Depression Change Profiles in Adolescents Treated for Comorbid Depression/Substance Abuse and Profile Membership Predictors

Abstract

Using data from a randomized trial in which adolescents with depressive and substance use disorders (SUD) received treatments for both disorders in either a sequenced or coordinated manner, we (a) determine the number and nature of depression response profiles through 1-year posttreatment and (b) examine whether 8 previously identified factors predict profile membership. There were 170 adolescents (M age = 16.4 years; 22% female; 28% Hispanic, 61% Non-Hispanic White) with comorbid depressive disorder/SUD randomized to one of three sequences of receiving the Adolescent Coping With Depression Course and Functional Family Therapy for SUD (depression treatment followed by SUD treatment; SUD treatment followed by depression treatment; coordinated treatment). Depression was assessed at 7 points from baseline to 1-year follow-up. A 4-class solution fit the data best, with groups labeled Mildly Depressed Responders (57.1%), Depressed Responders (18.8%), Depressed Non-Responders (12.9%), and Depressed with Recurrence (11.2%). The 4 change profiles differed on indices of all but 1 predictor (age); most differences were driven by lower scores among Mildly Depressed Responders. Profile membership was most strongly predicted by depression severity, cognitive distortions, hopelessness, and global functioning. The strongest predictor of Nonresponse was low family cohesion, whereas Recurrence was associated with hopelessness, suicide attempts, and starting treatment near the end of the school year. Most depressed adolescents experienced a positive response that was maintained. Understanding the most common profiles of depression change during and following treatment and the variables that predict change can help improve treatment outcomes and advance tailoring efforts.

Improvement in psychological wellbeing among adolescents with a substance use disorder attending an outpatient treatment programme

“…While numbers were small, about half of those with substantial baseline depressive symptoms resolved. These outcomes are consistent with international studies that elaborate on improvements in depressive symptoms and disorders over the course of addiction treatment (Hides et al 2010; Rohde et al 2016).…”

Social Support and Parental Conflict as Predictors of Outcomes of Group Cognitive Behavioral Therapy for Adolescent Depression

“…Additionally, similar to prior work (Curry et al, 2006 ; Feeny et al, 2009 ; Kolko et al, 2000 ), we did not find that adolescent-reported parental conflict predicted depressive symptom change with CBT. However, parental conflict did predict other indicators of outcome, like clinician-rated engagement and improvement, which is generally consistent with other work linking family dynamics to CBT outcomes (Asarnow et al, 2009 ; Feeny et al, 2009 ; Rohde et al, 2018 ). Together, these findings indicate that high parental conflict may interfere with engagement and improvement with treatment in general, rather than the effectiveness of CBT in changing depressive symptoms.…”

“…Further, another study found that high levels of school dysfunction and family dysfunction predicted worse outcomes across treatments (Gunlicks-Stoessel et al, 2010 ). Similarly, in a sample of depressed adolescents with comorbid substance use disorders, low family cohesion was the strongest predictor of nonresponse to group CBT with functional family therapy (Rohde et al, 2018 ). Overall, there is evidence to support the idea that high conflict and low social support may negatively impact treatment for depression in adolescents.…”

Relationship between addiction, anxiety, depression and socioeconomic status among addict people

“…In addition, this finding was congruent with [36] who demonstrated that, more than half of the studied sample had severe level of depression. In this respect, this finding partially supported by [37] who found that, more than one third of the studied sample had severe level of depression. The present study showed that, anxiety was positively and significantly correlated with depression.…”