Objectives: This study investigated the association between depression and substance use in a sample of middle-school students.

Methods: The 5721 students (59%-63% Hispanic) completed self-report items on depressive symptoms, recent smoking and binge drinking, and lifetime use of marijuana, cocaine, and inhalants.

Results: Symptoms of depression were strongly and positively related to substance use. For every type of use, a stepwise increase was seen between the percentage of students with low symptom frequency and the percentage of students with more symptoms. A sizable number of users reported symptoms indicating major depression. Depression scores showed few clinically meaningful differences among demographic subgroups. Substance use scores, in contrast, showed meaningful intergroup differences for racial/ethnic group and other demographic variables.

Conclusions: Depressive symptoms and substance use were associated in a sample of middle-school students who were largely non-White and predominantly Hispanic. Greater understanding of the nature of this association is needed; this understanding should be used to design prevention programs, and prevention programs should be introduced at least in the middle-school years.