Substance Use and the Treatment of Resistant Depression in Adolescents

Autor/inn/en	Goldstein, Benjamin I.; Shamseddeen, Wael; Spirito, Anthony; Emslie, Graham; Clarke, Greg; Wagner, Karen Dineen; Asarnow, Joan Rosenbaum; Vitiello, Benedetto; Ryan, Neal; Birmaher, Boris; Mayes, Taryn; Onorato, Matthew; Zelazny, Jamie; Brent, David A.
Titel	Substance Use and the Treatment of Resistant Depression in Adolescents
Quelle	In: Journal of the American Academy of Child & Adolescent Psychiatry, 48 (2009) 12, S.1182-1192 (11 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-8567
DOI	10.1097/CHI.0b013e3181bef6e8
Schlagwörter	Sexual Abuse; Schizophrenia; Drug Use; Suicide; Adolescents; Severity (of Disability); Depression (Psychology); Disabilities; Drug Therapy; Outcomes of Treatment; Science Education + Suchen Sie Ihr Suchwort? Sexueller Missbrauch; Schizophrenie; Drug consumption; Substance abuse; Drogenkonsum; Selbstmord; Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Schweregrad; Handicap; Behinderung; Naturwissenschaftliche Bildung
Abstract	Objective: Despite the known association between substance use disorders and major depressive disorder (MDD) among adolescents, little is known regarding substance use among adolescents with MDD. Method: Youths with MDD who had not improved after an adequate selective serotonin reuptake inhibitor trial (N = 334) were enrolled in the Treatment of SSRI-Resistant Depression in Adolescents trial. Analyses examined substance use (via the Drug Use Severity Index) and changes therein in relation to treatment and depressive symptoms. Adolescents meeting substance use disorder criteria via the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version at baseline were excluded. Results: Substance use was common: 28.1% reported repeated experimentation at baseline. Substance-related impairment was associated with baseline depression severity, older age, physical/sexual abuse, family conflict, hopelessness, and comorbid oppositional defiant disorder/conduct disorder. There was significant improvement in substance-related impairment among adolescents who responded to MDD treatment. Baseline suicidal ideation was higher among the subjects who progressed to high substance-related impairment (greater than or equal to 75th percentile) versus those whose substance-related impairment remained low (less than 75th percentile), and parental depressive symptoms predicted persistence of high substance-related impairment during the study. The MDD response was best among the adolescents with low 12 week substance-related impairment scores regardless of whether they had high or low baseline substance-related impairment. There were no significant differential effects of specific treatments, pharmacological or cognitive-behavioral therapy, on substance use. Conclusions: Substance use is common among adolescents with treatment-resistant MDD. The subjects who had persistently low substance-related impairment or who demonstrated reduced substance-related impairment had better MDD treatment response, although the direction of this association is uncertain. (Contains 4 tables.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10