Substance Use Patterns and Mental Health Comorbidities in Youth with a History of Depression or Suicidality: Findings from TX-YDSRN

Depression and substance use have a bi-directional relationship, but research in youth has focused on single substances and ignored comorbidities. We sought to gain a wider perspective by considering substance use of any kind, psychiatric symptoms, and demographic features together. Advanced grouping techniques identified three patterns of past-year substance use in depressed youth: non-use; moderate likelihood of using alcohol, nicotine, and cannabis; and high likelihood of using all substances. We then considered whether any demographic or psychiatric factors might predict substance use group. Compared to non-users, moderate and high likelihood users tended to be older. Youth in the high likelihood group were more likely to have a substance use disorder, ADHD, and higher suicidality. These findings suggest universal screening for substance use among depressed youth would help increase early intervention and customized care.