Occupations and the prevalence of major depressive episode in the National Survey on Drug Use and Health.

OBJECTIVE: This study explores the relationship of occupations to major depressive episode (MDE). METHOD: National Survey on Drug Use and Health (NSDUH) data from the civilian noninstitutionalized United States population are analyzed regarding mental illnesses, employment, and specific occupations and industries. This analysis uses combined 2005 to 2014 NSDUH data, comprising a sample of 433,000 adults aged 18 to 64 years old, of whom 22,700 were both employed and had experienced an MDE in the past year. RESULTS: The findings focus on 30 occupations with the highest prevalence of MDE (greater than 9.0%). There is no simple overarching concept that describes these occupations, although common factors suggest hypotheses about the relationship of occupation to depression. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The findings suggest the possibility of prioritizing available preventive and treatment interventions to occupational settings with the highest prevalence of MDE. (PsycINFO Database Record

Examination of Veteran Fathers' Parenting and Their Adolescent Children's Substance Use in the United States.

BACKGROUND: Adolescent children of U.S. military veterans may be at increased risk for engaging in substance use; however, this has yet to be examined using nationally representative data. Parental involvement and communication are potential protective factors to target with prevention efforts, but veterans' parenting has not been studied in general, nonclinical populations. OBJECTIVES: This study presents data on parenting characteristics among fathers who are veterans of the U.S. military and the substance use behaviors of their adolescent children. METHODS: Data were analyzed from approximately 2,200 veteran fathers, 13,100 nonveteran fathers, and their children aged 12 to 17 who participated in the National Survey on Drug Use and Health from 2004 to 2013. Parenting characteristics and adolescent substance use were compared by fathers' veteran status. RESULTS: Compared with nonveteran fathers, veteran fathers were less likely to have talked with their children about the dangers of substance use, were more likely to believe that their children used substances, and were just as likely to be parentally involved. Higher percentages of adolescent children of veterans than those of nonveterans engaged in tobacco use and nonmedical use of psychotherapeutic drugs. Parental involvement and father-child communication about the dangers of substance use did not explain differences in substance use among adolescents with veteran versus nonveteran fathers. Conclusions/Importance: Adolescent children of veterans appear to be a group in particular need of substance use prevention services. Parental involvement and father-child communication may be appropriate protective factors to address in prevention efforts.

Opioid abuse and depression in adolescents: Results from the National Survey on Drug Use and Health.

OBJECTIVE: To investigate the association of major depressive episode (MDE) with nonmedical prescription opioid use (NMPOU) and opioid abuse/dependence among adolescents aged 12 to 17. METHODS: We analyzed 5 years of data from the National Survey on Drug Use and Health (NSDUH). We used logistic regressions to study the relationship between MDE and NMPOU among all adolescents, as well as the relationship of MDE with opioid abuse/dependence among adolescents with NMPOU. Other covariates included: sociodemographics, alcohol abuse/dependence, nonopioid drug abuse/dependence, delinquency, school performance, religious services attendance, and family support/supervision. RESULTS: In the sample of all adolescents, 6% reported past year NMPOU, and 8% reported past year MDE. When NMPOU and MDE were comorbid, MDE usually preceded the NMPOU. In the sample of adolescents with NMPOU, 15% reported past year opioid abuse/dependence, and 20% reported past year MDE. In adjusted logistic regression, MDE was associated with both NMPOU (OR=1.51, p<0.001) among all adolescents and opioid abuse/dependence (OR=2.18, p<0.001) among adolescents with NMPOU. CONCLUSION: MDE occurs commonly in adolescents and is associated with NMPOU and opioid abuse/dependence. In terms of population attributable risk, which is a function of both the prevalence and the strength of the association, MDE is an important risk factor for NMPOU among adolescents and opioid abuse/dependence among adolescents with NMPOU. Preventive and clinical programs to decrease NMPOU and opioid abuse/dependence among adolescents should consider the prominent role of depression.

The mental health consequences of nonmedical prescription drug use among adolescents.

BACKGROUND: Nonmedical prescription drug use is estimated to be the second most abused category of drugs after marijuana among adolescents. Prescription drugs can be highly addictive and prolonged use can produce neurological changes and physiological dependence and could result in adverse mental health outcomes. This topic is largely unexplored, as current knowledge of possible mechanisms of the linkage between adverse mental health consequences and prescription drug misuse is limited. AIM OF THE STUDY: This study explores the relationship between nonmedical use of prescription drugs and depression outcomes among adolescents. Given their complex and confounded relationship, our purpose is to better understand the extent to which nonmedical use of prescription drugs is an antecedent of depressive episodes. METHODS: Using data from the 2008-2012 National Survey on Drug Use and Health, the study employs a propensity score matching methodology to ascertain whether nonmedical use of prescription drugs is linked to major depressive episodes among adolescents. RESULTS: The results document a positive relationship between nonmedical prescription drug use and major depressive episodes among adolescents. Specifically, the results indicate that adolescents who used prescription drugs non-medically are 33% to 35% more likely to experience major depressive episodes compared to their non-abusing counterparts. IMPLICATIONS FOR HEALTH POLICY: This provides additional evidence about the potential public health consequences of misuse of prescription drugs on adverse mental health outcomes. Given the significant increased risk of major depressive episode among adolescents who use prescription drugs nonmedically, it seems that the prevention of nonmedical prescription drug use warrants the utilization of both educational and public health resources. IMPLICATIONS FOR FUTURE RESEARCH: An important area for future research is to understand how any policy initiatives in this area must strike a balance between the need to minimize the misuse of prescription drugs and the need to ensure access for their legitimate health care use.

Binge drinking and the risk of suicidal thoughts, plans, and attempts.

BACKGROUND: Major depression is one of the strongest known risk factors for suicide. However, of the estimated 8.5 million adults with serious thoughts of suicide in the past year, only half had a major depressive episode (MDE). Identifying risk factors for suicide in the absence of depression may provide additional targets for prevention and intervention. This study uses nationally representative data to evaluate the association of binge drinking with suicidal thoughts, plans, and attempts in adults with and without MDE. METHODS: Combined 2008-2012 National Survey on Drug Use and Health data were analyzed. Sex-stratified prevalence estimates of past year suicide indicators were generated by past month binge drinking and past year MDE status. Logistic regression was used to evaluate the association of binge drinking with suicide indicators by sex with and without MDE. RESULTS: Unadjusted prevalence estimates for suicide indicators in males and females were higher among binge drinkers than among nonbinge drinkers, regardless of MDE status. Regression analyses indicated that binge drinking was associated with suicidal thoughts (adjusted odds ratio [aOR]=1.51, 95% confidence interval [CI]=1.28-1.79), plans (aOR=1.75, CI=1.23-2.48), and attempts (aOR=2.57, CI=1.74-3.79) in females without MDE and with suicidal thoughts in males without MDE (aOR=1.25, CI=1.04-1.49). Among males and females with MDE, binge drinking was not associated with any of the suicide indicators (p>.05). CONCLUSIONS: Binge drinking in females without MDE may be an indicator for identifying at risk individuals for targeting suicide prevention activities.