Changes in the Association of Drug Use with Depressive Disorders in Recent Decades: The Case of Cocaine

Abstract

The social meaning of cocaine changed during the s and 1990s. The present study examined changes in the psychological profile of cocaine users. We used Baltimore data of the National Institute of Mental Health-funded Epidemiologic Catchment Area study during 1981 (n = 3,006; 60% female) and 1993–1994 (n = 1,679; 52% female). The diagnostic interview schedule measured cocaine use and depressive disorders (dysthymia, major depressive disorder). The odds ratio of cocaine use for those with depression was 1.28 and 3.53 in 1981 and 1993–1994 respectively. The results suggest a historical period effect in the association of cocaine use and depression. Limitations and implications are discussed.

RESUME

La signification sociale de la utilisation de cocaïne a changé pendant les années et les années 1990. Cette étude a examinée change dans le profil psychologique des utilisateurs de cocaïne. Nous avons utilisé des données de Baltimore de l’étude “Epidemiologic Catchment Area” pendant 1981 (n = 3.006; femelle de 60%) et 1993–1994 (n = 1.679). Le “Diagnostic Interview Schedule” a mesuré des désordres dépressifs (Dysthymia, majeur désordre dépressif) et utilisation de cocaïne. Les chances de utilisation de cocaïne pour ceux avec la dépression était 1,28 et 3,53 en année 1981 et en années 1993–1994 respectivement. Les résultats suggèrent un effet de période historique en l’association de dépression et utilisation de cocaïne. Des limitations et les implications sont discutées.

RESUMEN

El significado social de la cocaína cambió durante los años y los años 1990. El actual estudio examinó cambios en el perfil psicológico de los usuarios de la cocaína. Utilizamos los datos de Baltimore del estudio “Epidemiologic Catchment Area” durante 1981 (n = 3.006; hembra del 60%) y 1993–1994 (n = 1.679). El “Diagnostic Interview Schedule” midió el uso de la cocaína y los desordenes depresivos (Dysthymia, desorden depresivo major). El probabilidades del uso de la cocaína para ésos con la depresión era 1,28 y 3,53 en 1981 y en 1993–1994 respectivamente. Los resultados sugieren un efecto del período histórico en la asociación del uso de la cocaína y de la depresión. Se discuten las limitaciones y las implicaciones.

Keywords :

• cocaine
• depressive disorders
• co-occurring
• historical
• epidemiologic catchment area study
• drug use trajectories

THE AUTHORS

Amy S.B. Bohnert, Ph.D., is a postdoctoral fellow at the VA National Serious Mental Illness Treatment Research Evaluation Center (SMITREC) and the University of Michigan Department of Psychiatry in Ann Arbor, MI. Her research focuses on social determinants of substance use and the epidemiology of outcomes related to substance use and other mental health conditions. She is currently a coinvestigator on a VA-funded study to develop a survey of clinician practices to manage suicide and overdose risk among clients in VA Addiction Treatment facilities.

Richard A. Miech, Ph.D., is a sociologist and the Chair of the Department of Health and Behavior Sciences at University of Colorado, Denver. His research focuses on social inequality and health, with special emphasis on illegal drug use and addiction, as well as the social processes that lead to the initiation of health disparities across socioeconomic strata and race/ethnicity. He is currently the principal investigator on a NIDA-funded study to examine the growing socioeconomic disparity in illegal drug use.