Trends and disparities in unmet treatment needs for co-occurring depression and alcohol use disorders among young adults in the U.S.

Abstract

Major depressive episode (MDE) and alcohol use disorder (AUD) often co-occur and the presence of one doubles the risk for the other, which brings disabling social and health consequences. Increasing evidence supports integrated treatment of co-occurring MDE and AUD, including combined medications for both conditions as well as behavioral therapies. While young adults suffer disproportionately from these co-occurring conditions, little is known about their treatment utilization. Using nationally representative data from the National Survey on Drug Use and Health (NSDUH), 2011-2019, this study examined temporal trends and disparities in the prevalence and treatment use for co-occurring MDE and AUD among young adults aged 18-25 in the U.S. Across the survey time, an increasing trend of MDE was revealed, whereas the prevalence of AUD decreased significantly. Meanwhile, the prevalence of co-occurring MDE and AUD remained steady. Among young adults with co-occurring MDE and AUD, while treatment use for MDE increased from 2011 to 2019, treatment use for AUD and co-occurring conditions remained stable. Observed widening disparities in co-occurring treatments utilized among young adults ages 18-25 are further perpetuated by gender, emerging adulthood, and socioeconomic status, warranting immediate action. Public Policy Relevance StatementYoung adults with co-occurring depression and alcohol disorders suffer from serious physical health, economic, and social consequences that can last a lifetime if left untreated. Examining trends regarding the prevalence of these conditions among young people 18-25 and their treatment use patterns reveals the unique needs of this population. These findings may enhance practice and policy innovations that conceivably could help to mitigate against widening disparities. aaa M ajor depressive episode (MDE) and alcohol use disorder (AUD) are two of the top five leading causes of death in developed countries, with young people bearing a disproportionate burden (Deady et al., 2016). MDE has been a key risk factor for suicidal behavior in young adults (Furr et al., 2001). Similarly, young adults with AUD are three to four times This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Major depression disorder may causally associate with the increased breast cancer risk: Evidence from two‐sample mendelian randomization analyses

“…An important assumption of MR is that the genetic IVs should not influence the outcome through a different biological pathway from the exposure of tested. Previous epidemiology studies suggested that MDD may lead to higher rates of smoking and alcohol intake 54,55 . Meta‐analysis of the observational epidemiological studies had suggested that smoking may weakly increase the breast cancer risk 56 .…”

“…Previous epidemiology studies suggested that MDD may lead to higher rates of smoking and alcohol intake. 54 , 55 Meta‐analysis of the observational epidemiological studies had suggested that smoking may weakly increase the breast cancer risk. 56 Dimou et al have observed a genetic predisposition to higher lifetime amount of smoking was positively associated with overall breast cancer ( OR = 1.13, 95% CI = 1.00–1.26; P = 0.04).…”

Preferences of young adults on the development of a new digital add-on alcohol intervention for depression treatment: A qualitative study

“…In the United States, treatment use for a major depressive episode (MDE) increased significantly between 2011 and 2019 among young adults (18–25 years), whereas AUD treatment use has increased far less among this age group with co-occurring MDE and AUD ( Lu et al, 2022 ). Moreover, treatment use for both conditions has stayed stable, with <9 % of young adults with co-occurring MDE and AUD being treated for both conditions during 2011–2019 ( Lu et al, 2022 ). These treatment use trends may be attributed to various factors from both a health provider and consumer perspective.…”

“…Consequently, alcohol use problems may remain undetected and untreated. According to Lu et al (2022) , another explanation may lie in a potential mismatch between this young population and current AUD treatment. Young people may not relate to existing AUD programmes, as these often seem to be aimed at and attended by older adults (who are in different life stages) or people with more severe AUD ( Kelly et al, 2008 ; Lu et al, 2022 ).…”

“…According to Lu et al (2022) , another explanation may lie in a potential mismatch between this young population and current AUD treatment. Young people may not relate to existing AUD programmes, as these often seem to be aimed at and attended by older adults (who are in different life stages) or people with more severe AUD ( Kelly et al, 2008 ; Lu et al, 2022 ). Moreover, barriers for mental health help-seeking may also play a role, as young adults may not be ready to stop drinking or may lack transportation to attend programmes, fear negative opinions on the part of others or experience stigma and prefer to solve problems alone ( Lu et al, 2022 ; Wu et al, 2007 ; Ebert et al, 2019 ).…”