TY - JOUR
T1 - Major depression and treatment response in adolescents with ADHD and substance use disorder
AU - Warden, Diane
AU - Riggs, Paula D.
AU - Min, Sung Joon
AU - Mikulich-Gilbertson, Susan K.
AU - Tamm, Leanne
AU - Trello-Rishel, Kathlene
AU - Winhusen, Theresa
N1 - Funding Information:
Funding for the main study was provided by NIDA ( U10DA013732 , U10DA013716 , U10DA020024 ). Data analysis for this secondary analysis was also supported by NIDA. NIDA's Publications Committee approved the manuscript for submission for publication.
Funding Information:
Diane Warden, Ph.D., M.B.A. has owned stock in Pfizer, Inc. and Bristol Meyers Squibb within the last 5 years and has received funding from the National Alliance for research in schizophrenia and depression.
Funding Information:
Paula D. Riggs, M.D. has received funding from the National Institute on Drug Abuse in the past 5 years and has received honoraria and/or travel support for giving scientific presentations at the American Academy of Child and Adolescent Psychiatry, Sheppard Pratt Hospital; McGill University; University of Washington; California Society of Addiction Medicine; Science and Management of Addiction Foundation; and the Colorado Department of Behavioral Health.
PY - 2012/1/1
Y1 - 2012/1/1
N2 - Background: Major depressive disorder (MDD) frequently co-occurs in adolescents with substance use disorders (SUDs) and attention deficit hyperactivity disorder (ADHD), but the impact of MDD on substance treatment and ADHD outcomes and implications for clinical practice are unclear. Methods: Adolescents (n = 303; ages 13-18) meeting DSM-IV criteria for ADHD and SUD were randomized to osmotic release methylphenidate (OROS-MPH) or placebo and 16 weeks of cognitive behavioral therapy (CBT). Adolescents with (n = 38) and without (n = 265) MDD were compared on baseline demographic and clinical characteristics as well as non-nicotine substance use and ADHD treatment outcomes. Results: Adolescents with MDD reported more non-nicotine substance use days at baseline and continued using more throughout treatment compared to those without MDD (p< 0.0001 based on timeline followback; p< 0.001 based on urine drug screens). There was no difference between adolescents with and without MDD in retention or CBT sessions attended. ADHD symptom severity (based on DSM-IV ADHD rating scale) followed a slightly different course of improvement although with no difference between groups in baseline or 16-week symptom severity or 16-week symptom reduction. There was no difference in days of substance use or ADHD symptom outcomes over time in adolescents with MDD or those without MDD treated with OROS-MPH or placebo. Depressed adolescents were more often female, older, and not court ordered. Conclusions: These preliminary findings suggest that compared to non-depressed adolescents with ADHD and SUD, those with co-occurring MDD have more severe substance use at baseline and throughout treatment. Such youth may require interventions targeting depression.
AB - Background: Major depressive disorder (MDD) frequently co-occurs in adolescents with substance use disorders (SUDs) and attention deficit hyperactivity disorder (ADHD), but the impact of MDD on substance treatment and ADHD outcomes and implications for clinical practice are unclear. Methods: Adolescents (n = 303; ages 13-18) meeting DSM-IV criteria for ADHD and SUD were randomized to osmotic release methylphenidate (OROS-MPH) or placebo and 16 weeks of cognitive behavioral therapy (CBT). Adolescents with (n = 38) and without (n = 265) MDD were compared on baseline demographic and clinical characteristics as well as non-nicotine substance use and ADHD treatment outcomes. Results: Adolescents with MDD reported more non-nicotine substance use days at baseline and continued using more throughout treatment compared to those without MDD (p< 0.0001 based on timeline followback; p< 0.001 based on urine drug screens). There was no difference between adolescents with and without MDD in retention or CBT sessions attended. ADHD symptom severity (based on DSM-IV ADHD rating scale) followed a slightly different course of improvement although with no difference between groups in baseline or 16-week symptom severity or 16-week symptom reduction. There was no difference in days of substance use or ADHD symptom outcomes over time in adolescents with MDD or those without MDD treated with OROS-MPH or placebo. Depressed adolescents were more often female, older, and not court ordered. Conclusions: These preliminary findings suggest that compared to non-depressed adolescents with ADHD and SUD, those with co-occurring MDD have more severe substance use at baseline and throughout treatment. Such youth may require interventions targeting depression.
KW - Adolescents
KW - Attention deficit hyperactivity disorder
KW - Comorbid disorder
KW - Major depressive disorder
KW - Substance use disorder
KW - Treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=84155167324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84155167324&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2011.08.001
DO - 10.1016/j.drugalcdep.2011.08.001
M3 - Article
C2 - 21885210
AN - SCOPUS:84155167324
SN - 0376-8716
VL - 120
SP - 214
EP - 219
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - 1-3
ER -