Over-the-Counter Drugs and Other Substances Used in Attempted Suicide Presented to Emergency Departments in Montreal, Canada.

Background: Over-the-counter (OTC) analgesics are frequently used in suicide attempts. Accessibility, toxicity, and unsupervised acquisition of large amounts may be facilitators. Aims: To identify patient characteristics associated with OTC drug use as a suicide attempt method among adults. Method: A cross-sectional study was conducted using chart review of all individuals who presented to the emergency department (ED) of two adult general hospitals following a suicide attempt during 2009-2010 in Montreal, Canada. Results: Among the 369 suicide attempters identified, 181 used overdosing, 47% of whom used OTC drugs. In logistic regression, women and those with medical comorbidity were more likely to use overdosing, while those with substance use disorders were less likely to do so. Among those who overdosed, women were more likely to use OTC drugs, while those who were Caucasian, had children, comorbidities, diagnoses with substance use disorders, and made attempts in the Fall were less likely to do so. Substances most frequently used were: acetaminophen among OTC drugs (30%); antidepressants (37%), anxiolytics (30%), opioids (10%), and anticonvulsants (9%) among prescription drugs; and cocaine (10%) among recreational drugs. Limitations: Reasons for the suicide method choice were not available. Conclusion: OTC drugs, in particular acetaminophen, are frequently used in suicide attempts. Accessibility to these drugs may be an important contributor.

Recurrent suicidal ideation in young adults.

OBJECTIVES: Recurrent suicidal ideation (SI) may be linked to an increased risk of making suicide plans and suicide attempts. The objectives were to describe the frequency of SI recurrence in a population-based sample of young adults, and to compare mental health diagnoses, substance use, use of health services and medication use among those with and without recurrent SI. METHODS: Data were collected from 785 participants at age 20 years and again at age 24. Chi-square tests were used to compare participants with and without recurrent SI. RESULTS: Of 56 participants who reported SI at age 20, 32% reported SI four years later. Thirty-nine percent of participants with recurrent SI reported poor mental health compared to 8% of participants who never reported SI; 11% (vs. 4%) had sought professional help, 44% (vs. 8%) had been diagnosed with a mood and/or anxiety disorder, and 22% (vs. 2%) had taken medication for a mental health problem. Past-year substance use was higher among those with recurrent SI than among those with no SI: 67% vs. 42% smoked cigarettes, 56% vs. 39% used other tobacco products, 89% vs. 74% binge drank, 56% vs. 42% used marijuana and 33% vs. 17% reported using illicit drugs. CONCLUSION: One third of young adults with a history of SI reported SI four years later. Because SI can recur, clinicians should monitor young adults with a history of SI, assess their substance use and mood/anxiety disorders and if needed, refer them for psychological or psychiatric care.

Association Between Childhood Sleep-Disordered Breathing and Disruptive Behavior Disorders in Childhood and Adolescence.

We examined the association between sleep-disordered breathing (SDB) and disruptive behavior disorders in 605 children participating in a population-based cohort study. Nineteen percent of children snored (sometimes or often) and 10% had obstructive sleep apnea (OSA) symptoms. Thirteen percent had an ADHD diagnosis or symptoms and 5-9% had behavioral problems or a conduct disorder. Snoring or OSA symptoms were associated with a twofold difference in the odds of ADHD diagnosis or symptoms. OSA symptoms were associated with a threefold to fourfold difference in the odds of behavioral problems or conduct disorder. Clinicians should consider inquiring about SDB in children with disruptive behavior disorders and should also consider disruptive behavior disorders as potential sequelae of SDB.

Attempted Suicide Among Students and Young Adults in Montreal, Quebec, Canada: A Retrospective Cross-Sectional Study of Hospitalized and Nonhospitalized Suicide Attempts Based on Chart Review.

