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Am J Psychiatry 1992; 149:1341-1347
Copyright © 1992 by American Psychiatric Association
Depressive illness among chemically dependent adolescents
EY Deykin, SL Buka and TH Zeena
Department of Maternal and Child Health, Harvard School of Public Health, Boston, MA 02115.
OBJECTIVE: The purpose of this study was to investigate the prevalence and
correlates of depression among adolescents being treated for chemical
dependence. METHOD: Using the National Institute of Mental Health
Diagnostic Interview Schedule, the authors interviewed 223 adolescents,
aged 15-19 years, who were in residential treatment for alcohol or drug
dependence diagnosed according to DSM-III-R criteria. Data on
sociodemographic characteristics, school and social performance, past
history, family composition, familial alcohol and drug abuse, and previous
victimization of the subjects were also gathered. RESULTS: Fifty-four
(24.7%) of the subjects met the DSM-III-R criteria for depression. Very few
of the traditional correlates of depression discriminated depressed from
nondepressed subjects, suggesting that the presence of chemical dependence
overrides other predictors of depression. Only female gender, paternal
psychopathology, and victimization (physical abuse, sexual abuse) emerged
as important variables associated with depression. However, subjects whose
onset of depression preceded their chemical dependence had different
characteristics from those whose depression began after their chemical
dependence. CONCLUSIONS: The prevalence of depressive illness in these
chemically dependent adolescents was approximately three times that
reported for nonreferred groups of similar age. This high rate of
depression reflects the contributions of two distinct groups--those with
primary depression and those with depression subsequent to chemical
dependence--whose characteristics differed, suggesting the possibility of
two pathologic processes, similar in manifestation but with different
associated features and possibly with distinct etiologies. Confirmation of
these findings in further research could indicate that the two forms of
depression may require different treatment approaches.
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