The bidirectional predictive association between methamphetamine use and depression

BACKGROUND AND AIMS: Co-occurrence of methamphetamine dependence and depression is high, though the direction of this temporal relationship is unclear. We investigated the direction of the temporal relationship between methamphetamine use and depression. DESIGN: A longitudinal random-intercept cross-lagged panel model analysis was conducted using 12 contiguous weeks of data from a randomised controlled trial (ACTRN12618000366257). SETTING: Melbourne, Geelong and Wollongong, Australia. PARTICIPANTS: 153 adult participants dependent on methamphetamine. MEASUREMENTS: Each week, days of methamphetamine use in the past week were assessed using the Timeline Followback, and clinically significant symptoms of depression were defined as a score of 4 or greater on the Brief Psychiatric Rating Scale depression item. RESULTS: Relative to their average, if an individual increased their methamphetamine use in one week, their probability of experiencing clinically significant depressive symptoms increased the following week [estimate = 0.271, 95% confidence interval (CI) = 0.177-0.365, P < 0.001]. Additionally, if an individual's probability of experiencing clinically significant depressive symptoms increased in one week above their average, their subsequent week's methamphetamine use increased (estimate = 0.414, 95% CI = 0.291-0.537, P < 0.001). SUMMARY: There appears to be evidence of a bidirectional relationship between days of methamphetamine use and clinically significant depressive symptoms within a weekly timeframe.