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Limited studies focus on the development of major depressive disorder (MDD) among individuals with early-onset substance use and the presence of depression symptoms prior to age 18. Although predicting the candidates for depression may not be possible, NIMH reports genetics, biological, psychological, and environmental factors produce an equal potential of contributing to the progression of MDD. The study primarily aims to evaluate the presence of depression symptoms prior to 18 and early-onset substance abuse to understand the development of adult major depressive disorder in the United States.


The study extracted data from the 2018 National Survey on Drug Use and Health data where 43,026 total adults were included and 3,953 reported with MDD. Weighted multiple logistic regression (MLR) analyses were used to evaluate the associations of early-onset substance use and depression symptoms prior to age 18 with adult MDD.


The overall prevalence of MDD was 7.2% and decreased with age (9.2%, 6.0%, and 3.0% for age groups 18-49, 50-64, and 65+, respectively). The MLR analysis revealed early-onset alcohol, smokeless tobacco, cigar, marijuana, and inhalant use as well as early-onset depression symptoms were associated with increased odds of MDD (p


The findings inspire new efforts to grow in service capacity to meet and exceed the mental health care needs of each age group through proper evaluation of symptoms and presence of substance use in early years.

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