Subramaniam Geetha A, Stitzer Maxine A, Clemmey Philip, Kolodner Ken, Fishman Marc J
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York..
Drs. Subramaniam, Stitzer, and Fishman (part-time) are with the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore; Drs. Subramaniam and Fishman are also with Mountain Manor Treatment Center, Baltimore; and Dr. Kolodner is a private statistical consultant in Baltimore. At the time of the study, Dr. Clemmey was with Mountain Manor Treatment Center; he is now with St. Luke's-Roosevelt Hospital, New York.
J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):1062-1069. doi: 10.1097/chi.0b013e31806c7ad0.
To characterize baseline depressive symptoms among substance-abusing adolescents and determine their association with post residential treatment substance use outcomes.
In total, 153 adolescents (mean age 6.6 years, +/- 0.11) entering residential treatment were assessed at intake and at 3, 6, 9, and 12 months. Beck Depression Inventory (BDI) and Global Appraisal of Individual Needs were administered to assess depression, other risk factors, and substance use. A regression model was developed with 10 risk factors including BDI scores of >/=11 versus <11 to predict the outcome measure mean percentage of days in the past 90 days with any (nonnicotine) substance use.
At intake, 55% had BDI scores of >/=11. A baseline BDI score of >/=11 was significantly associated with greater mean percentage of days of substance use (27.5 +/- 3.8% versus 15.4 +/- 4.0% days, p <.01) across 1-year follow-up. Two other factors were significant: length of drug career >2 years and having an opioid use disorder.
Results from this prospective study, although preliminary, suggest the association of depressive symptoms with poorer substance outcomes and the utility of the BDI as a prognostic tool. They highlight the need for interventions targeting co-occurring depressive symptoms that may improve adolescent substance treatment outcomes.
描述药物滥用青少年的基线抑郁症状，并确定这些症状与住院治疗后药物使用结果之间的关联。
共有153名进入住院治疗的青少年（平均年龄16.6岁，标准差±0.11）在入院时以及在3、6、9和12个月时接受评估。使用贝克抑郁量表（BDI）和个体需求综合评估来评估抑郁、其他风险因素和药物使用情况。建立了一个回归模型，纳入10个风险因素，包括BDI得分≥11与＜11，以预测过去90天内使用任何（非尼古丁）药物的天数的平均百分比这一结果指标。
入院时，55%的青少年BDI得分≥11。在为期1年的随访中，基线BDI得分≥11与药物使用天数的平均百分比更高显著相关（分别为27.5±3.8%和15.4±4.0%，p＜0.01）。另外两个因素也具有显著性：吸毒史超过2年以及患有阿片类药物使用障碍。
这项前瞻性研究的结果虽然是初步的，但表明抑郁症状与较差的药物使用结果之间存在关联，以及BDI作为一种预后工具的效用。这些结果凸显了针对并发抑郁症状进行干预的必要性，这可能会改善青少年药物治疗的结果。
