The mediating effects of depressive symptoms on the association of childhood maltreatment with non-medical use of prescription drugs.

BACKGROUND

Childhood maltreatment might increase the risk of subsequent drug use behavior, and depressive symptoms have been reported to be associated both childhood maltreatment and non-medical use of prescription drugs (NMUPD). This large-scale study aimed to test the mediating effects of depressive symptoms on the association of childhood maltreatment with NMUPD among Chinese adolescents.

METHODS

A secondary analysis of the cross-sectional data collected from 7th to 12th graders who were sampled using a multistage, stratified cluster, random sampling method in the 2015 School-based Chinese Adolescents Health Survey. There were 24,457 students who were invited to participate and 23,039 students' questionnaires were completed and qualified for our survey (response rate: 94.2%).

RESULTS

In the adjusted models without mediation, the results showed that students who reported that they had experienced emotional abuse were at a higher risk of past year use and past month use of opioids (past year: Adjusted OR [AOR] = 1.07, 95% CI = 1.05-1.10; past month: AOR = 1.08, 95% CI = 1.06-1.10) and sedatives (past year: AOR = 1.06, 95% CI = 1.03-1.08; past month: AOR = 1.15, 95% CI = 1.13-1.16). The results of mediation analyses demonstrated that there were significant standardized indirect effects of emotional abuse on opioids use and sedatives use through depressive symptoms, respectively (P < 0.001).

LIMITATIONS

Our study sample only included school students, and causal inference could not be examined due to the cross-sectional design.

CONCLUSIONS

Depressive symptoms play a significant mediator role on the association of childhood maltreatment with NMUPD. Interventions targeted at adolescents who are involved in NMUPD should pay attention to their histories of childhood maltreatment.