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The Patient Health Questionnaire-9 (PHQ-9), the standard nine-item depression severity scale used to monitor sertraline response, consistently fails to show meaningful score reduction in patients who continue drinking, not because sertraline is ineffective, but because alcohols depressogenic effects outpace the drugs therapeutic action

In the study, around 2.06 million high schoolers - 13 percent of the study population - and four percent of middle schoolers - 470,000 participants - reported 'current' tobacco use

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