The Link Between Adolescent Depression, Young Adult Alcohol And Marijuana Use, And The Role Of Mental Health Services

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Public Health and Policy


Doctor of Public Health

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Adolescent depression is an increasingly significant public health problem. Depressed adolescents are at greater risk for negative young adult outcomes, such as depression continuity and development of substance use disorders. This study examined the relationships between adolescent depression and young adult depression, problematic alcohol use, and marijuana use. The influence of mental health services on depression and substance use was also investigated. Mental health services have the potential to alter depressed adolescents' trajectories and deter negative transitions into young adulthood. Univariate, bivariate, and multivariate analyses were performed using secondary data from the National Longitudinal Study of Adolescent Health Survey (Add Health), which examined adolescent health related behaviors and young adult outcomes during a six-year period. The initial sample consisted of 12 to 16 year old adolescents (n=6836), who participated in all three waves. Significant findings showed depressed adolescents were three times more likely to transition into depressed young adults. Depressed adolescents were less susceptible to increased problematic alcohol use and co-occurrence over time. Depressed adolescents who did not receive mental health services had higher levels of impairment that continued and/or elevated in young adulthood. Overall, this study highlights the diverse and multifaceted pathways linking adolescent depression to young adult alcohol use and co-occurrence. The findings underscore the importance of examination of sub-group variations, particularly gender and adolescent alcohol use patterns, to clarify divergent relationships between depression and substance use outcomes. Implications include increased knowledge about multiple depressive pathways and need for gender-specific intervention strategies.