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

Abstract

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