Depression with and without Comorbid Substance Dependence in a Child Welfare Sample of Young Adults

Heather Orton Anderson,Anne M Libby

doi:10.1155/2011/475248

Abstract

The objective of this study was to estimate the prevalence of depression with and without substance dependence and examine the effect of risk factors on subsequent disorders among a cohort of young adults in the US Child Welfare System (CWS). We used longitudinal data for 834 young adults age 18–21 from the National Survey of Child and Adolescent Well-being. Depressive symptoms and substance use were measured at baseline (age 11–15); diagnoses of depression and substance dependence were identified at the last wave of data collection (age 18–21). Likelihood of subsequent depression with or without substance dependence was three times higher for those with clinically significant depressive symptoms at baseline. Frequent use of substances at baseline significantly increased the likelihood of subsequent depression with comorbid substance dependence compared to depression alone. These results support screening youth in the CWS at younger ages for both depressive symptoms and substance use with the hope that these disorders can be detected earlier.

Highlights

The US Child Welfare System (CWS) sees a large number of youth with mental health problems because they have often experienced maltreatment and other risk factors such as poverty and separation from caregivers [1,2,3]
The goal of the current study was to build on prior work of the authors [14] and use the newest data from Wave 5 of National Survey of Child and Adolescent Well-Being (NSCAW) to fill the following gaps: (1) estimate the prevalence of major depression with and without comorbid substance dependence among young adults in NSCAW, (2) estimate the effect of depressive symptoms and frequent substance use at baseline of NSCAW on subsequent depression with and without substance dependence, and (3) examine the effect of other possible risk factors measured at baseline of NSCAW on subsequent depression with and without comorbid substance dependence
In the National Comorbidity Study (NCS), past year major depression was seen in 21.2%, 11.7%, and 15.6% of young adults and adults age 17 to 18, 19 to 20, and 21 to 22 years, respectively [36]

Summary

Introduction

The US Child Welfare System (CWS) sees a large number of youth with mental health problems because they have often experienced maltreatment and other risk factors such as poverty and separation from caregivers [1,2,3]. A study of youth age 2 to 14 years (n = 3, 803) in the US CWS estimated that nearly half had significant emotional or behavioral problems upon entering the system [3]. One such study found that among youth in grades 6, 8, and 10 (n = 9, 863), substance use significantly increased the risk of depression, with relative risks ranging from 2.5 to 3.1 depending on the type of substance used [10]. Comorbid depression and substance use disorder is a risk factor for poor treatment outcomes, treatment dropout, and earlier relapse [11]. Youth with depression and comorbid substance use disorder have an increased risk for suicidal behaviors, including ideation, attempt, and completed suicide [12]

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Conclusion