OBJECTIVE: We conducted a chart review to identify postsecondary students and nonstudents in the same age range who presented to the emergency department following a suicide attempt to (1) compare demographic characteristics and suicide risk factors and (2) determine factors associated with more serious attempts requiring hospitalizations. METHOD: The study was conducted in 1 tertiary trauma hospital and 1 community hospital affiliated with McGill University, Montreal, Quebec, Canada, between January 1, 2009, and March 31, 2010. Charts of patients with potential suicide attempts were identified from medical records using ICD-10 codes that indicated traumatic injury, intentional self-harm, poisoning, and psychiatric or perception/cognition disorders and from the emergency department triage file using keywords that indicated suicidality or self-harm at presentation. RESULTS: In multivariable logistic regression models (odds ratio, 95% CI), students were younger (per 5-year increase: 0.22, 0.12-0.41), less likely to be born in Canada (0.17, 0.06-0.44), and more likely to use less violent methods (laceration, poisoning, other, multiple methods) versus more violent methods (collision, jump, fire burns, firearm, hanging) in their attempt. Fewer students had a history of substance abuse (0.12, 0.02-0.94) but were not different from nonstudents on history of other mental disorders. Less students attempted suicide in the winter/spring (January-April) versus fall (September-December) semester (0.32, 0.11-0.91). Students who attempted suicide were more likely to have family/social support. Those who attempted suicide in the previous year were more likely to require hospitalization for their current suicide attempt. CONCLUSIONS: Knowledge of specific factors associated with suicide attempts in young people can help inform and guide suicide prevention efforts in both academic and community settings. Specific to the findings of this study regarding the method of suicide attempt used, for example, limiting access to dangerous substances or large quantities of medications may help prevent or reduce suicide attempts in this population.

Short-Term Natural Course of Depressive Symptoms and Family-Related Stress in Adolescents After Separation From Father.

OBJECTIVE: To determine if separation from a father is associated with short-term changes in mental health or substance use in adolescents. METHODS: Every 3 months, during a 5-year period, we followed 1160 Grade 7 students participating in the Nicotine Dependence in Teens Study who were living with both parents. Participants who reported not living with their father for 6 or more consecutive months during follow-up were categorized as separated from father. Pooled regressions within the framework of generalized estimating equations were used to model the associations between separation from father and indicators of mental health (depressive symptoms, and worry and [or] stress about family relationships or the family situation) and substance use (alcohol use and cigarette smoking) 4 to 6 and 7 to 9 months postseparation, controlling for age, sex, and baseline level of the outcome variable. RESULTS: Compared with adolescents living with both parents, adolescent offspring separated from their fathers were more likely to report depressive symptoms (ß = 0.17, 95% CI 0.01 to 0.33) 4 to 6 months postseparation, as well as worry and (or) stress about their parents separating or divorcing (OR 2.39, 95% CI 1.29 to 4.43), a new family (OR 4.25, 95% CI 2.33 to 7.76), and the family financial situation (OR 2.35, 95% CI 1.53 to 3.60). Separation from father was also marginally significantly related to worry and (or) stress about their relationship with their father (OR 1.53; 95% CI 0.98 to 2.39). At 7 to 9 months postseparation, separation from father continued to be associated with worry and (or) stress about their parents separating or divorcing, a new family, and the family financial situation. Separation from father was no longer associated with worry and (or) stress about their relationship with their father, but it was associated with worry and (or) stress about their relationship with their mother. Separation from father was not related to use of alcohol or cigarettes. CONCLUSION: Adolescent offspring experienced family-related stress and transient depression symptoms in the 4- to 9-month period following separation from their fathers.

Cohort Profile: The Nicotine Dependence in Teens (NDIT) Study.

The Nicotine Dependence in Teens (NDIT) study is a prospective cohort investigation of 1294 students recruited in 1999-2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Its primary objectives were to study the natural course and determinants of cigarette smoking and nicotine dependence in novice smokers. The main source of data was self-report questionnaires administered in class at school every 3 months from grade 7 to grade 11 (1999-2005), for a total of 20 survey cycles during high school education. Questionnaires were also completed after graduation from high school in 2007-08 and 2011-12 (survey cycles 21 and 22, respectively) when participants were aged 20 and 24 years on average, respectively. In addition to its primary objectives, NDIT has embedded studies on obesity, blood pressure, physical activity, team sports, sedentary behaviour, diet, genetics, alcohol use, use of illicit drugs, second-hand smoke, gambling, sleep and mental health. Results to date are described in 58 publications, 20 manuscripts in preparation, 13 MSc and PhD theses and 111 conference presentations. Access to NDIT data is open to university-appointed or affiliated investigators and to masters, doctoral and postdoctoral students, through their primary supervisor (www.nditstudy.ca).

Genetic variants and early cigarette smoking and nicotine dependence phenotypes in adolescents.

