Substance use disorders and psychiatric comorbidities and their sex differences in adolescents treated at an addiction psychiatric outpatient clinic

Abstract

Background Substance use disorders (SUDs) among adolescents are frequently associated with other psychiatric disorders. The diagnostic criteria of the SUDs are problematic for adolescents, who may have a developing problem with substance dependence but not meeting the criteria for either substance abuse or dependence. There is a scarcity of studies about the sex differences and the associations of the SUDs and psychiatric comorbidity in adolescents. Methods Structured background information, clinical data, and EuroADAD assessments were gathered from 359 adolescents (12–19 years) who were treated at a tertiary level outpatient clinic for adolescents with psychiatric and substance abuse problems between 2006 and 2010. Referring conditions were either suspected/probable dual diagnosis or intoxication requiring treatment in an emergency department. The mean age was 15.8 years and 52.6% were girls. The diagnoses were assessed during the treatment period by the treating clinician. Sex differences in psychiatric diagnoses and substance use patterns were examined in bivariate analyses. Results A third of the girls (31.7%) had depression as their primary diagnosis (9.4% of the boys). The most common primary diagnosis for boys (34.1%) was conduct disorder (21.7% of the girls). 53.4% of the girls were diagnosed for both psychiatric and substance use disorders (51.8% of the boys). Alcohol use disorders were the most common SUDs for girls (29.6%) and polysubstance use disorders for boys (23.5%). Conclusions In this clinical and thus selected group of adolescents, the girls had higher rates of depression and alcohol use disorders, and the boys conduct disorder and polysubstance use disorders.