The relationship between depressive symptom levels and subsequent increases in substance use among youth with severe emotional disturbance.
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.
Wu
Ping
P
Mailman School of Public Health, Columbia University, New York, New York 10032, USA. wup@childpsych.columbia.edu
Hoven
Christina W
CW
Liu
Xinhua
X
Fuller
Cordelia J
CJ
Fan
Bin
B
Musa
George
G
Wicks
Judith
J
Mandell
Donald
D
Cook
Judith A
JA
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
D013287:Illicit Drugs