BACKGROUND: While the heritability of cigarette smoking and nicotine dependence (ND) is well-documented, the contribution of specific genetic variants to specific phenotypes has not been closely examined. The objectives of this study were to test the associations between 321 tagging single-nucleotide polymorphisms (SNPs) that capture common genetic variation in 24 genes, and early smoking and ND phenotypes in novice adolescent smokers, and to assess if genetic predictors differ across these phenotypes. METHODS: In a prospective study of 1294 adolescents aged 12-13 years recruited from ten Montreal-area secondary schools, 544 participants who had smoked at least once during the 7-8 year follow-up provided DNA. 321 single-nucleotide polymorphisms (SNPs) in 24 candidate genes were tested for an association with number of cigarettes smoked in the past 3 months, and with five ND phenotypes (a modified version of the Fagerstrom Tolerance Questionnaire, the ICD-10 and three clusters of ND symptoms representing withdrawal symptoms, use of nicotine for self-medication, and a general ND/craving symptom indicator). RESULTS: The pattern of SNP-gene associations differed across phenotypes. Sixteen SNPs in seven genes (ANKK1, CHRNA7, DDC, DRD2, COMT, OPRM1, SLC6A3 (also known as DAT1)) were associated with at least one phenotype with a p-value <0.01 using linear mixed models. After permutation and FDR adjustment, none of the associations remained statistically significant, although the p-values for the association between rs557748 in OPRM1 and the ND/craving and self-medication phenotypes were both 0.076. CONCLUSIONS: Because the genetic predictors differ, specific cigarette smoking and ND phenotypes should be distinguished in genetic studies in adolescents. Fifteen of the 16 top-ranked SNPs identified in this study were from loci involved in dopaminergic pathways (ANKK1/DRD2, DDC, COMT, OPRM1, and SLC6A3). IMPACT: Dopaminergic pathways may be salient during early smoking and the development of ND.

Lithium dosing and serum concentrations across the age spectrum: from early adulthood to the tenth decade of life.

OBJECTIVES: Little is known about how lithium should be dosed to achieve therapeutic but safe serum concentrations in older adults. In this paper, we investigate how the lithium dose-concentration ratio changes across the lifespan. METHODS: This was a cross-sectional analysis of 63 current lithium users aged 20-95 years using data from McGLIDICS (the McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study). Participants underwent blood and urine tests, including serum lithium concentrations. Multivariate analyses were conducted to evaluate potential correlates of the lithium dose-concentration ratio. RESULTS: We found that between the ages of 40-95 years, the total daily dose of lithium required to achieve a given serum concentration decreases threefold (500 vs. 1,500 mg for 1.0 mmol/L). Greater age, once-daily dosing, and lower renal function (estimated glomerular filtration rate) were independently associated with a lower lithium dose-concentration ratio. CONCLUSIONS: The lithium dose required to achieve a given serum lithium concentration decreases threefold from middle to old age, with this trend continuing into the ninth and tenth decades of life. In order to avoid lithium toxicity in aging patients, continued serum concentration monitoring and judicious dose reduction may be required, particularly in those patients with reduced renal function.

Is environmental temperature related to renal symptoms, serum lithium levels, and other laboratory test results in current lithium users?

OBJECTIVE: Lithium continues to be an important mood disorder treatment. Although patients exposed to higher environmental temperatures may have serum lithium level elevations due to dehydration, there is conflicting data in the literature. In addition, no study has assessed the association between temperature and other renal laboratory tests and symptoms in lithium users. METHODS: This is a cross-sectional analysis of 63 current lithium users who participated in the McGill Geriatric Lithium-induced Diabetes Insipidus Clinical Study. The relationship between mean daily temperature with diabetes insipidus symptoms, glomerular filtration rate, urine osmolality, serum sodium, lithium level, and lithium dose-level ratio was assessed. RESULTS: Although a higher temperature on the day of laboratory testing trended toward being independently associated with a lower lithium dose-level ratio (Beta = -0.17, p = 0.08), this was not found when using a dichotomous measure of temperature (T > 20°C). No association was observed between temperature and other renal parameters. CONCLUSIONS: The association of temperature with lithium levels, renal symptoms, and laboratory tests appears to be of relatively little clinical importance in lithium users in temperate climates. However, future research should re-examine patients living in climates with extreme temperatures (e.g., >40°C), who may theoretically be at higher risk.

The McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study (McGLIDICS).

