Supplementary Material for: Substance use -related factors and recurrent depression among former adolescent psychiatric inpatients.

Introduction: Recurrent depression is a challenging and common disorder in clinical psychiatry. Comorbid substance use disorder poses a challenge to effective treatments. The association between depression and substance abuse is widely documented, but less is known about how the recurrence of depression is associated with substance use disorders and the temporal connections between the two disorders in adolescence and early adulthood. Methods: In this study we analyzed the associations between recurrent depression and substance use patterns in former adolescent psychiatric inpatients, during initial inpatient hospitalization and follow-up period of 10-15 years. Study population consisted of 235 individuals admitted for adolescent psychiatric inpatient care, of whom 84 were in recurrent depression group and 151 in single depressive episode group. Substance use experimentation ages, substance use frequencies during adolescence, onset ages of substance use disorders and number of substance use disorder diagnoses in adolescence and early adulthood were analysed between the the two groups. Results: Recurrent depression was associated with alcohol use disorders (p=0.014) and multiple drug use disorders (p=0.034) in early adulthood in males. In logistic regression analysis, alcohol use disorder was found to associate with recurrent depression in males (OR 3.6, 95% CI 1.27-10.75, p=0.017). There was no statistically significant difference in temporal associations between recurrent or single episode depression in regard to onset age of substance use. Conclusions: Our results emphasize the need for early recognition and integrated treatment of substance use and depression in adolescence.

引言：复发性抑郁症是临床精神病学中兼具挑战性与高患病率的精神障碍。共病物质使用障碍会为有效治疗带来额外挑战。尽管抑郁症与物质滥用之间的关联已被广泛证实，但目前学界对青少年及早成年阶段抑郁症复发与物质使用障碍的关联模式，以及两种疾病间的时序关联仍知之甚少。
方法：本研究针对曾接受青少年精神科住院治疗的患者，分析其首次住院期间及10至15年随访期内的复发性抑郁症与物质使用模式之间的关联。本研究的研究队列共纳入235名曾接受青少年精神科住院治疗的个体，其中84人属于复发性抑郁症组，151人属于单次抑郁发作组。本研究对比两组受试者的物质使用尝试年龄、青少年时期物质使用频率、物质使用障碍起病年龄，以及青少年及早成年阶段的物质使用障碍诊断次数。
结果：男性群体中，早成年阶段的复发性抑郁症与酒精使用障碍（p=0.014）及多种药物使用障碍（p=0.034）存在显著关联。Logistic回归分析显示，男性群体的酒精使用障碍与复发性抑郁症存在独立关联（优势比OR=3.6，95%置信区间CI：1.27~10.75，p=0.017）。在物质使用起病年龄的时序关联方面，复发性抑郁组与单次抑郁发作组之间未观察到统计学显著差异。
结论：本研究结果凸显了在青少年阶段早期识别并开展物质使用障碍与抑郁症整合治疗的必要性。