Jacques Laget

Substance use and depression. Comparative course in adolescents.

ObjectiveTo examine the relation between depression and substance use in adolescents and the concomitant courses of both disorders.MethodsFour individual interviews were administered to 85 adolescent substance users aged 14–19 years (mean 17.1 years, SD 1.4) over a 3.5 year period using the Adolescent Drug Abuse Interview (ADAD) and the Beck Depression Inventory (BDI-13).ResultsNo predictive effect was observed on one dimension over the other, but each dimension was predictive of its own course. A decrease in substance-use severity paralleled a decrease in depressive state. Similarly, stable substance-use rates, either at a low or a high level, tended to be associated with low or high levels of depression, respectively. However, an increase in substance use was not accompanied by an increase in depressive states. Moreover, depression varied greatly between adolescents, and according to gender and age.ConclusionsDepressive states and substance use in adolescents can vary considerably overtime, and are closely but rather synchronically related. Since most of the adolescents do not seek help for substance-related problems, substance use should be systematically assessed in adolescents presenting with a depressive state.

Adolescent's Suicide Attempts: Populations at Risk, Vulnerability, and Substance Use #

Adolescence corresponds to a transition period that requires adaptation and change capacities and skills. Most young people succeed with this challenge, whereas a minority fail. In order to identify with the teenage culture, become autonomous, and differentiate from their parents, some adolescents choose to use drugs, beginning with the use of cigarettes, alcohol, cannabis, followed by other illicit drugs such as opiates and stimulants. A high proportion of these adolescents attempt suicide, which is the primary cause of death during adolescence in many European countries. Who are the “vulnerable” adolescents? What are the mechanisms that can explain the varieties of drug-use initiation or suicide attempts? Can “protective factors” be identified? What kind of strategies might be developed at a social and political level in order to prevent or to minimize drug abuse and suicide attempts, among other harmful behaviors? These issues will be discussed on the basis of the recent literature and in the light of a recent study carried out in the French-speaking part of Switzerland on large cohorts of adolescent drug users. Unresolved critical issues are noted and future needed research is suggested.

DRUG USE AND SUICIDE ATTEMPTS: THE ROLE OF PERSONALITY FACTORS

This study on suicide attempts is part of a large research project on dependent behavior in adolescents and young adults. 228 subjects aged 14–25 (107 “drug abusers,” 121 controls) from the French speaking part of Switzerland were evaluated on the basis of a semi-structured interview (Mini International Neuropsychiatric Interview), enabling a DSM-IV diagnosis, and self-reports (SSS by Zuckermann, MMPI-2, IDI by Hirschfeld). 31.5% of “drug abuser” males and 41.2% of “drug abuser” females committed one or more suicide attempts. The results of a logistic regression show that the significant factor explaining suicide attempts in drug users is emotional reliance for males and experience-seeking for females.

Adolescent drug use escalation and de-escalation: A 3-year follow-up study

This study aims to assess adolescents drug use with a longitudinal perspective in order to identify factors interacting with drug use onset and course. Supported by the Swiss Federal Office of Public Health, the study was initiated in 1999 with a follow-up in 2001 and 2002. The first objective was to measure risk factors for substance use initiation. The second objective was to analyse the co-variation of substance use with environmental, social, relational, medical and psychological factors. A total of 102 adolescents, aged 14–19 years, were recruited for the study in the French-speaking part of Switzerland. Results clearly show that substance use is not a disorder per se in adolescence, but that it is part of a multidimensional complex of problems that some adolescents may encounter: increase and decrease in substance use is paralleled with an increase or decrease in the other areas. This implies that prevention of substance use should not be focused mainly on substances but should consider the adolescent’s environment and significant life areas.

A multidimensional evaluation of adolescent drug abusers: Preliminary results of a longitudinal study

Publisher Summary This chapter presents a multidimensional evaluation of adolescent drug abusers. It presents preliminary results of a longitudinal study. The objective is to obtain a better understanding of addictive behavior during adolescence, to draw individual profiles in different areas, and to evaluate life trajectories. Several evaluation instruments were included in the protocol in order to achieve the objectives. (a) The MINI (Mini International Neuropsychiatric Interview): an interview schedule, which gives a psychiatric diagnosis in different areas. In this research project only diagnoses referring to drug and alcohol abuse and dependence were investigated. A life events inventory (SUPEA), an evaluation covering major life events on a lifetime scale. Questions were asked in an interview that made it possible to control information and get details on when the event happened and how many times it happened. (c) The adolescent drug abuse diagnosis, which provides a comprehensive evaluation of the subjects and enables measurement of their evolution over time. The SUPEA research team developed a French version of the instrument in agreement and with the collaboration of Alfred Friedman, the instruments author. It was adapted from the Addiction Severity Index (ASI), an investigation instrument that was developed for adults.