OBJECTIVE: Despite being a common and potentially serious condition, nephrogenic diabetes insipidus (NDI) remains poorly understood in older lithium users. Our main objective was to compare the prevalence of NDI symptoms and decreased urine osmolality ([UOsm] < 300 milli-Osmoles [mOsm/kg]) among geriatric and adult lithium users. We also assessed NDI symptoms, serum sodium (Na+), and urine specific gravity (USG) as possible surrogate measures of decreased UOsm, and ascertained whether potential etiologic factors independently correlated with decreased UOsm. METHOD: This was a cross-sectional study of 100 consecutive outpatients treated with lithium from 6 tertiary care clinics, of which 45 were geriatric (aged 65 years and older) and 55 adult (aged 18 to 64 years). Patients completed a symptom questionnaire and underwent laboratory tests, including UOsm, serum Na+, and USG. RESULTS: Geriatric and adult lithium users had similar rates of decreased UOsm (12.5%, compared with 17.9%, P = 0.74), but geriatric patients reported less symptoms (P < 0.05). Although UOsm did not correlate with symptoms or current serum Na+, USG of less than 1.010 was suggestive of UOsm of less than 300 mOsm/kg. Age, lithium duration, and serum lithium level were independently associated with UOsm. CONCLUSIONS: The prevalence of decreased UOsm is similar in geriatric and adult lithium users, but older patients are less likely to report urinary and thirst symptoms. Although subjective symptoms do not correlate with UOsm, USG may be a cost-efficient clinical surrogate measure for UOsm. We suggest clinicians increase their vigilance for decreased UOsm, especially in lithium users with advanced age, longer duration of lithium exposure, and higher lithium levels. This may potentially prevent lithium intoxication, falls, hypernatremic events, and renal dysfunction.

Measurement invariance of the depressive symptoms scale during adolescence.

BACKGROUND: This study examined (1) the factor structure of a depressive symptoms scale (DSS), (2) the sex and longitudinal invariance of the DSS, and (3) the predictive validity of the DSS scale during adolescence in terms of predicting depression and anxiety symptoms in early adulthood. METHODS: Data were drawn from the Nicotine Dependence in Teens (NDIT) study, an ongoing prospective cohort study of 1,293 adolescents. RESULTS: The analytical sample included 527 participants who provided complete data or had minimal missing data over follow-up. Confirmatory factor analysis revealed that an intercorrelated three-factor model with somatic, depressive, and anxiety factors provided the best fit. Further, this model was invariant across sex and time. Finally, DSS scores at Time 3 correlated significantly with depressive and anxiety symptoms measured at Time 4. CONCLUSIONS: Results suggest that the DSS is multidimensional and that it is a suitable instrument to examine sex differences in somatic, depressive, and anxiety symptoms, as well as changes in these symptoms over time in adolescents. In addition, it could be used to identify individuals at-risk of psychopathology during early adulthood.

Sustained waterpipe use among young adults.

INTRODUCTION: Waterpipe smoking is increasingly popular among North American youth. However, the extent to which waterpipe use is sustained over time is not known. The objective of this study was to describe the frequency and the predictors of sustained waterpipe use over 4 years among young adults. METHODS: Data were available in a prospective cohort investigation of 1,293 seventh-grade students recruited in a convenience sample of 10 secondary schools in Montreal, Canada, in 1999. Data on past-year waterpipe use were collected from 777 participants when they were age 20 years on average (in 2007-2008) and again when they were age 24 years (in 2011-2012) in mailed self-report questionnaires. Twenty potential predictors of sustained waterpipe use were tested, each in a separate multivariable logistic regression model. RESULTS: About 51% of 182 waterpipe users at age 20 reported waterpipe use 4 years later. Most sustained users (88%) smoked a waterpipe less than once a month. Parental smoking, being currently employed, less frequent cigarette smoking, and more frequent marijuana use were associated with sustained waterpipe use. CONCLUSIONS: Half of the young adults who used waterpipe during young adulthood reported use 4 years later. Young adults who sustain waterpipe use appear to do so as an activity undertaken occasionally to socialize with others.

The association between CHRN genetic variants and dizziness at first inhalation of cigarette smoke.

