Treatments for Co-Occurring Depression and Substance Use in Young People: A Systematic Review

Background: Depression and problematic substance use represent two of the major social and health problems facing young people internationally. Frequently, these conditions co-occur and this co-occurrence is associated with greater functional impact, poorer treatment outcomes, and increased costs to both society and the individual. Objective: This review aims to identify peer-reviewed published trials of interventions for co-occurring substance use and depression delivered to young people, describe these interventions, and critique the methodological quality of the studies. Method: Eleven electronic databases were searched. The reference lists of relevant review papers were searched manually for additional studies not identified by the electronic database search. Results: Initially, 1,976 studies were identified, of which 22 were classified as trial studies of youth-based treatment interventions for co-occurring substance use and depression. Ten of these studies met criteria for review. The majority (60%) utilized a pharmacotherapy component, but found it to be generally no better than placebo when both groups received adjunct counselling. Methodological quality of studies varied. Conclusions: There is a dearth of trials of interventions for co-occurring depression and substance use disorders in young people. The limited data available is promising regarding the overall effectiveness of a psychological counselling approach. Given the importance of early intervention, and the difficulties faced when engaging youth in treatment, there is a need for further focused effort amongst this group. This may require more innovative techniques in intervention design and implementation. Recent advances in Internet- and mobile phone-based therapies present a potential avenue for further research.