Patterns of substance use in adolescents attending a mental health department

Abstract

Objective: To describe patterns of substance use in adolescents initiating mental health treatment, and to analyse factors associated to a high risk pattern of substance use differentially by gender. Methods:Two hundred and thirty seven 12-to 17-year-old new patients in an urban public mental health service were prospectively recruited and evaluated using semi-structured interviews and standardized questionnaires to obtain socio-demographic, psychopathological, family, school and substance use data. Results:The most prevalent primary diagnoses among males were attention deficit disorder and conduct disorder, while among females they were eating disorders, affective and conduct disorders. Substance use disorder was diagnosed as follows: cannabis in 10.1% of the sample, alcohol in 3.4% and other drugs in 0.4%. A pattern of substance use with high risk of developing problems (at least regular use of alcohol or occasional use of cannabis or other illegal drugs) was found in 48.9% of the sample. After adjusting for age in the multivariate logistic regression, this pattern of risky use of drugs was found to be associated with Youth Self Report scales of thought problems, delinquent and aggressive behaviour, in both genders. Altered family structure, having had to repeat a school grade and Youth Self Report attention problems were only significantly associated with risky drug consumption in females. Conclusion:The high prevalence of risky and problematic substance use in adolescents entering mental health treatment warrant early systematic screening and specific preventive and terapeutic interventions, addressing mental health psychoeducation and motivation to avoid drugs, as well as differential associated risk factors for males and females.

Integrating Substance Use Treatment Into Adolescent Health Care

“…Adolescents with co-occurring SU and psychiatric problems are now commonly understood to be the rule rather than the exception [32, 33], and psychiatric comorbidities complicate treatment and can result in poorer outcomes [34]. SU treatment samples typically show higher rates of conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, depression, anxiety, post-traumatic stress disorder, and borderline personality than community samples [35, 36].…”

Adolescents and Dual Diagnosis in a Psychiatric Emergency Service

“…Como se esperaba, la presencia más frecuentemente hallada en el grupo de patología dual era de un trastorno externalizante y el consumo abusivo de cannabis (Díaz et al, 2011). Es más, este grupo mostró una frecuencia más alta de visitas involuntarias (llegada mediante ambulancia) y una tasa más alta de ingreso a unidades asistenciales ambulatorias, en comparación con el grupo de trastorno psiquiátrico.…”

Personality psychopathology, drug use and psychological symptoms in adolescents with substance use disorders and community controls

“…On the other hand, the Negative Emotionality scale showed some interesting associations mainly with higher use of other type of drugs, which highlights the importance of internalizing symptoms (Hussong et al, 2011), and negative emotionality (Elkins et al, 2006) in the development of SUD in adolescents. Previous studies have reported a high prevalence of psychiatric comorbidity among adolescent patients with SUD (Couwenbergh et al, 2006; Hawkins, 2009; Magallón-Neri et al, 2012), mainly in combination with conduct disorder and other disruptive behavior disorders (Hawkins, 2009), but it is also relevant with affective disorders, specially in girls, as suggested by Díaz et al (2011).…”