title: The relationship between depressive symptom levels and subsequent increases in substance use among youth with severe emotional disturbance.
abstract: OBJECTIVE
  This study examined the relationship between levels of depressive symptoms and subsequent increases in substance use among 784 youth with severe emotional disturbance enrolled in Medicaid-funded behavioral health care plans.
  
  
  METHODS
  Youth at five sites nationwide were interviewed about their emotional and behavior problems, as well as their use of cigarettes, alcohol, and drugs--at both baseline and follow-up.
  
  
  RESULTS
  (1) Levels of depressive symptoms were significantly associated with concurrent substance use at baseline. (2) Baseline levels of depressive symptoms predicted subsequent changes in substance use, especially use of illicit drugs and multiple drugs. (3) These findings remained significant, even after controlling for sociodemographic, family, and individual characteristics.
  
  
  CONCLUSIONS
  These results indicate that depressive symptoms early in life may signal a risk for increasing involvement in substance use among severe emotional disturbed youth. This finding has important clinical implications for the prevention of substance misuse in this population.
authors.affiliation: Mailman School of Public Health, Columbia University, New York, New York 10032, USA. wup@childpsych.columbia.edu
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
authors.forename: Christina W
authors.initials: CW
authors.lastname: Hoven
authors.forename: Xinhua
authors.initials: X
authors.lastname: Liu
authors.forename: Cordelia J
authors.initials: CJ
authors.lastname: Fuller
authors.forename: Bin
authors.initials: B
authors.lastname: Fan
authors.forename: George
authors.initials: G
authors.lastname: Musa
authors.forename: Judith
authors.initials: J
authors.lastname: Wicks
authors.forename: Donald
authors.initials: D
authors.lastname: Mandell
authors.forename: Judith A
authors.initials: JA
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D001521:Behavior Therapy; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D018450:Disease Progression; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D010552:Personality Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D014481:United States
chemical_list: D013287:Illicit Drugs