|Behaviors May Indicate Risk of Adolescent Depression
New findings from a study supported by the National Institute on Drug Abuse
(NIDA), National Institutes of Health, show that girls and boys who exhibit high
levels of risky behaviors have similar chances of developing symptoms of depression.
However, gender differences become apparent with low and moderate levels of risky
behaviors with girls being significantly more likely than boys to experience
symptoms of depression. The study, which incorporates data from almost 19,000
teens, is published in the May 15, 2006 issue of the Archives of Women’s
“The burden of illness associated with depression during adolescence is considerable,
and psychosocial problems — including substance abuse — are associated
with depressive disorders in teens,” says NIDA Director Dr. Nora D. Volkow. “The
findings from this study create a more complete picture of commonalities and
differences of the risk of depression among boys and girls who engage in risky
behaviors, and provide information for healthcare providers to consider as they
screen, evaluate, and treat their young patients.”
Symptoms of depression include loss of appetite, feeling blue, loss of interest
in things that used to be of interest, being bothered by things that previously
were not bothersome, and not feeling hopeful about the future.
Dr. Martha Waller, of the Pacific Institute for Research and Evaluation, and
her colleagues provided new findings from teen interviews conducted as part of
the National Longitudinal Study of Adolescent Health in 1995. The researchers
clustered the teens into 16 groups according to their behaviors and correlated
these behaviors with symptoms of depression. Groups included abstainers, who
refrained from engaging in sexual activity and from using alcohol, tobacco, or
other drugs; teens who engaged in low and moderate risk behaviors, such as experimenting
with substance abuse or sex; and teens who engaged in high-risk behaviors, such
as exchanging sex for drugs or money or abuse of intravenous drugs.
“Differences in symptoms of depression between girls and boys were guided by
risk behaviors,” says Dr. Waller. “Among abstainers, there were no differences
between girls and boys in their likelihood of having symptoms of depression.”
When abstaining girls were compared with risk-taking girls, the researchers
observed that any risk activity, no matter how modest in degree, was associated
with an increased risk of symptoms of depression. For example, girls who experimented
with drugs and girls who experimented with tobacco and alcohol were more than
twice as likely to have symptoms of depression as girls who abstained completely.
Girls who experimented with sex were almost four times as likely to have such
symptoms, while girls who used intravenous drugs were almost 18 times as likely
to have symptoms of depression as girls who abstained completely.
Among boys, most, but not all risk profiles were associated with a greater likelihood
of such symptoms, compared to abstainers. Boys who drank alcohol and boys who
were binge drinkers were about two-and-one-half times as likely to experience
symptoms of depression, while those who abused intravenous drugs were about six
times as likely to have symptoms of depression as boys who abstained completely.
For most of the high-risk behaviors profiled there were also no significant
gender differences in symptoms of depression. However, for one — exchanging
sex for money or drugs — girls were seven times more likely than boys to
report such symptoms. Among teens who engaged in low and moderate risk behaviors,
girls were significantly more likely than boys to report symptoms of depression.
“Although it has not been shown that these behaviors trigger depression, it
may be that screening for substance abuse and other behaviors in teens may provide
enough information to the health care provider to also warrant screening for
depression, particularly for girls,” says Dr. Waller. “Both substance abuse and
sexual activity may alter a girl’s social context, which could induce stress
and/or change self-perceptions, both of which could contribute to depression.
In addition, there may be differences in how girls and boys physically respond
to substance abuse that help explain the gender differences.”
Because girls who exhibited low and moderate risk behaviors were observed to
be at greater risk for depression than boys, the scientists suggest that future
research should examine the characteristics of these groups to determine the
mechanisms underlying this difference.
“There are significant changes in the brain during adolescence and there is
growing interest in understanding how substance abuse may change brain structure
and chemistry, and in turn, cognition and emotion,” says Dr. Volkow. “Future
research will investigate more closely the roles of risky behaviors and the influence
of gender in the development of adolescent depression.”
The National Institute on Drug Abuse is a component of the National Institutes
of Health, U.S. Department of Health and Human Services. NIDA supports most of
the world’s research on the health aspects of drug abuse and addiction. The Institute
carries out a large variety of programs to ensure the rapid dissemination of
research information and its implementation in policy and practice. Fact sheets
on the health effects of drugs of abuse and information on NIDA research and
other activities can be found on the NIDA home page at http://www.drugabuse.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research
Agency — includes 27 Institutes and Centers and is a component of
the U.S. Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical and translational medical
research, and it investigates the causes, treatments, and cures for both common
and rare diseases. For more information about NIH and its programs, visit www.nih.gov.