Abstract
Residential instability, including transience (i.e. unusually frequent mobility), is associated with higher risk for emotional and behavioural problems in children and young adults. However, most studies have not compared the effect of recent v. more distal moves on mental health or on mental health treatment. This study examined associations between recent (past year) and distal (past 2-4 years) residential transience and past year major depressive episode (MDE) and mental health treatment in a nationally representative sample of US adolescents aged 12-17. Data are from the 2010-2014 National Surveys on Drug Use and Health (n = ~107 300 adolescents). T-tests were used to examine the prevalence of MDE by number of moves in the past 5 years among a nationally representative sample of adolescents. Additionally, multivariable logistic regression models were used to evaluate the adjusted association between recent (⩾2 moves in the past year) and distal (⩾4 moves in the past 5 years, but no recent transience) and (1) past year MDE and (2) past year mental health treatment among adolescents with MDE. MDE prevalence increased linearly with number of moves in the past 5 years (p < 0.001). The adjusted odds of MDE were greater among youths with distal transience (adjusted odds ratio (AOR) = 1.25, 95% confidence interval (CI) = 1.09-1.44) and among those with proximal transience (AOR = 1.31, 95% CI = 1.17-1.46), compared with those without transience in the past 5 years. The MDE prevalence did not differ between those with distal and proximal transience (p = 0.163). In youths with past year MDE, the prevalence of past year mental health treatment was greater among those with proximal transience compared with those without transience (AOR = 1.40, 95% CI = 1.15-1.70), but there was no significant difference in treatment among those with distal v. no transience. Distal and recent transience are associated with past year MDE among adolescents. Adolescents with MDE who had recent transience were more likely to receive past year mental health treatment compared with those without transience. However, those with only distal transience were not more likely to receive treatment. Parents, school officials and health care providers should be aware that residential mobility in the past 5 years may indicate increased odds of depression among adolescents even among adolescents whose housing stability has improved in the past year.
Highlights
The deleterious effects of depression are staggering – depression is the tenth leading cause of disability-adjusted life years lost (McKenna et al, 2005) and an attributable risk for about 50% of all suicidal ideation (Goldney et al, 2000)
One particular risk factor for depression that has received a fair amount of research is residential mobility and residential transience
Adolescents without transience were more likely to report living in a large metropolitan area than those with transience, but they were less likely to report living in a small metropolitan area compared with those with transience
Summary
The deleterious effects of depression are staggering – depression is the tenth leading cause of disability-adjusted life years lost (McKenna et al, 2005) and an attributable risk for about 50% of all suicidal ideation (Goldney et al, 2000). One particular risk factor for depression that has received a fair amount of research is residential mobility and residential transience. Residential transience is loosely defined as frequent residential mobility (Breakey and Fischer, 1995; Clark, 2010). This can be a stressful life event that, depending on frequency, may become a chronic stressor (Young and Dietrich, 2015). Social support networks, especially peer support networks (Hostinar et al, 2015), are important buffers to life stress (Hostinar and Gunnar, 2015; Tennant et al, 2015). In addition to the stress created by frequent moving being a risk factor for mental health
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