Dimensions of Depression Associated with Substance Use Disorders: Evidence of Shared and Non-Shared Symptomology Restricted; Files Only

Abstract

Major depressive disorder (MDD; depression) affects nearly one in every six Americans in their lifetime, with about 16 million affected each year. MDD can interfere with everyday life and also has high comorbidity with other mental health disorders, including substance use disorders (SUDs). Studies have consistently found comorbidity between MDD and SUDs, but little is known about the specific depressive symptoms associated with different SUDs. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) lists nine criteria for MDD, 5 of which must be met for a diagnosis. In the present study, we examined comorbidity between specific DSM-5-TR MDD criteria and the three most common SUDs: alcohol, cannabis, and tobacco. This project was completed using data from The National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) a cross-sectional, nationally representative study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). NESARC-III collected information on 36,309 individuals (% female= 56.31). Disorder criteria were assessed using the NIAAA Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5). NESARC-III data includes 3,963 participants (10.91% of the sample) who met diagnostic criteria for past year MDD. It was hypothesized that substance-specific symptom profiles would associate with DSM-5-TR MDD criteria, such that tobacco and alcohol use disorders would be related to increased rates of suicidal ideation due to the lasting neurobiological effects of these substances on the nervous system. Data were cleaned and recoded using R statistical software. Past year SUD questions were recoded into the eleven DSM-5-TR criteria to create substance-specific factor/severity scores. Logistic regression analysis examined mild, moderate, and severe SUDs as a predictor of depression criteria items. All analyses controlled for sex, age, income, education, and frequency of substance use. Results demonstrated that with increasing SUD severity, there is an increased risk of all MDD criteria items, with varying odds across drugs. Analyses indicated risk of MDD symptom criteria items may not increase linearly as severity increases across substance use disorders. This study adds to the limited research on comorbidly between specific DSM-5-TR symptom criteria and SUDs.

Table of Contents

Major Depressive Disorder                                                                                                        1

Substance Use & Use Disorders                                                                                               3

MDD Comorbidity with Substance Use & Disorders                                                           4

Diagnosing MDD and SUDs                                                                                                      6

Significance                                                                                                                                10

Methodology                                                                                                                               10

Participants                                                                                                                                 10

Assessments                                                                                                                                12

Data Cleaning                                                                                                                             13

Data Analysis Plan                                                                                                                     16

Results                                                                                                                                          16

Prevalence of MDD and SUDs                                                                                                  16

Likelihood of Depression by SUD Severity                                                                            18

Associations Between Depression Symptomology and Alcohol Use Disorder              19

Associations Between Depression Symptomology and Cannabis Use Disorder           20

Associations Between Depression Symptomology and Tobacco Use Disorder             20

Associations Between Sub-Threshold Depression Symptomology and SUDs               21

Discussion                                                                                                                                   22

Summary of Major Findings                                                                                                    22

Considerations                                                                                                                           25

Implications                                                                                                                               26

Limitations                                                                                                                                 27

Conclusion                                                                                                                                  28

References                                                                                                                                   29

Figure 1                                                                                                                                        39

Figure 2                                                                                                                                        40

Figure 3                                                                                                                                        41

Table 1                                                                                                                                          42

Table 2                                                                                                                                          43

Table 3                                                                                                                                          44

Table 4                                                                                                                                          45

Table 5                                                                                                                                          46

Table 6                                                                                                                                          47

Table 7                                                                                                                                          48

Table 8                                                                                                                                          49

Table 9                                                                                                                                          50

Table 10                                                                                                                                        51

Supplementary Materials Text                                                                                                52

About this Honors Thesis

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School	Emory College
Department	Human Health
Degree	B.A.
Submission	Honors Thesis
Language	English
Research Field	Psychology, Clinical
Keyword	Comorbidity Major Depressive Disorder Substance Use Disorders
Committee Chair / Thesis Advisor	Dr. Rohan Palmer , Emory University
Committee Members	Dr. Jill Welkley, Emory University Dr. Deanna Kaplan, Emory University

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