TY - JOUR
T1 - Onset of alcohol or substance use disorders following treatment for adolescent depression
AU - Curry, John
AU - Silva, Susan
AU - Rohde, Paul
AU - Ginsburg, Golda
AU - Kennard, Betsy
AU - Kratochvil, Christopher
AU - Simons, Anne
AU - Kirchner, Jerry
AU - May, Diane
AU - Mayes, Taryn
AU - Feeny, Norah
AU - Albano, Anne Marie
AU - Lavanier, Sarah
AU - Reinecke, Mark
AU - Jacobs, Rachel
AU - Becker-Weidman, Emily
AU - Weller, Elizabeth
AU - Emslie, Graham
AU - Walkup, John
AU - Kastelic, Elizabeth
AU - Burns, Barbara
AU - Wells, Karen
AU - March, John
PY - 2012/4
Y1 - 2012/4
N2 - Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original TADS treatment response rating and a more restrictive symptom count rating. During follow-up, diagnostic interviews were completed at 6-or 12-month intervals to assess onset of AUD or SUD as well as MDD recovery and recurrence. Results: Achieving a positive response to MDD treatment was unrelated to subsequent AUD but predicted a lower rate of subsequent SUD, regardless of the measure of positive response (11.65% vs. 24.72%, or 10.0% vs. 24.5%, respectively). Type of initial MDD treatment was not related to either outcome. Prior to depression treatment, greater involvement with alcohol or drugs predicted later AUD or SUD, as did older age (for AUD) and more comorbid disorders (for SUD). Among those with recurrent MDD and AUD, AUD preceded MDD recurrence in 24 of 25 cases. Conclusion: Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD. Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery.
AB - Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original TADS treatment response rating and a more restrictive symptom count rating. During follow-up, diagnostic interviews were completed at 6-or 12-month intervals to assess onset of AUD or SUD as well as MDD recovery and recurrence. Results: Achieving a positive response to MDD treatment was unrelated to subsequent AUD but predicted a lower rate of subsequent SUD, regardless of the measure of positive response (11.65% vs. 24.72%, or 10.0% vs. 24.5%, respectively). Type of initial MDD treatment was not related to either outcome. Prior to depression treatment, greater involvement with alcohol or drugs predicted later AUD or SUD, as did older age (for AUD) and more comorbid disorders (for SUD). Among those with recurrent MDD and AUD, AUD preceded MDD recurrence in 24 of 25 cases. Conclusion: Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD. Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery.
KW - adolescents
KW - alcohol use disorders
KW - major depression
KW - substance use disorders
UR - http://www.scopus.com/inward/record.url?scp=84864306136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864306136&partnerID=8YFLogxK
U2 - 10.1037/a0026929
DO - 10.1037/a0026929
M3 - Article
C2 - 22250853
AN - SCOPUS:84864306136
SN - 0022-006X
VL - 80
SP - 299
EP - 312
JO - Journal of Consulting and Clinical Psychology
JF - Journal of Consulting and Clinical Psychology
IS - 2
ER -