Problematic Substance Use in Depressed Youth: Associations with Suicidal Ideation and Suicide Attempt History

Objective: Depressed youth exhibit higher rates of suicidal behavior compared to healthy controls, with problematic substance use potentially intensifying this risk. Accordingly, this study aimed to examine the impact of comorbid depression and problematic substance use and its association with suicidality in youth populations. Methods: We examined differences in clinical features and demographic characteristics between 797 depressed youth ages 8-20 years with and without problematic substance use from the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Additionally, to assess whether the effect of depression severity on suicidal ideation and suicide attempt history were influenced by problematic substance use, multivariable linear and logistic regression analyses were conducted. Results: Depressed youth with problematic substance use (versus those without) were significantly older, more likely to exhibit suicidal ideation and a history of suicide attempts and had significantly worse school functioning after controlling for age, sex, race, and ethnicity. Problematic substance use did not moderate the effect of depression severity on suicidal ideation or suicide attempt history. Conclusions: Findings shed light on the impact of problematic substance use in depressed youth which may allow for earlier and more specified intervention efforts aimed at identifying and targeting youth suicidality.