(PS1-D92) Effects of Depression on Substance Use At-risk Youth with ADHD

Adolescence is a critical period for the development of an individual, with both physical and mental changes. These changes can pose a high risk for mental health disorders, including substance use. Various preventive interventions for substance use disorder have been conducted, showing that the most successful time to intervene is during adolescence. The risk for substance use disorders can be prevented through early intervention. Adolescents with ADHD are also at a higher risk for substance use disorders than their peers. The purpose of this study was to examine if symptoms of depression are associated with an increased risk for substance use in adolescents with ADHD. We expect adolescents with ADHD who have elevated symptoms of depression will be at greater risk for substance use than adolescents with ADHD who do not have elevated symptoms of depression.

 This study was conducted from a larger subset of data (n = 245) that investigated the effectiveness of a Brief Early Intervention (BEI), for adolescents with ADHD that are at risk for the development of a substance use disorder. Participants (n =159) for this study were required to meet the following inclusion criteria: be between the ages of 12-18, have a DSM-V diagnosis of ADHD, have an IQ above 79, and be at risk for the development of substance use disorder. Exclusionary criteria for this study include DSM-V severe criteria for substance use disorder, medical conditions that may be affected by stimulants, diagnosis of bipolar disorder, schizophrenia, or other psychotic disorders, and diagnosis of ASD or intellectual or language impairments. Teens were classified based on their pattern of substance use between baseline and follow-up: 1) never engaged in substance use; 2) reported use at baseline but stopped by follow-up; 3) reported no use at baseline but had started by follow-up; and 4) reported use at both baseline and follow-up. To analyze depressive symptoms the t-score of the subscale withdrawn/depressed was used from the Youth Score Report (YSR). The Disruptive Behavior Disorder Rating Scale (DBD) was used to assess the severity of ADHD symptoms across four categories: inattention, hyperactivity/impulsivity, oppositional defiant disorder, and conduct disorder. A one-way ANOVA was used to evaluate predictors of use categories.

Preliminary results with a portion of the final sample indicate that teens' self-report of depressive symptoms at baseline (F = 1.125,  p = .348) and at follow-up (F = 1.301,  p = .278) was not a significant predictor of substance use category. In contrast parent report of baseline ODD (F = 4.486,  p = .005) and CD (F = 4.454,  p = .006) symptoms as well as follow-up ODD (F = 4.377,  p = .006) and CD (F = 6.588,  p = .000) symptoms were associated with substance use category. Pairwise comparisons indicated that the always reported use group had higher ODD symptoms at baseline and follow-up than never reported use group. Pairwise comparisons indicated that the stopped use group had higher CD symptoms at baseline and follow-up than the never reported use group. Overall, these findings suggest that symptoms of depression may not be as strongly related to substance use among adolescents with ADHD as other disruptive behaviors and conduct problems.