Numerous single nucleotide polymorphisms (SNPs) in multiple nicotinic receptor genes (CHRN) are associated with smoking. However few studies have examined the association between CHRN SNPs and subjective responses to smoking in adolescents which may relate to sustained smoking, such as dizziness at first inhalation. The objective of this study was to investigate the association between 61 SNPs in eight CHRN genes (CHRNA3, CHRNA4, CHRNA5, CHRNA6, CHRNA7, CHRNB2, CHRNB3, CHRNB4) and dizziness at first inhalation. Data were available from a longitudinal cohort investigation of 1293 students 12-13year-old at baseline. Students completed self-report questionnaires at school every 3months for 5years during secondary school, and a mailed questionnaire three years later. DNA extracted from blood or saliva was genotyped for 61 CHRN SNPs selected using a gene tagging approach. Associations were modeled using logistic regression controlling for sex, race and age at first cigarette. Complete data were available for 356 of 475 participants (75%) who initiated smoking. The minor alleles of three SNPs in CHRNA6 (rs7812298, rs2304297, rs7828365) were associated with a decreased probability of dizziness (OR(95% CI)=0.54 (0.36, 0.81), 0.59 (0.40, 0.86) and 0.58 (0.36, 0.95), respectively), while one SNP in each of three other genes (rs3743077 (CHRNA3), rs755204 (CHRNA4), rs7178176 (CHRNA7)) was associated with an increased probability of dizziness (OR(95% CI)=1.40 (1.02, 1.90), 1.85 (1.05, 3.27) and 1.51 (1.06, 2.15), respectively). Thus, several SNPs located in CHRN genes are associated with dizziness at first inhalation, a smoking initiation phenotype that may relate to sustained smoking.

Symptoms of depression are longitudinally associated with sedentary behaviors among young men but not among young women.

OBJECTIVE: A habitual sedentary lifestyle is associated with adverse health outcomes; however, the predictors of sedentary behaviors have not been sufficiently explored to inform the development and delivery of effective interventions to reduce sedentary behaviors. This study examined whether reports of symptoms of depression could predict weekly time spent in sedentary behaviors (i.e., television watching, computer use) 4years later. METHOD: Self-reported symptoms of depression were assessed at age 20years (2007-08), and television watching time and computer use were assessed at age 24years (2011-12) in 761 adults (45% men) participating in the Nicotine Dependence in Teens study. Data were analyzed using linear regression analysis, with separate models for men and women. RESULTS: After controlling for past sedentary behavior, symptoms of depression at age 20years predicted more computer use 4years later in men (R(2)=.21, ß=.13, p<.05), but not in women. Symptoms of depression did not predict television watching. CONCLUSIONS: Results highlight the need to distinguish between types of sedentary behaviors as their predictors may differ. Further, they provide support for the hypothesis that psychological factors, in this case symptoms of depression, may relate to select sedentary behaviors in young men.

Heterogeneity of Depressive Symptom Trajectories through Adolescence: Predicting Outcomes in Young Adulthood.

OBJECTIVE: This study describes developmental trajectories of depressive symptoms in adolescents and examines the association between trajectory group and mental health outcomes in young adulthood. METHODS: Depressive symptoms were self-reported every three months from grade seven through grade 11 by 1293 adolescents in the Nicotine Dependence in Teens (NDIT) study and followed in young adulthood (average age 20.4, SD=0.7, n=865). Semi-parametric growth modeling was used to identify sex-specific trajectories of depressive symptoms. RESULTS: THREE DISTINCT TRAJECTORY GROUPS WERE IDENTIFIED: 50% of boys and 29% of girls exhibited low, decreasing levels of depressive symptoms; 14% of boys and 28% of girls exhibited high and increasing levels; and 36% of boys and 43% of girls exhibited moderate levels with linear increase. Trajectory group was a statistically significant independent predictor of depression, stress, and self-rated mental health in young adulthood in boys and girls. Boys, but not girls, in the high trajectory group had a statistically significant increase in the likelihood of seeking psychiatric care. CONCLUSIONS: Substantial heterogeneity in changes in depressive symptoms over time was found. Because early depressive symptoms predict mental health problems in young adulthood, monitoring adolescents for depressive symptoms may help identify those most at risk and in need of intervention.

OBJECTIF: Cette étude décrit les trajectoires développementales des symptômes dépressifs chez les adolescents et examine l'association entre le groupe des trajectoires et les résultats de santé mentale au début de l'âge adulte. MÉTHODES: Les symptômes dépressifs ont été auto-déclarés tous les trois mois, de la 7e à la 11e année, par 1293 adolescents de l'étude prospective NICO, et ont fait l'objet d'un suivi au début de l'âge adulte (âge moyen 20,4, ET=0,7, n=865). Une modélisation semi-paramétrique de la croissance a été utilisée pour identifier les trajectoires sexospécifiques des symptômes dépressifs. RÉSULTATS: Trois groupes de trajectoires distincts ont été discernés: 50% des garçons et 29% des filles présentaient des niveaux faibles, décroissants de symptômes dépressifs; 14% des garçons et 28% des filles présentaient des niveaux élevés et croissants; et 36% des garçons et 43% des filles présentaient des niveaux modérés avec accroissement linéaire. Le groupe de trajectoires était un prédicteur indépendant statistiquement significatif de dépression, de stress, et de santé mentale autoévaluée chez les jeunes adultes, filles et garçons. Les garçons, mais pas les filles, du groupe de trajectoires élevées avaient une hausse statistiquement significative de la probabilité de recourir à des soins psychiatriques. CONCLUSIONS: Une hétérogénéité substantielle des changements des symptômes dépressifs avec le temps a été observée. Parce que les symptômes dépressifs précoces prédisent des problèmes de santé mentale au début de l'âge adulte, surveiller les symptômes dépressifs des adolescents peut contribuer à identifier ceux qui sont les plus à risque et qui ont besoin d'une intervention.

