Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA.
Department of Statistics & Data Science, Dietrich College of Humanities and Social Sciences, Carnegie Mellon University, Pittsburgh, PA, USA.
J Affect Disord. 2024 Jan 1;344:397-406. doi: 10.1016/j.jad.2023.10.066. Epub 2023 Oct 14.
Few studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD).
Data from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016-2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations.
The overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18.
These findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.
鲜有研究关注青少年物质使用和抑郁症状与成年期重度抑郁症（MDD）之间的关联。
数据来自于 2016-2019 年全国药物使用与健康调查中的 168859 名成年人，其中 15959 人在过去一年中经历过 MDD，表现为 MDD 症状明显的重度抑郁发作（MDE）。采用加权多变量逻辑回归（MLR）分析确定关联。
总体 MDD 的患病率为 7.2%，而 18 岁前无早期抑郁症状的成年人的患病率为 4.6%。变量聚类分析显示，18 岁前青少年使用酒精、香烟、大麻、可卡因、致幻剂和吸入剂与一个聚类有关。MLR 分析表明，18 岁前出现抑郁症状是 MDD 的主要危险因素，而 18 岁前使用酒精、大麻和吸入剂与 MDD 的发病风险增加相关（p<0.05），这在全数据和 18 岁前无抑郁症状的成年人亚组中均成立。18 岁前使用可卡因与 MDD 仅在全数据中相关，而青少年使用无烟烟草与 MDD 仅在 18 岁前无抑郁症状的人群中相关。
这些发现强调了青少年期同时存在共病的早期物质使用和抑郁症状与成年期 MDD 的关系。干预策略应同时针对 18 岁前的早期物质使用和抑郁症状。
