Prevalence and Correlates of Depression and Drinking Behaviors Among Adolescents and Emerging Adults in a Suburban Emergency Department

ABSTRACT

Background: Both alcohol use and depression are concerning health issues among youth. The Emergency Department (ED) is a critical location to access youth with depressive symptoms and alcohol misuse. Objectives: To inform future interventions in the ED, this study examined the relationship between drinking behaviors and depressive symptoms among youth seeking ED care. Methods: Youth ages 14–20 were recruited from a level-1 trauma ED located in the Midwest as part of a larger ongoing study. Participants completed an electronic screening survey, which included assessment of alcohol use, depressive symptoms, and demographic variables. Two logistic regression models were conducted to assess the relationship between depressive symptoms with alcohol consumption and specific alcohol-related consequences. Results: Among 3,659 participants, bivariate analysis indicated that individuals screening positive for depression were more likely to be female, nonwhite, receive public assistance, and report higher scores on both alcohol consumption and alcohol-related consequences. Regression analyses indicated alcohol consumption, inability to stop drinking once starting, and feelings of guilt or remorse after drinking were significantly positively related to screening positive for depression. Conclusions/Importance: Current findings support use of the ED as a location for identifying youth who are experiencing co-morbid alcohol use and depressive symptoms. Future research should focus on the effectiveness of brief intervention in the ED that focuses on the co-occurrence of alcohol misuse and depressive symptoms among youth.

Keywords:

• Alcohol consumption
• alcohol consequences
• depression
• youth
• emergency department

Funding

This investigation was supported by the National Institutes of Health under Ruth L. Kirschstein National Research Service Award T32 DA007267 and NIAAA #018122. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Rikki Patton

Rikki Patton is an Assistant Professor in the School of Counseling at the University of Akron. Her research focuses on substance use among underserved populations and she is particularly interested in the integration of substance use treatment in nonsubstance use treatment settings. Dr. Patton has a Ph.D. in Human Development and Family Science from The Ohio State University and completed a post-doctoral fellowship through the Substance Abuse Research Center at the University of Michigan.

Chung Hin (Joshua) Lau

Chung Hin (Joshua) Lau was a Psychology student at the University of Michigan. He graduated with a B.A. in Psychology (Honors) and a minor in Community Action and Social Change. He also completed his honors thesis “Prevalence and Correlates of Depression and Drinking Behavior among Adolescents and Young Adults in the Suburban Emergency Department” in 2013. After graduation, he worked at the University of Michigan Injury Center and Adult Inpatient Psychiatry Unit at the University of Michigan Health System as a research assistant and a psychiatric care worker respectively. Mr. Lau is currently pursuing a Masters degree in Nursing Science at the Chinese University of Hong Kong.

Frederic C. Blow

Frederic C. Blow, Ph.D., is Professor and Director of both the Substance Abuse and the Mental Health Services Outcomes & Translation Research Sections in the Department of Psychiatry, the Director of the University of Michigan Addiction Research Center, and a career researcher and educator in the field of substance use screening, interventions, and treatments. He is a national expert in mental health and substance abuse services research and policy, with a focus on evidence-based practices.  His areas of research expertise include substance abuse prevention from a lifespan developmental perspective, substance use and violence, alcohol screening and diagnosis for older adults, mental disorders and concurrent substance abuse, alcohol and drug abuse brief interventions in healthcare settings, risk factors for suicide, and mental health services research.

Megan L. Ranney

Megan L. Ranney is an Assistant Professor in the Department of Emergency Medicine at Rhode Island Hospital/Alpert Medical School of Brown University. She is also the Director of the Brown Emergency Digital Health Innovation program. Dr. Ranney's primary research interests are in developing and testing digitally-based behavioral health interventions for high-risk emergency department patients.

Rebecca M. Cunningham

Rebecca M. Cunningham is Associate Chair for Research and Professor for the University of Michigan's Department of Emergency Medicine, Director of the CDC funded UM Injury Center, and Professor in Health Behavior & Health Education, University of Michigan School of Public Health. Dr. Cunningham has a distinguished career in researching intentional injury and substance use prevention, particularly of youth and young adult populations. Her focus on brief interventions in the emergency room has helped position the emergency department as a critical location for public health interventions, specifically for violence. She is currently leading two NIH-funded studies on substance abuse: one focusing on the intersection of youth violence and drug use, and one focusing on underage alcohol misuse and associated injury. Dr. Cunningham concurrently continues her work as a practicing Emergency Department physician at the University of Michigan Health System.

Maureen A. Walton

Maureen A. Walton is an Associate Professor in the Department of Psychiatry and Addiction Research Center at the University of Michigan. Her research interests include developing and testing the efficacy of interventions for alcohol, drug use and violence in community health care settings, such as the emergency department, primary care, and substance use treatment. Her research focuses on the interrelationship among multiple risk behaviors such as alcohol, illicit drugs, and violence, particularly among traditionally understudied populations such as adolescents, women, and African-Americans. She is the multiple principal investigator on a brief alcohol intervention study among underage drinkers presenting to the UM Emergency Department (ED). In addition, she is a co-investigator on studies (funded by NIDA and NIAAA) examining substance use trajectories among youth, brief alcohol and drug interventions among adults in the ED, and integrated violence prevention therapy for patients in substance use treatment. Dr. Walton and colleagues recently completed studies examining brief interventions for alcohol and violence among adolescents presenting to urban ED's, marijuana prevention interventions among youth in primary care settings, and health services interventions among not-in-treatment adults with substance use disorders. Dr. Walton has a Ph.D. in Ecological and Community Psychology from Michigan State University and a M.P.H. in Heath Promotion from San Diego State University.