title: The relation of substance use with different levels of depressive symptoms and the moderating effect of sex and age in Taiwanese adolescents.
abstract: BACKGROUND
  The aim of this cross-sectional study was to examine (a) the relation of substance use with different levels of depressive symptoms and (b) the moderating effect of sex and age on the association between different levels of depressive symptoms and substance use in Taiwanese adolescents.
  
  
  METHODS
  The study group consisted of 9070 adolescent students in southern Taiwan aged 12 to 19 years who were sorted into 3 different levels of depressive symptoms on the Center for Epidemiologic Studies Depression Scale. The Questionnaire for Experience in Substance Use was used to assess each participant's experience with smoking, alcohol consumption, betel nut chewing, sedative/hypnotic use, and illicit drug use in the preceding year. The rates of substance use were compared among adolescents with different levels of depressive symptoms using generalized linear mixed-model analysis. The moderating effects of sex and age on the association between different levels of depressive symptoms and substance use were also examined.
  
  
  RESULTS
  Adolescents with severe depressive symptoms had higher rates of using all 5 kinds of substances than did nondepressed ones. Adolescents with minor depressive symptoms had higher rates of using all substances except for illicit drugs than did nondepressed ones. There was no significant difference in the rates of substance use between adolescents with severe and minor depressive symptoms. Sex and age had no moderating effect on the association between the level of depressive symptoms and substance use.
  
  
  CONCLUSIONS
  It is necessary to carefully screen substance use among adolescents with depressive symptoms, even if they are below the threshold for significant depression.
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital No 100, Kaohsiung 807, Taiwan.
authors.forename: Peng-Wei
authors.initials: PW
authors.lastname: Wang
authors.forename: Huang-Chi
authors.initials: HC
authors.lastname: Lin
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.forename: Tai-Ling
authors.initials: TL
authors.lastname: Liu
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D044466:Asian People; D002648:Child; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012737:Sex Factors; D013334:Students; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult