Relationship between depression and substance use disorders in adolescent women during the transition to adulthood

Objectives: To examine the continuity of substance use disorder (SUD) in ad olescent women during the transition to adulthood and to assess psychosocia l functioning associated with SUD. Furthermore, to examine concurrent and l ongitudinal relationships between major depressive disorder (MDD) and SUD d uring this developmental transition. Method: One hundred fifty-five women, aged 17 to 19 years, were recruited from 3 high schools and were followed a nnually for 5 years. Comprehensive diagnostic and psychosocial assessments were performed with standardized instruments. The primary outcome measures included MDD and SUD during follow-up in those with and without a prior his tory of MDD or SUD, and psychosocial functioning associated with SUD. Resul ts: The 5-year incidence of SUD was 9.6% and, by the end of follow-up, 18.7 % had a lifetime episode. Prior SUD significantly increased the risk for SU D diagnosis during the study. Go-occurrence of MDD and SUD was high during adolescent and early adult years, with episodes of both disorders occurring in close temporal proximity. SUD also predicted MDD over time, but the rev erse was not true. After controlling for the effects of MDD on social adjus tment, SUD was associated with significant impairment in school functioning . Conclusions: These results suggest that the risk for new onset and recurr ence of SUD is high during the developmental transition to adulthood. SUD d uring this developmental period is associated with significant school-relat ed problems. The findings also suggest that SUD and MDD frequently co-occur during the post-high school transition in women. Given the significant psy chosocial dysfunction associated with these illnesses, early detection of t hese problems and effective intervention are crucial.