Comorbidity of migraine and mood episodes in a nationally representative population-based sample.

OBJECTIVE: To examine the lifetime comorbidity of migraine with different combinations of mood episodes: (1) manic episodes alone; (2) depressive episodes alone; (3) manic and depressive episodes; (4) controls with no lifetime history of mood episodes, as well as sociodemographic and clinical correlates of migraine for each migraine-mood episode combination. BACKGROUND: Migraine has been found to be comorbid with bipolar disorder and major depressive disorder in clinical and population-based samples. However, variability in findings across studies suggests that examining mood episodes separately may be fruitful in determining which of these mood episodes are specifically associated with migraine. METHODS: Using a cross-sectional, population-based sample from the Canadian Community Health Survey 1.2 (n = 36,984), sociodemographic and clinical correlates of migraine were examined in each combination of mood episodes as well as controls. Logistic regression analyses controlling for age, sex, and education level compared the lifetime prevalence of migraine (1) between controls and each combination of mood episodes, and then (2) among the different combinations of mood episodes. RESULTS: Migraine comorbidity in all combinations of mood episodes was associated with lower socioeconomic status, earlier onset of affective illness, more anxiety, suicidality and use of mental health resources. Compared with controls, the adjusted odds ratio of having migraine was 2.0 (95% confidence interval [CI] 1.4-2.8) for manic episodes alone, 1.9 (95% CI 1.6-2.1) for depressive episodes alone, and 3.0 (95% CI 2.3-3.9) for subjects with both manic and depressive episodes. Compared with those with manic episodes alone and depressive episodes alone, the odds of having migraine were significantly increased in subjects with both manic and depressive episodes (odds ratio 1.5 vs. manic episodes alone; 1.8 vs. depressive episodes alone). In addition, migraine comorbidity was associated with different correlates depending on the specific combination of mood episodes; in subjects with both manic and depressive episodes, migraine comorbidity was associated with an earlier onset of mental illness, while in subjects with either manic or depressive episodes alone, migraine comorbidity was associated with increased suicidality and anxiety. CONCLUSIONS: Migraine comorbidity appears to delineate a subset of individuals with earlier onset of affective illness and more psychiatric complications, suggesting that migraine assessment in mood disorder patients may be useful as an indicator of potential clinical severity. Differences in the prevalence of migraine as well as sociodemographic and clinical correlates associated with specific combinations of mood episodes underscore the importance of examining this comorbidity by specific type of mood episode.

The association between past and current physical activity and depressive symptoms in young adults: a 10-year prospective study.

PURPOSE: The objectives of this study were to assess (1) the longitudinal associations of past moderate-to-vigorous physical activity (MVPA) and involvement in team sports during secondary school with depressive symptoms in early adulthood, and (2) the cross-sectional associations of current MVPA and involvement in team sports with depressive symptoms during young adulthood. METHODS: Data were drawn from the Nicotine Dependence in Teens study, which is an ongoing prospective cohort study of 1293 adolescents aged 12-13 years at baseline (52% female). Data analyses involved latent growth curve modeling and multiple hierarchical linear regression models. RESULTS: Current MVPA (ß = -0.12), but not past MVPA, participation was significantly negatively related to depressive symptoms during young adulthood (P < .05). Both current and past involvement in team sports were significantly negatively related to depressive symptoms (ß ≥ -0.09; P < .05); however, these associations were no longer significant (P = .08) when covariates were controlled for. CONCLUSIONS: Findings provide insight about the unique associations between the timing and type of physical activity and depressive symptoms, suggesting that physical activity within team sport contexts should be encouraged so that young adults may experience less depressive symptoms.