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Non-Medical Substance Use Among U.S. Adults with a Current or Past Symptoms of Major Depressive Disorder

Burkett, Hannah L
http://orcid.org/0000-0003-4698-794X
http://rave.ohiolink.edu/etdc/view?acc_num=kent1745608102745953

Abstract Details

, PHD, Kent State University, College of Public Health.
The objective of this work was to describe and understand modern drug use behaviors among US adults with current or past depression using grounded in the self-medication hypothesis (SMH). Additionally this work estimated the effect of healthcare interaction, symptom severity and specific medical intervention on the prevalence of non-medical drug use (NMU). I described the prevalence and distribution of depressive symptoms within the general adult population. I produced externally valid estimates grounded in a well measured descriptive framework. Out of the estimated 42 million US adults experiencing current depression, only an estimated 22.4% had a lifetime diagnosis. The largest overall association with having a lifetime diagnosis was seen for comorbid physical and mental health conditions and the largest associations of demographic characteristics were seen among characteristics independently associated with healthcare access. I explored the effect of diagnosis and symptom management on the rates of NMU considering 8 separate drug classes. For all drug classes, the highest prevalence of past week NMU was among those with unmanaged depression, although the prevalence among those with managed depression was still higher than among those without depression. these results suggest that symptom management does reduce to prevalence of drug use significantly and that the effect is consistent across drug groups. Finally, I used a causal framework to estimate the impact attributable to medical use of a prescribed antidepressant on the odds of drug NMU. Propensity weights were calculated to balance the sample on the exposure. After adjustment for selection bias and confounding, among US adults with a history of depression, those who medically used a prescription antidepressant in the past year had reduced odds of past week NMU for all drug groups as compared to those with a history of depression who did not use a prescription antidepressant. The magnitude and significance of the reduction differed by drug group. The increasing prevalence of unmanaged depression among US adults is concerning and has serious implications for the overall health and productivity of the population. My work demonstrated that diagnosis, symptom management and pharamcological treatment for current or past depression was associated with a decrease in the odds of NMU. Timely screening to identify individuals experiencing depression and early interventions to treat such symptoms could prevent self-treatment behaviors from becoming established and further exacerbating depressive symptoms.
Lynette Phillips (Committee Chair)
Joshua Black (Committee Member)
Deric Kenne (Committee Member)
Madhav Bhatta (Committee Member)
155 p.
Epidemiology; Mental Health; Public Health
Non-Medical Use Substance Abuse Major Depressive Disorder Depressive Symptoms Undiagnosed Depression Self Medication Population Survey

Recommended Citations

Citations

  • Burkett, H. L. (2025). Non-Medical Substance Use Among U.S. Adults with a Current or Past Symptoms of Major Depressive Disorder [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1745608102745953

    APA Style (7th edition)

  • Burkett, Hannah. Non-Medical Substance Use Among U.S. Adults with a Current or Past Symptoms of Major Depressive Disorder. 2025. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1745608102745953.

    MLA Style (8th edition)

  • Burkett, Hannah. "Non-Medical Substance Use Among U.S. Adults with a Current or Past Symptoms of Major Depressive Disorder." Doctoral dissertation, Kent State University, 2025. http://rave.ohiolink.edu/etdc/view?acc_num=kent1745608102745953

    Chicago Manual of Style (17th edition)

kent1745608102745953
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© 2025, all rights reserved.
This open access ETD is published by Kent State University and OhioLINK.
Release 3.2.12