey (EBMHS), as part of the 5-site National Institute of Mental Health Epidemiologic Catchment Area (NIMH-ECA) Program. The 2091 respondents (18-64 years of age) reinterviewed after one year were initially selected by means of multistage probability sampling of adult household residents in eastern Baltimore, Maryland. The findings for men and women indicated that both high psychiatric distress at baseline interview and concurrent heavy alcohol use were associated with higher levels of psychiatric distress at one-year follow-up. Differences across population subgroups were also noted. Among women, the results further suggested that prior heavy alcohol use was an additional predictor of psychiatric distress levels after one year; this was not found for men.