Background

The literature regarding bidirectional relationships of depressive symptoms to cigarette and alcohol use is mixed, and limited regarding e-cigarette and cannabis use. Moreover, COVID-19 has significantly impacted mental health and substance use, especially among young adults. Thus, this is a critical period for focused research on these relationships among young adults.

Methods

We analyzed longitudinal data (assessments in Fall 2018, 2019, and 2020) from 3,006 young adults (M_age = 24.56 [SD = 4.72], 54.8% female, 31.6% sexual minority, 71.6% White, 5.3% Black, 12.2% Asian, 11.4% Hispanic) from 6 US metropolitan statistical areas. Cross-lagged panel models were conducted to examine bidirectional associations between depressive symptoms and past 30-day use of cigarettes, e-cigarettes, cannabis, and alcohol (respectively), controlling for sociodemographics.

Results

During the study period, depressive symptoms decreased before the pandemic but increased during, cigarette and e-cigarette use decreased in both periods, alcohol use showed no change before but increases during the pandemic, and cannabis use increased in both periods. Additionally, each outcome demonstrated greater stability before versus during COVID-19. Finally, greater antecedent depressive symptoms correlated with more days of subsequent cigarette (β = 0.03, SE = 0.01, p =.011) and e-cigarette use (β = 0.03, SE = 0.01, p =.021), but fewer days of alcohol use (β = -0.02, SE = 0.01, p =.035). W2 cannabis use and alcohol use, respectively, were related to W3 depressive symptoms (cannabis: β = 0.09, SE = 0.02, p <.001; alcohol: β = 0.06, SE = 0.02, p =.002). No other cross-lagged associations were significant.

Conclusions

Intervention efforts targeting depression and substance use should explicitly address the potential for onset and escalation of substance use and depressive symptoms, respectively, especially during societal stressors.

中文翻译：

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抑郁症状与香烟、电子烟、大麻和酒精使用之间的双向关联：在 COVID-19 之前和期间对年轻人进行交叉滞后小组分析

 背景

关于抑郁症状与吸烟和饮酒双向关系的文献是混杂的，并且关于电子烟和大麻使用的文献有限。此外，COVID-19 严重影响了心理健康和药物使用，尤其是年轻人。因此，这是重点研究年轻人之间这些关系的关键时期。

 方法

我们分析了 3,006 名年轻人（M_年龄= 24.56 [SD = 4.72]，54.8% 女性，31.6% 性少数群体，71.6% 白人，5.3% 黑人，12.2% 亚裔）的纵向数据（2018 年、2019 年和 2020 年秋季的评估） ，11.4% 西班牙裔）来自美国 6 个大都市统计区。采用交叉滞后面板模型来检查抑郁症状与过去 30 天使用香烟、电子烟、大麻和酒精（分别）之间的双向关联，并控制社会人口统计数据。

 结果

在研究期间，抑郁症状在大流行前有所减少，但在大流行期间有所增加，香烟和电子烟的使用在这两个时期都减少了，酒精的使用在大流行期间没有变化，但在大流行期间有所增加，大麻的使用在这两个时期都有所增加。此外，与 COVID-19 期间相比，每项结果都表现出更高的稳定性。最后，较大的先前抑郁症状与随后吸烟的天数（β = 0.03，SE = 0.01，p = 0.011）和电子烟的使用天数（β = 0.03，SE = 0.01，p = 0.021）相关，但天数更少酒精使用率（β = -0.02，SE = 0.01，p =.035）。 W2 大麻使用和酒精使用分别与 W3 抑郁症状相关（大麻：β = 0.09，SE = 0.02，p <.001；酒精：β = 0.06，SE = 0.02，p =.002）。没有其他显着的交叉滞后关联。

 结论

针对抑郁症和药物滥用的干预措施应明确分别解决药物使用和抑郁症状发生和升级的可能性，特别是在社会压力下。