Directions of the relationship between substance use and depressive symptoms from adolescence to young adulthood.
Both substance use and depression are common in adolescence and often comorbid. Past research has produced conflicting results on whether there is a temporal relationship and if so, in which direction it operates and how it may vary by sex. The purpose of this paper is to explore the longitudinal, potentially bidirectional, relationships between high-frequency substance use and depressive symptoms from adolescence into young adulthood for males and females.



Using data from the National Longitudinal Study of Adolescent to Adult Health we investigated longitudinal associations between high frequency substance use (alcohol, cigarettes, and marijuana) and depressive symptoms. The linear mixed effects models were stratified by sex and used a lagged measure of the dependent variable to test temporal relationships. A random intercept was used for respondent ID.



Increases in depressive symptoms were significantly associated with a later increase of about a half day in marijuana use frequency for males and nearly a two day increase in smoking frequency for females. Conversely, increases in smoking frequency were significantly associated with approximately a 0.6-point increase for females and 0.4-point increase for males in depressive symptoms at a later wave.



Results indicate a bidirectional relationship between smoking and depressive symptoms for females. For males, there was evidence supporting self-medication with marijuana and for smoking being associated with later increases in depressive symptoms. Results inform how substance use and depression screening, prevention and treatment efforts should be paired and targeted for males and females.
Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St., Room 208, Chapel Hill, NC 27516, United States; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 401 Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445, United States. Electronic address: wilkina@live.unc.edu.
Andra L
AL
Wilkinson
Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St., Room 208, Chapel Hill, NC 27516, United States; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 401 Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445, United States.
Carolyn Tucker
CT
Halpern
Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St., Room 208, Chapel Hill, NC 27516, United States; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7420, Chapel Hill, NC 27599-7420, United States.
Amy H
AH
Herring
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D063425:Binge Drinking / Q000453:epidemiology; D000073865:Cigarette Smoking / Q000453:epidemiology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D011446:Prospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Adolescence; Depression; Gender; Substance use; Young adulthood