at 3-year follow-up. A significantly greater proportion of those reporting past-month MA use (26%) had MDD relative to those MA-abstinent (11%), and those with MDD had used MA more frequently during the follow-up period than those without MDD. The effects of behavioral treatment on depressive symptoms were also studied in a group of 863 MA users (73% male) in Thailand. In this study 35% of the sample reported high levels of depressive symptoms at baseline as measured by the CES-D (Sutcliffe et al., 2009). Follow-up analysis revealed that those subjects who stopped MA use during this trial and maintained sobriety had significantly fewer depressive symptoms than those who continued MA use. These studies suggest that increased MA use may contribute to the exacerbation of affective symptoms and, in contrast, maintaining drug abstinence may reduce the severity of the depressive episodes or symptoms.
