Across development, maternal depression has been found to be a risk factor for youth psychopathology generally and youth depression specifically. Maternal Expressed Emotion (EE) has been examined as a predictor of outcome among youth with depression. The present study explored the associations between youth psychopathology and two predictors-maternal depression within the child's lifetime and maternal EE-in a study of children at risk for depression. One hundred and seventy-one youth, ages 8-12, and their mothers participated. To assess maternal and youth psychopathology, dyads were administered structured diagnostic assessments, and mothers and children completed self-report measures of their own depressive symptoms. In addition, mothers completed the Achenbach Child Behavior Checklist-Parent Report Version (CBCL) for their children. Maternal EE was assessed based on the Five Minute Speech Sample. History of maternal depression was associated with high maternal EE, and the combination of maternal depression history and maternal EE was associated with children's own reports of higher depressive symptoms. Current maternal depressive symptoms were associated with mothers' reports of children's Internalizing scores on the CBCL, and maternal depression history, current maternal depressive symptoms, and maternal EE were strongly associated with mothers' reports of children's Externalizing and Total Problem scores on the CBCL. History of maternal depression and a rating of high or borderline Critical EE (characterized by maternal critical comments and/or reports of a negative relationship) were independently associated with children's depression diagnoses.

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Objective Overdoses (OD) are among the leading causes of death in youth with substance use disorders (SUDs). We aimed to identify the prevalence of OD and characteristics associated with a history of OD in youth presenting for SUD outpatient care. Methods Systematic retrospective medical record review of consecutive psychiatric and SUD evaluations for patients age 16 to 26 years at entry into an outpatient SUD treatment program for youth. Unintentional OD was defined as substance use without intention of self-harm that was associated with a significant impairment in level of consciousness. Intentional OD was defined as ingestion of a substance that was reported as a suicide attempt. T-tests, Pearson’s chi-square, and Fisher’s exact tests were performed to evaluate characteristics associated with a history of OD. Results We examined the medical records of 200 patients (157 males and 43 females) with mean age 20.2 (±) 2.8 years. At intake 58 patients (29%) had a history of OD and 62% of those patients had a history of unintentional OD only (n=36). Youth with ≥2 SUDs were 3 times more likely to have a history of OD compared to youth with 1 SUD (all p<0.05). Compared to those without a history of OD those with an OD were more likely to be female and have lifetime histories of: alcohol, cocaine, amphetamine, anxiety, depressive, and/or eating disorders (all p<0.05). Conclusion High rates of OD exist in treatment-seeking youth with SUD. OD was associated with more SUD and psychiatric co-morbidity.

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