Citation

Suchting R, Vincent JN, Lane SD, Green CE, Schmitz JM, Wardle MC. Drug Alcohol Depend. 2018; 194: 310-317.

Affiliation

Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, Houston, TX, United States; Department of Psychology, University of Illinois at Chicago, Behavioral Sciences Building, 1007 W. Harrison St., Chicago, IL, United States. Electronic address: mwardle@uic.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2018.10.029

PMID

30472571

Abstract

BACKGROUND: Depressive symptoms may contribute to cocaine use. However, tests of the relationship between depression and severity of cocaine use have produced mixed results, possibly due to heterogeneity in individual symptoms of depression. Our goal was to establish which symptoms of depression are most strongly related to frequency of cocaine use (one aspect of severity) in a large sample of current cocaine users. We utilized generalized additive modeling to provide data-driven exploration of the relationships between depressive symptoms and cocaine use, including examination of non-linearity. We hypothesized that symptoms related to anhedonia would demonstrate the strongest relationship to cocaine use.

METHOD: 772 individuals screened for cocaine use disorder treatment studies. To measure depressive symptoms, we used the items of the Beck Depression Inventory, 2nd Edition. Cocaine use frequency was measured as proportion of self-reported days of cocaine use over the last 30 days using the Addiction Severity Index.

RESULTS: Models identified 18 significant predictors of past-30-day cocaine use. The strongest predictors were Crying, Pessimism, Changes in Appetite, Indecisiveness, and Loss of Interest. Noteworthy effect sizes were found for specific response options on Suicidal Thoughts, Worthlessness, Agitation, Concentration Difficulty, Tiredness, and Self Dislike items.

CONCLUSIONS: The strongest predictors did not conform to previously hypothesized "subtypes" of depression. Non-linear relationships between items and use were typical, suggesting BDI-II items may not be monotonically increasing ordinal measures with respect to predicting cocaine use. Qualitative analysis of strongly predictive response options suggested emotional volatility and disregard for the future as important predictors of use.

Copyright © 2018 Elsevier B.V. All rights reserved.

Language: en

Keywords

Addiction; Beck Depression Inventory 2nd Edition; Cocaine; Depressive symptoms; Drug abuse; Generalized additive model; Machine learning