Treatments for co-occurring depression and substance use in young people: a systematic review

Curr Drug Abuse Rev. 2014;7(1):3-17. doi: 10.2174/1874473707666141015220608.

Abstract

Background: Depression and problematic substance use represent two of the major social and health problems facing young people internationally. Frequently, these conditions co-occur and this co-occurrence is associated with greater functional impact, poorer treatment outcomes, and increased costs to both society and the individual.

Objective: This review aims to identify peer-reviewed published trials of interventions for co-occurring substance use and depression delivered to young people, describe these interventions, and critique the methodological quality of the studies.

Method: Eleven electronic databases were searched. The reference lists of relevant review papers were searched manually for additional studies not identified by the electronic database search.

Results: Initially, 1,976 studies were identified, of which 22 were classified as trial studies of youth-based treatment interventions for co-occurring substance use and depression. Ten of these studies met criteria for review. The majority (60%) utilized a pharmacotherapy component, but found it to be generally no better than placebo when both groups received adjunct counselling. METHODological quality of studies varied.

Conclusions: There is a dearth of trials of interventions for co-occurring depression and substance use disorders in young people. The limited data available is promising regarding the overall effectiveness of a psychological counselling approach. Given the importance of early intervention, and the difficulties faced when engaging youth in treatment, there is a need for further focused effort amongst this group. This may require more innovative techniques in intervention design and implementation. Recent advances in Internet- and mobile phone-based therapies present a potential avenue for further research.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Combined Modality Therapy
  • Counseling*
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / therapy*
  • Diagnosis, Dual (Psychiatry)
  • Humans
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / therapy*
  • Treatment Outcome