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 Research & Giving News Article  With national studies showing a shift to a younger age of onset for both depression and substance & illicit drug use among adolescents, D. Ping Wu, Ph.D., Columbia University (1998 Young Investigator), decided to try to better understand these changes by examining the relationship between depression and substance use/abuse in this population. His study had three aims. First he wished to examine the relationship between various types of depression and different substances (cigarettes, alcohol, marijuana and other drugs). He also wanted to conduct a “longitudinal” study (research which follows a group of subjects over an extended period of time, often several years) to examine the depression/substance abuse relationship over time. Lastly, Dr. Wu aimed to analyze gender differences as it relates to depression and substance abuse. The results of Dr. Wu’s study reinforced that rates of alcohol use and abuse are significantly higher in depressed youth, as compared with their non-depressed peers. His data further indicate that the comorbidity between alcohol use and depression can be partly explained by shared risk factors. Finally, Dr. Wu uncovered substantial gender differences in this area. His findings suggest a significant link between alcohol use and depression among boys, while in girls there is a marked relationship between smoking and depression. Another researcher who studied comorbidity in young people is D. Tova M. Ferro, Ph.D, Columbia University (1998 Young Investigator), in her work on understanding the co-occurrence of Major Depression and Conduct Disorder in children. Conduct Disorder is characterized by a pattern of behaviors that violate the rights of others – including behaviors such as physical aggression, verbal abuse, and destruction of property. According to the National Institute of Mental Health (NIMH), this disorder is common among youths in juvenile detention, and those who end up in the criminal justice system. Bipolar disorder is a mental illness that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe, and can result in damaged relationships, difficulty with day-to-day functioning, and poor job or school performance. Bipolar disorder occurs in about one percent of the population over 18. The condition typically develops in late adolescence or early adulthood, however, some people have their first symptoms during childhood, and some develop them late in life. Researcher Filoteia Simona Noaghuil, M.D., Columbia University (2002 Young Investigator), is attempting to determine signs in pre-pubescent children that indicate a future susceptibility to developing bipolar disorder. She is doing this by conducting a follow-up study of adults who were diagnosed before puberty with either depression alone, or with a comorbid combination of depression and another disorder (either Attention Hyperactivity Disorder, Conduct Disorder, or Psychotic Depression), or who have a family history of bipolar disorder. It is Dr. Noaghuil’s hypothesis that the rates of bipolar disorder will be highest in the children who suffered from one of these co-occurring conditions, or who had a family history of the illness. Attention Deficit Hyperactivity Disorder (ADHD) is a condition principally characterized by inattention, hyperactivity, and impulsivity. The disorder becomes apparent in some children in the early years of schooling, and is one that makes it hard for these children to control their behavior and pay attention. It is estimated that between 3 and 5 percent of children have ADHD – or approximately 2 million children in the United States. Additionally, by adolescence those with ADHD are 5.5 times likelier than the general population to suffer from depression as well. W. Burleson Daviss, M.D., University of Pittsburgh (2002 Young Investigator), is involved in an ongoing study of potential risk factors for these conditions to co-occur. Dr. Daviss will also compare the symptoms and general impairment of a depressed group of ADHD patients, with ADHD patients without depression. He theorizes that those adolescents suffering from both depression and ADHD will be significantly more impaired than those with only ADHD. He further suggests that the symptoms and severity of the two conditions will vary over time independently of each other. Dr. Daviss’ work should shed additional light on the course of illness for children with both conditions, and inform future treatment approaches. Also studying comorbid depression and ADHD in children is Aileen Oandasan, M.D., University of Texas Medical Branch at Galveston (2003 Young Investigator), who is investigating the problem from a clinical perspective. Young people with both ADHD and depression may have more complicated and protracted courses of illness than those with only one condition, with impairment often persisting into adulthood. Furthermore, the course of each disorder is more severe – and response to treatment reduced – when this is the case. Dr. Oandasan is examining two ways of treating children suffering from both of these conditions. Typically, psychiatrists use either a combination of drugs that include a stimulant and an antidepressant (a two-drug approach), or buproprion monotherapy (a single-drug approach). In her ongoing study, Dr. Oandasan seeks to compare the two approaches, and determine which one is more effective in treating these children. Mental illness in children and adolescents reduces young people’s ability to maintain healthy relationships with family and friends, and to perform up to potential in school. When a psychiatric disorder is compounded by a secondary condition – often depression – it makes the formative and teenage years that much more difficult. NARSAD is committed to supporting scientists who are studying co-occurring disorders, in order to meaningfully aid the progress towards alleviating – and with hope, eventually curing – the suffering of these children. |
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