title: Onset of alcohol or substance use disorders following treatment for adolescent depression.
abstract: OBJECTIVE
  This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD).
  
  
  METHODS
  For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original TADS treatment response rating and a more restrictive symptom count rating. During follow-up, diagnostic interviews were completed at 6- or 12-month intervals to assess onset of AUD or SUD as well as MDD recovery and recurrence.
  
  
  RESULTS
  Achieving a positive response to MDD treatment was unrelated to subsequent AUD but predicted a lower rate of subsequent SUD, regardless of the measure of positive response (11.65% vs. 24.72%, or 10.0% vs. 24.5%, respectively). Type of initial MDD treatment was not related to either outcome. Prior to depression treatment, greater involvement with alcohol or drugs predicted later AUD or SUD, as did older age (for AUD) and more comorbid disorders (for SUD). Among those with recurrent MDD and AUD, AUD preceded MDD recurrence in 24 of 25 cases.
  
  
  CONCLUSIONS
  Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD. Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, and Duke Clinical Research Institute, Durham, North Carolina 27705, USA. john.curry@duke.edu
authors.forename: John
authors.initials: J
authors.lastname: Curry
authors.forename: Susan
authors.initials: S
authors.lastname: Silva
authors.forename: Paul
authors.initials: P
authors.lastname: Rohde
authors.forename: Golda
authors.initials: G
authors.lastname: Ginsburg
authors.forename: Betsy
authors.initials: B
authors.lastname: Kennard
authors.forename: Christopher
authors.initials: C
authors.lastname: Kratochvil
authors.forename: Anne
authors.initials: A
authors.lastname: Simons
authors.forename: Jerry
authors.initials: J
authors.lastname: Kirchner
authors.forename: Diane
authors.initials: D
authors.lastname: May
authors.forename: Taryn
authors.initials: T
authors.lastname: Mayes
authors.forename: Norah
authors.initials: N
authors.lastname: Feeny
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Albano
authors.forename: Sarah
authors.initials: S
authors.lastname: Lavanier
authors.forename: Mark
authors.initials: M
authors.lastname: Reinecke
authors.forename: Rachel
authors.initials: R
authors.lastname: Jacobs
authors.forename: Emily
authors.initials: E
authors.lastname: Becker-Weidman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Weller
authors.forename: Graham
authors.initials: G
authors.lastname: Emslie
authors.forename: John
authors.initials: J
authors.lastname: Walkup
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kastelic
authors.forename: Barbara
authors.initials: B
authors.lastname: Burns
authors.forename: Karen
authors.initials: K
authors.lastname: Wells
authors.forename: John
authors.initials: J
authors.lastname: March
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D005473:Fluoxetine