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Social Psychiatry and Psychiatric Epidemiology

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13-08-2022 | Suicide | Original Paper

Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system

Authors: Elle Lett, Matthew P. Abrams, Emery Moberg, G. Perusi Benson, Jacob E. Perlson

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 11/2022

Abstract

Purpose

Syndemics are co-occurring epidemics that cluster within populations due to shared socio-structural factors and are often in populations with intersecting forms of vulnerability. Suicide, depression, and substance use all disproportionately affect transgender and gender diverse (TGD) youth. In this study, we test a syndemic model of the relationship between these three mental health conditions in the context of economic deprivation and interpersonal discrimination.

Methods

We used data on substance use, depressive symptoms, suicidality, and social–structural factors from 2680 TGD youth captured in the 2017 and 2019 survey waves of the Youth Risk Behavior Surveillance System. We used a latent class analysis (LCA) to identify groups with distinct patterns of self-reported substance use and depressive symptoms, and regression models to characterize the relationship between substance-use, depressive symptoms, class membership, social–structural factors, and suicidality.

Results

A three-class LCA solution identified a subset of student respondents in a “high use” latent class characterized by high self-reported substance use frequency and depressive symptoms compared with other classes. Online bullying (aOR: 1.58; 95% CI: 1.28–1.95) and housing insecurity (aOR: 8.78; 95% CI: 4.35–17.71) were associated with increased odds of “high use” class membership relative to the “no use” class membership. “High use” class membership was associated with increased odds of suicidal ideation (aOR: 2.26; 95% CI: 1.75–2.94), plans (aOR: 2.59; 95% CI: 2.01–3.36), and attempts (aOR: 6.85; 95% CI: 3.17–15.68).

Conclusion

The co-occurrence of substance use and depressive symptoms is associated with socio-structural factors and may drive risk for suicidality among TGD youth. Meaningful suicide prevention efforts that address disproportionate risk in this population must be attentive to and mitigate the shared determinants of mood symptoms and substance use behavior.

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Title: Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system
Authors: Elle Lett
Matthew P. Abrams
Emery Moberg
G. Perusi Benson
Jacob E. Perlson
Publication date: 13-08-2022
Publisher: Springer Berlin Heidelberg
Keywords: Suicide
Suicide
Mood Disorders
Affective Disorder
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 11/2022
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-022-02348-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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