The Prevalence of Substance Misuse and Emotional and Behavioral Problems in Adolescents Admitted to Pediatric Wards and Those Attending the Antenatal Clinic

Abstract

Objective To determine the prevalence of substance misuse and emotional and behavioral problems in adolescents admitted to pediatric wards and those attending the antenatal clinic. The detection rates of these problems were also investigated. Design A cohort study with self and parent completed questionnaires: Assessment of Substance Misuse in Adolescents, Resistance to Peer Influence Scale, self and parental ratings of the adolescents behavior using the Strength and Difficulties Questionnaire (SDQ). The detection of these problems and the action taken were determined by the scrutiny of their medical records using a standard assessment form. Setting South West London. Subject Adolescents aged between 13 and 17 years admitted to pediatric wards and those attending the antenatal clinic between November, 2001 and September, 2003 were included. Main Outcome Measure Self-reported prevalence of substance use; self and parent reported prevalence of emotional and behavioral problems and their detection rates by health professionals. Results Among 275 adolescents approached, 100 took part among whom 58% were smokers, 80% used alcohol, 17% used illicit drugs. Prevalence of substance misuse was 18% in males and 33% in females (37% in pregnant and 27% in nonpregnant adolescents). On the SDQ (parental version) 22% had scores in the borderline or abnormal range, 7% of adolescents (SDQ child version) had scores in the borderline or abnormal range. Moreover, the scores on SDQ parental and child version were higher than British norms. Among the 100 adolescents, 15 had documented evidence of substance misuse problems of whom one was referred and 11 had SDQ scores in the abnormal range of whom also one was referred to specialized mental health services. Conclusions There is considerable psychiatric morbidity including substance misuse in adolescents admitted to pediatric wards and those attending the antenatal clinic with low detection rates of these problems. It is recommended that screening instruments such as the SDQ and the ASMA are used as part of routine assessments for their detection offering opportunities for early intervention by health professionals.