Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, TX, USA.
Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA.
J Affect Disord. 2024 Dec 1;366:210-216. doi: 10.1016/j.jad.2024.08.128. Epub 2024 Aug 24.
There is a robust relationship between depression and substance use in youth, with higher levels of substance use associated with greater depressive symptomatology. However, previous research has examined individual substances, without consideration of psychiatric comorbidities. Here, we investigate patterns of substance use among depressed and/or suicidal youth within the context of psychiatric comorbidities.
945 youth with depression and/or suicidality from the Texas Youth Depression and Suicide Research Network (TX-YDSRN) were assessed for current use of alcohol, nicotine, cannabis, and other drugs and comorbid psychiatric diagnoses. We used latent class analysis to identify patterns of past-year substance use, then examined if demographics or psychiatric disorders predicted class membership.
We identified three patterns of substance use: non-use (63.4 %), moderate likelihood of using alcohol, nicotine and cannabis (23.8 %), and high likelihood of using all substances (12.7 %). Compared to non-users, individuals in the moderate and high likelihood classes were more likely to be older. Individuals in the high likelihood class were more likely to have a substance use disorder, ADHD, and higher suicidality scores.
We cannot ascertain the causal or temporal ordering of substance use and psychiatric diagnoses due to the cross-sectional nature of the study.
Using a brief, self-report measure of substance use, we identified three classes of substance users differing in probability of past-year use, which were predicted by older age and some psychiatric comorbidities. While research on universal screening of substance use in youth remains limited, we discuss who may benefit from such screening among depressed youth.
青少年的抑郁和物质使用之间存在着很强的关系，物质使用水平越高，抑郁症状越严重。然而，之前的研究只检查了个别物质，而没有考虑到精神共病。在这里，我们在精神共病的背景下研究抑郁和/或有自杀意念的青少年的物质使用模式。
来自德克萨斯州青少年抑郁和自杀研究网络（TX-YDSRN）的 945 名有抑郁和/或自杀倾向的青少年接受了当前使用酒精、尼古丁、大麻和其他药物以及合并的精神诊断评估。我们使用潜在类别分析来识别过去一年物质使用的模式，然后检查人口统计学特征或精神障碍是否预测类别成员身份。
我们确定了三种物质使用模式：非使用者（63.4%）、中度可能使用酒精、尼古丁和大麻（23.8%）以及高度可能使用所有物质（12.7%）。与非使用者相比，中度和高度可能使用的类别中的个体年龄较大。高度可能使用类别的个体更有可能患有物质使用障碍、注意力缺陷多动障碍和更高的自杀意念得分。
由于研究的横断面性质，我们无法确定物质使用和精神诊断的因果或时间顺序。
使用简短的自我报告物质使用测量方法，我们确定了三种物质使用者群体，他们在过去一年中使用的可能性不同，这是由年龄较大和一些精神共病预测的。虽然关于青少年普遍筛查物质使用的研究仍然有限，但我们讨论了在抑郁青少年中谁可能受益于这种筛查。
