[Frequency of smoking, drinking, and substance use and their relationship to psychiatric comorbidity in depressed child and adolescent population]

Abstract

Introduction: Adolescence is a risk period for both affective disorders and unhealthy behaviours. The association between depression and smoking and drinking problems is well established in the literature on adult and adolescent patients. Smoking at a young age increases the risk of substance abuse in later life, which in turn further increases the functional impairment caused by psychiatric illness. In our study, we investigated the frequency of smoking, alcohol consumption and substance use and their association to psychiatric diagnoses in a child population suffering from depression.

Methods: The study was carried out on 267 children at risk for depression. Psychiatric diagnosis was set up based on a semi-structured interview, while information on the severity of depressive symptoms and unhealthy behaviours was collected through self-report questionnaires.

Results: Mean age of the sample was 12.4 years (sd: 2.6 years), a major depressive disorder was present in 51%. Smoking and alcohol drinking rates were increased in the sample, 19.9% and 24%, respectively. MDD and comorbid anxiety disorders in general increased the risk of alcohol consumption (OR=2.81 and OR=2.61, respectively), while comorbid behavioural disorders enhanced the likelihood of smoking (OR=3.72). More specifically, generalized anxiety disorder, social phobia and conduct disorder had the highest importance of the comorbid diagnoses identified in the study.

Conclusions: Early screening for smoking and alcohol drinking is very important in child and adolescent populations suffering from depressive symptoms. Comorbid psychiatric illnesses, such as anxiety and conduct disorder, increase the risk of unhealthy behaviours. Early preventive measures might positively influence later quality of life.