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. PsycINFO Database Record (c) 2012 APA, all rights reserved.
RCT Entities:
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. PsycINFO Database Record (c) 2012 APA, all rights reserved.
Authors: Frank M Tims; Michael L Dennis; Nancy Hamilton; Betty J Buchan; Guy Diamond; Rod Funk; Laura B Brantley Journal: Addiction Date: 2002-12 Impact factor: 6.526
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Authors: Carolyn A McCarty; Brian T Wymbs; W Alex Mason; Kevin M King; Elizabeth McCauley; John Baer; Ann Vander Stoep Journal: J Abnorm Child Psychol Date: 2013-10
Authors: Benjamin I Goldstein; Michael Strober; David Axelson; Tina R Goldstein; Mary Kay Gill; Heather Hower; Daniel Dickstein; Jeffrey Hunt; Shirley Yen; Eunice Kim; Wonho Ha; Fangzi Liao; Jieyu Fan; Satish Iyengar; Neal D Ryan; Martin B Keller; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2013-07-31 Impact factor: 8.829
Authors: Amy T Peters; Rachel H Jacobs; Claudia Feldhaus; David B Henry; Anne Marie Albano; Scott A Langenecker; Mark A Reinecke; Susan G Silva; John F Curry Journal: J Adolesc Health Date: 2015-11-11 Impact factor: 5.012