Directions of the relationship between substance use and depressive symptoms from adolescence to young adulthood

Abstract

Purpose Both substance use and depression are common in adolescence and often comorbid. Past research has produced conflicting results on whether there is a temporal relationship and if so, in which direction it operates and how it may vary by sex. The purpose of this paper is to explore the longitudinal, potentially bidirectional, relationships between high-frequency substance use and depressive symptoms from adolescence into young adulthood for males and females. Methods Using data from the National Longitudinal Study of Adolescent to Adult Health we investigated longitudinal associations between high frequency substance use (alcohol, cigarettes, and marijuana) and depressive symptoms. The linear mixed effects models were stratified by sex and used a lagged measure of the dependent variable to test temporal relationships. A random intercept was used for respondent ID. Results Increases in depressive symptoms were significantly associated with a later increase of about a half day in marijuana use frequency for males and nearly a two day increase in smoking frequency for females. Conversely, increases in smoking frequency were significantly associated with approximately a 0.6-point increase for females and 0.4-point increase for males in depressive symptoms at a later wave. Conclusions Results indicate a bidirectional relationship between smoking and depressive symptoms for females. For males, there was evidence supporting self-medication with marijuana and for smoking being associated with later increases in depressive symptoms. Results inform how substance use and depression screening, prevention and treatment efforts should be paired and targeted for males and females.

Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults

“…However, the relative associations of depression symptoms with simultaneous substance use were much greater for use of alcohol with tobacco and marijuana than the other outcomes. Although our cross‐sectional study cannot determine the direction of these relationships, recent results from a longitudinal study suggest bidirectional relationships between substance use and depression in a non‐clinical sample .…”

Fertility trajectories and later-life depression among parents in England

“…Measures of household wealth, social support, social isolation, and physical health were drawn from Wave 4, in order to reduce the probability of reverse causation (as, e.g., poor mental health may lead people to withdraw from social activities). Two indicators of smoking history were included: (a) 'teen smoker', included because of known associations between teenage smoking, other risky behaviours-including sexual risktaking-and adolescent mental health (Hale and Viner 2016;Wilkinson et al 2016;Guleria et al 2017); and (b) 'current smoker' in later life, included because of known associations between smoking and mental health at older ages (Shahab et al 2015). Figure 1 presents an overview of the structure of the ELSA data used and the expected conceptual linkages underlying the analysis.…”

Intergenerational Continuity in Depression: The Importance of Time-Varying Effects, Maternal Co-morbid Health Risk Behaviors and Child’s Gender

“…Though directionality is difficult to ascertain, some evidence suggests that depressive symptoms can lead to substance use, consistent with the self-medication hypothesis (Khantzian 1985). However, this evidence varies depending on substance type (e.g., cigarettes vs. marijuana; Wilkinson et al 2016; Womack et al 2016). Conversely, substance use may precede depressive symptoms, with studies demonstrating a greater risk for subsequent depressive symptoms among cannabis users (Lev-Ran et al 2014) and individuals suffering from an alcohol use disorder (Boden and Fergusson 2011).…”