Depression symptoms and substance abuse in adolescents with asthma

Background: Depression and risk behaviors occur often in adolescents in the United States, but their frequency in youth with asthma is not well documented. Objective: To establish rates of and associations between depression and substance use in youth with asthma. Methods: The Centers for Disease Control and Prevention conducted the 2005 Youth Risk Behavior Survey with 13,917 students in grades 9 to 12 from 159 high schools in 40 states, producing a nationally representative distribution of students by grade, sex, and race/ethnicity. The Youth Risk Behavior Survey documents self-reported suicide intent and health risk behaviors, including use of tobacco, marijuana, alcohol, and cocaine. Results: In 720 adolescents reporting current asthma (5.2% of the total sample), depression symptoms, cigarette smoking, and cocaine use occurred more frequently than in youth without asthma. Substance use increased with depression; of youth with asthma reporting suicidal ideation, 40% had smoked cigarettes, 67% had smoked marijuana, 37% had engaged in binge drinking, and 12% had used cocaine in the past 30 days. Overall odds ratios for substance abuse in the group with asthma were not altered when controlling for age, sex, and race, although odds ratios for specific risk behaviors in those with asthma varied slightly within age, sex, and race groups. Conclusions: National rates of depression and associated risk behaviors in youth with asthma have not been previously reported, indicate a need to screen adolescents with asthma for depression, and suggest that risk behaviors in this population may signal heightened need for intervention.