Infectious Disease

Few teens with depression, substance abuse disorder treated for both

October 20, 2021

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According to the results of a survey published on the JAMA Network Open, between 2011 and 2019 less than 12% of adolescents with major depression and substance use disorder were treated for both conditions.

“Research shows that treating depression alone does not significantly reduce” [substance use disorder (SUD)], and SUD treatment alone does not lead to depression remission, ”study author Wenhua Lu, PhD, from the Department of Community Health and Social Medicine at the City University of New York, and colleagues wrote. “Unfortunately, we lack comprehensive knowledge of trends and patterns in the unmet treatment needs of adolescents when illnesses occur at the same time.

Infographic data derived from: Lu W, et al. JAMA network open. 2021; doi: 10.1001 / jamanetworkopen.2021.30280.

“In addition, previous results have identified differences in adolescent depression and SUD based on certain demographic, family, and social characteristics (e.g., gender, race, family structure, housing stability),” they added.

The researchers examined temporal trends and socio-demographic disparities in concurrent major depression and SUD treatment. The study population included 136,262 (51.1% boys; 13.8% Black; 23.2% Hispanic; 53.6% White) U.S. adolescents ages 12-17 who participated in the National’s annual cross-sectional surveys between 2011 and 2011 Survey on Drug and Health participated in 2019. The exposure years, adolescence, gender, race and ethnicity, type of insurance, annual household income, family structure and living stability were used as exposures. The presence and treatment of a co-occurring 12-month depressive episode and SUD served as primary endpoints and measures.

The results showed a stability in the range of 1.4% to 1.7% in the annual prevalence of concurrent depressive episodes and SUD between 2011 and 2019. Adolescents with concurrent major depressive episodes and SUD showed a significant increase in the prevalence of Treatment of major depression episode only, from 28.5% in 2011 to 42.5% in 2019 (OR = 1.07; 95% CI 1.02-1.11); however, the prevalence of treatment use for SUD only decreased from 4.8% to 1.5% (OR = 0.92; 95% CI, 0.85–0.99).

Lu and colleagues found a fluctuation in the overall prevalence of treatment use for both diseases between 4.5% and 11.6%, without a significant linear course over time (OR = 0.95; 95% CI, 0.87-1 , 03). They observed extensive treatment differences in boys for SUD and both diseases, older adolescents for major depressive episodes, Hispanic adolescents for concurrent illnesses (adjusted OR [aOR] = 0.52; 95% CI 0.27–0.98) and adolescents from Asia, Hawaiian natives, or Pacific islanders for major depressive episodes (aOR = 0.24; 95% CI, 0.10–0.58) and concomitant illnesses (adjusted OR = 0.04; 95% CI, 0.01-0.33). In addition, they found a connection between moving the household at least three times in the last 12 months and an increased likelihood that adolescents received treatment for both diseases (aOR = 2.52; 95% CI 1.26-5.05).

“The results of this study indicate persistent deficiencies in current adolescent mental health and SUD treatment capabilities, underscore the need for improved coordination between service delivery systems, and call for improved political and financial support for adolescents with unmet treatment needs,” said Lu and colleagues wrote.

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