Baseline depressive symptoms predict poor substance use outcome following adolescent residential treatment.
OBJECTIVE
To characterize baseline depressive symptoms among substance-abusing adolescents and determine their association with post residential treatment substance use outcomes.


METHODS
In total, 153 adolescents (mean age 6.6 years, +/- 0.11) entering residential treatment were assessed at intake and at 3, 6, 9, and 12 months. Beck Depression Inventory (BDI) and Global Appraisal of Individual Needs were administered to assess depression, other risk factors, and substance use. A regression model was developed with 10 risk factors including BDI scores of >/=11 versus <11 to predict the outcome measure mean percentage of days in the past 90 days with any (nonnicotine) substance use.


RESULTS
At intake, 55% had BDI scores of >/=11. A baseline BDI score of >/=11 was significantly associated with greater mean percentage of days of substance use (27.5 +/- 3.8% versus 15.4 +/- 4.0% days, p <.01) across 1-year follow-up. Two other factors were significant: length of drug career >2 years and having an opioid use disorder.


CONCLUSIONS
Results from this prospective study, although preliminary, suggest the association of depressive symptoms with poorer substance outcomes and the utility of the BDI as a prognostic tool. They highlight the need for interventions targeting co-occurring depressive symptoms that may improve adolescent substance treatment outcomes.
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York.. Electronic address: gsubram@jhmi.edu.
Geetha A
GA
Subramaniam
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York.
Maxine A
MA
Stitzer
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York.
Philip
P
Clemmey
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York.
Ken
K
Kolodner
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York.
Marc J
MJ
Fishman
D000293:Adolescent; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D012114:Residential Treatment; D012307:Risk Factors; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*