Short communicationMajor depression associated with earlier alcohol relapse in treated teens with AUD
Introduction
Brown et al. Brown et al., 1994, Brown et al., 2000 demonstrated that early relapse is the norm among adolescents treated for alcohol use disorders (AUDs; alcohol abuse or dependence). Our own recent work (Cornelius et al., 2003) confirmed that finding. However, the factors that contribute to early relapse in treated teenagers remain unclear. For example, it is unclear whether the common comorbid diagnosis of major depressive disorder (MDD) is associated with an earlier relapse to alcohol use among teens with AUD. Brown et al. Brown et al., 1994, Brown et al., 2000 could not assess whether MDD was associated with an earlier relapse to alcohol use, because subjects with MDD were excluded from their study sample.
The purpose of the present study was to evaluate whether MDD is associated with an earlier alcohol relapse in treated teenagers with AUDs. Based on previous work with adults Daley & Marlatt, 1992, Pickens et al., 1985, we hypothesized that MDD would be associated with an earlier alcohol relapse among our teenage sample. To investigate this hypothesis, we determined the time to relapse among our sample of 116 adolescents with AUDs and compared the time to relapse of those with comorbid MDD to that of those who did not display comorbid MDD.
Section snippets
Methods
The study currently being reported was the Relapse Study of the Pittsburgh Adolescent Alcohol Research Center (PAARC), a center grant funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) studying AUDs among adolescents. The Relapse Study was designed to study clinical course and relapse among adolescents with AUDs. Prior to participation in the study, written informed consent was obtained after the procedures had been fully explained. The study was approved by the University
Results
The study sample consisted of 116 adolescents with current diagnoses of an AUD (alcohol dependence or alcohol abuse) between the ages of 14 and 18. The participants in this study included 75 boys (64.7%) and 41 girls (35.3%). Their mean age was 16.8 (±1.19). These subjects included 110 whites and 6 African–Americans. Fifty of these subjects (43.1%) demonstrated a current diagnosis of MDD. Those 50 subjects with MDD did not significantly differ from those without MDD on any measures of alcohol
Discussion
To our knowledge, this is the first study to evaluate whether MDD is associated with earlier relapse among adolescents with AUDs. The results of this study suggest that the presence of MDD is associated with an earlier relapse to alcohol use among adolescents with an AUD. These results are consistent with the results of previous studies involving adults with AUDs in the past Daley & Marlatt, 1992, Pickens et al., 1985 and extend the results of previous work involving adolescents with AUDs Brown
Acknowledgments
This work was conducted at the Pittsburgh Adolescent Alcohol Research Center (PAARC), a center grant funded by the National Institute on Alcohol Abuse and Alcoholism (P50 AA08746). Additional funding was provided by the following grants: R01 AA013370, R01 DA14635, R01 AA13397, R01 AA11929, P50 DA05605, K01 AA00324, K02 AA0291, K02 AA00249, and a grant from the Department of Veterans Affairs (MIRECC to VISN 4, Stars and Stripes Network).
References (10)
- et al.
Correlates of success following treatment for adolescent substance abuse
Applied & Preventive Psychology
(1994) - et al.
Fluoxetine in adolescents with major depression and an alcohol use disorder: An open label trial
Addictive Behaviors
(2001) - et al.
Rapid relapse generally follows treatment for substance use disorders among adolescents
Addictive Behaviors
(2003) - et al.
Schedule for affective disorders and schizophrenia for school-age children—resent and lifetime version (K-SADS0PL): Initial reliability and validity data
Journal of the American Academy of Child and Adolescent Psychiatry
(1997) - et al.
Inter-rater reliability of the SCID alcohol and substance use disorders section among adolescents
Drug and Alcohol Dependence
(2000)
Cited by (88)
Predictors and moderators of marijuana and heavy alcohol use outcomes in adolescents treated for co-occurring substance use and psychiatric disorders in a randomized controlled trial
2021, Journal of Substance Abuse TreatmentCitation Excerpt :More specifically, adolescents with comorbid SUD, externalizing, and internalizing disorders tend to experience a worse course of illness than those without such comorbidity (Rowe et al., 2004; Shane et al., 2003; Tomlinson et al., 2004). Across SUD outpatient, intensive outpatient, and inpatient/residential settings, comorbidity also impedes treatment response (Cornelius et al., 2004; Grella et al., 2004; Rowe et al., 2004; Shane et al., 2003; Tomlinson et al., 2004; White et al., 2004). Treatments designed to target comorbid symptom presentations are both necessary and scarce.
Evaluating alcohol demand, craving, and depressive symptoms among women in alcohol treatment
2020, Addictive BehaviorsA randomized trial of an integrated cognitive behavioral treatment protocol for adolescents receiving home-based services for co-occurring disorders
2020, Journal of Substance Abuse TreatmentCitation Excerpt :Not surprisingly, comorbidity is generally associated with a more severe course of illness, including suicide attempts/death (Brent et al., 1993; King et al., 1996), as well as aggressive and high-risk criminal behavior in early adulthood (Clingempeel, Britt, & Henggeler, 2008). In addition, comorbidity complicates treatment and has been associated with poorer treatment outcomes in terms of both substance use and psychiatric outcomes across outpatient, intensive outpatient, and inpatient/residential settings (Cornelius et al., 2004; Rowe et al., 2004; Shane, Jasiukaitis, & Green, 2003; Tomlinson, Brown, & Abrantes, 2004; White et al., 2004). Adolescents with comorbid SUD, externalizing and internalizing disorders, and those with a higher number of diagnoses in total tend to have the worst outcomes (Rowe et al., 2004; Shane et al., 2003; Tomlinson et al., 2004).
Integrated Treatment of Adolescents with Co-occurring Depression and Substance Use Disorder
2019, Child and Adolescent Psychiatric Clinics of North AmericaThe Impact of Motivational Interviewing on Delinquent Behaviors in Incarcerated Adolescents
2016, Journal of Substance Abuse TreatmentAge-varying associations between substance use behaviors and depressive symptoms during adolescence and young adulthood
2015, Drug and Alcohol DependenceCitation Excerpt :The co-occurrence of substance use and depression has important implications for the treatment both of substance use and mental health problems, as individuals with co-occurring disorders often have more severe substance use and mental health problems compared to individuals with standalone disorders (Couwenbergh et al., 2006; Grella et al., 2001; Rowe et al., 2004). Comorbidity is associated with worse alcohol and drug treatment outcomes among adults (Brown et al., 2004; Compton et al., 2003; Timko et al., 2010) and adolescents (Cornelius et al., 2004; Vourakis, 2005; White et al., 2004), as well as higher rates of suicide (Davis et al., 2008). Our results demonstrate significant associations between substance use behaviors and depressive symptoms throughout adolescence and young adulthood and allude to a role of polysubstance use in depression.