Depression, Methamphetamine use, and Alcohol Consumption among Thai Youth in Chiang Mai Province: The Exploration of Perceptions of Depression and Associations between Substance Use and Depressive Symptoms

Background: Methamphetamine use and alcohol consumption have reached epidemic levels among rural Thai adolescents and young adults in Chiang Mai Province, Thailand. High levels of depressive symptoms often occur among individuals who abuse or who are dependent on methamphetamine and alcohol. An understanding of the nature of associations between these substances and depressive symptoms can advance understanding of prevention and treatment options among individuals most at risk. Understanding the nature of depression as perceived by this population and the individual and social correlates can inform culturally-appropriate interventions. Methods: A mixed methods design was implemented and employed the use of a convergent parallel design to understand depressive symptoms and their correlates. Data obtained from a structured survey included information pertaining to lifetime and recent methamphetamine use, alcohol consumption, other illicit drugs, and depressive symptoms and was used for the epidemiological analyses. Primary variables of interest were lifetime and recent methamphetamine use, lifetime and recent alcohol consumption and depressive symptoms. In-depth interviews were conducted among 24 adolescent and young adult participants aged 14 - 24 from January – February 2013. Qualitative research was conducted to explore the perception of depression among Thai youth and potential factors responsible for the onset of depression in this population. Results: Multivariate linear regression revealed statistically significant associations between recent methamphetamine use and CES-D scores. Multivariate logistic regression revealed significant associations between lifetime and recent methamphetamine use and high levels of depressive symptoms. Multivariate linear and logistic regression models did not reveal statistically significant associations between lifetime/recent alcohol consumption and depressive symptoms. Explorations of symptoms of depression as perceived by respondents demonstrated similarities to Western cultures. Social antecedents were specific to the context of rural Chiang Mai. Substance use, abuse, and dependence were viewed as a way to self-medicate depressive symptoms. Conclusions: Methamphetamine use, alcohol consumption, and depressive symptoms are prevalent among Thai adolescents and young adults in Chiang Mai. This research suggests that culturally-relevant and integrated interventions for depression, methamphetamine use, and alcohol consumption are needed in rural Chiang Mai Province

Methamphetamine use is associated with high levels of depressive symptoms in adolescents and young adults in Rural Chiang Mai Province, Thailand

Abstract Background High levels of depressive symptoms often occur among individuals that use or that are dependent on methamphetamine (MA). Thailand is currently experiencing an epidemic of MA use among youth. Understanding the nature of the relationship between depressive symptoms and MA use and identifying those most at risk can further understanding of prevention and treatment options for youth who use MA and present with depressive symptoms. Methods In 2011, we conducted a cross sectional epidemiologic study that examined associations between MA use and high levels of depressive symptoms among adolescents and young adults aged 14–29 living in Chiang Mai province, Thailand. A combination of cluster and systematic sampling was conducted to obtain a study sample of participants actively recruited in Chiang Mai province. Depressive symptoms were measured using a Thai translation of the Centers for Epidemiologic Studies Depression scale (CES-D). The independent variables measured reported lifetime and recent MA use within the past 3 months. Multivariate logistic regression models were used to assess associations between MA use and high levels of depressive symptoms. Results Approximately 19 % (n = 394) of the sample reported ever having consumed MA and 31 % (n = 124) of lifetime users reported recent MA use within the past 3 months. Recent MA use was associated with high levels of depressive symptoms (aPOR recent use: 2.60, 95 % CI: 1.20, 5.63). Conclusions This is one of the first studies to examine the association between MA use and high levels of depressive symptoms in a general Thai population. The odds of having high levels of depressive symptoms was significantly greater among recent MA users compared to non-users. These findings support the need for policies, programs and interventions to prevent and treat depressive symptoms presenting among MA using Thai adolescents and young adults in rural Chiang Mai province, Thailand to aid in cessation of MA use. Furthermore, additional research is needed to investigate treatment options for adolescents and young adults in Thailand that use MA and present with high levels of depressive symptoms