Diverging Trends in the Relationship Between Binge Drinking and Depressive Symptoms Among Adolescents in the U.S. From 1991 Through 2018

Purpose: From 1991 to 2018, binge drinking among U.S. adolescents has precipitously declined; since 2012, depressive symptoms among U.S. adolescents have sharply increased. Binge drinking and depressive symptoms have historically been correlated, thus understanding whether there are dynamic changes in their association informs prevention and intervention. Methods: Data were drawn from the U.S. nationally representative cross-sectional Monitoring the Future surveys (1991–2018) among school-attending 12th-grade adolescents (N = 58,444). Binge drinking was measured as any occasion of more than five drinks/past 2 weeks; depressive symptoms were measured with four items (e.g., belief that life is meaningless or hopeless), dichotomized at 75th percentile. Time-varying effect modeling was conducted by sex, race/ethnicity, and parental education. Results: In 1991, adolescents with high depressive symptoms had 1.74 times the odds of binge drinking (95% confidence interval 1.54–1.97); by 2018, the strength of association between depressive symptoms and binge drinking among 12th^-grade adolescents declined 24% among girls and 25% among boys. There has been no significant relation between depressive symptoms and binge drinking among boys since 2009; among girls, the relationship has been positive throughout most of the study period, with no significant relationship from 2016 to 2017. Conclusions: Diverging trends between depressive symptoms and alcohol use among youth are coupled with declines in the strength of their comorbidity. This suggests that underlying drivers of recent diverging population trends are likely distinct and indicates that the nature of comorbidity between substance use and mental health may need to be reconceptualized for recent and future cohorts.