title: [Frequency of smoking, drinking, and substance use and their relationship to psychiatric comorbidity in children and adolescents with depression].
abstract: BACKGROUND
  Adolescence is a high-risk period with regard to the development of both affective disorders and unhealthy behaviors. The association between depression and smoking and drinking in adulthood and adolescence has been well established. Smoking in a young age increases the risk of substance abuse later in life, which in turn further increases the functional impairment caused by psychiatric illnesses. In our study, we investigated the frequency of smoking, alcohol consumption and substance abuse and their association with psychiatric disorders in a child population affected by depression.
  
  
  METHODS
  The study was carried out on 267 children at risk for depression. Psychiatric diagnosis was assessed by a semi-structured interview, while information on severity of depressive symptoms and on unhealthy behaviors was collected through self-report questionnaires.
  
  
  RESULTS
  Mean age of the sample was 12.4 years (SD: 2.6 years) and a major depressive disorder (MDD) was present in 51%. The prevalence of smoking and drinking behaviors was increased in the sample, 19.9% and 24%, respectively. MDD and comorbid anxiety disorders increased the risk of alcohol consumption (OR=2.81 and OR=2.61), while comorbid behavioral disorders enhanced the likelihood of smoking (OR=3.72). Of the various comorbid disorders, generalized anxiety disorder, social phobia and conduct disorder was shown to have notable effects.
  
  
  CONCLUSIONS
  Early screening for smoking and drinking behavior is very important in child and adolescent populations affected by depression. Anxiety and behavioral disturbances associated with depression increase the risk of unhealthy behaviors. Taking preventive measures as early as possible might significantly influence quality of life later as an adult.
authors.affiliation: Szegedi Tudomanyegyetem, Szent-Gyorgyi Albert Orvos- es Gyogyszeresztudomanyi Kozpont, Gyermekpszichiatriai Onalló Osztály, Szeged, Hungary. kiss@gyip.szote.u-szeged.hu
authors.forename: Eniko
authors.initials: E
authors.lastname: Kiss
authors.forename: Bettina
authors.initials: B
authors.lastname: Pikó
authors.forename: Agnes
authors.initials: A
authors.lastname: Vetró
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires