Substance Use Disorders In Children Research Articles

Effect of methylphenidate on substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: a systematic review

Effect of methylphenidate on substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: a systematic review

Psychological disorders and suicide attempts in youths during the pre-COVID and post-COVID era in a Taiwan pediatric emergency department.

The COVID-19 pandemic has had a significant impact on pediatric patients, increasing their vulnerability to psychological fragility. The aim of this study was to investigate the epidemiology and clinical spectrum of pediatric psychological fragility and suicide attempts in the emergency department (ED) before and after the onset of the COVID-19 outbreak. A total of 340 pediatric patients admitted to the ED for psychological fragility between 2019 and 2022 were retrospectively collated and categorized according to three periods: pre pandemic, pandemic, and post pandemic. Epidemiological and clinical information were analyzed and compared among the three groups. Moreover, patients with suicidal ideation or suicidal attempts and types of substance use disorders in children with suicidal attempts sent to the ED were analyzed. The proportion of psychological fragility increased during the pandemic period (0.4%) and the post-pandemic period (0.8%) compared to that in the pre-pandemic period (0.28%). Suicide ideation was the highest before the pandemic period (0.04%), while suicidal attempts were the highest in the post pandemic period (0.42%). Significantly elevated trends in suicide attempts involving overdose and injury were observed among the three groups (p < 0.05). Intensive care unit (ICU) admission rates increased significantly after the COVID-19 outbreak (p < 0.05), and major depressive disorder was the most common psychological fragility in the ED in all three groups. An increase in the proportion of pediatric psychological fragility in the ED was noted in the post pandemic period than before or during the pandemic. With higher rates of ICU admissions and an increase in suicide attempts among children and adolescents during the pandemic compared to before or after the pandemic, it is of utmost importance to provide mental health support to this vulnerable population in order to prevent suicide attempts in the event of a new global outbreak of infectious diseases.

3.1 Religiosity, Spirituality, and Substance Use Disorders in Children, Adolescents, and Transitional-Aged Youth

3.1 Religiosity, Spirituality, and Substance Use Disorders in Children, Adolescents, and Transitional-Aged Youth

1.70 AACAP Medication Tables Summarizing and Grading Research on Pharmacotherapy for Substance Use Disorders in Children and Adolescents

1.70 AACAP Medication Tables Summarizing and Grading Research on Pharmacotherapy for Substance Use Disorders in Children and Adolescents

Prevalence, Demographic Characteristics and Comorbid Psychiatric Disorders in Children and Adolescents with Substance Use Disorder in Iran

Background: The present study aimed to investigate the prevalence of substance use disorder in Iranian children and adolescents and its relationship with demographic characteristics and psychiatric comorbidities.&#x0D; Methods: The data were taken from a national survey on the prevalence of psychiatric disorders in Iranian children and adolescents. The national survey was conducted on 30,532 children and adolescents aged 6-18 years which were selected using multistage cluster sampling. The psychiatric disorders were assessed by employing k-SADS-PL questionnaire and interviews carried out by 240 clinical psychologists with the participants and their parents. Data were analyzed by Chi-square test and logistic regression.&#x0D; Results: A total of 277 (0.97%) were diagnosed as people with substance use disorder that were further studied for comorbid disorders. Among the various types of drugs, hypnotic/sedative/anti-anxiety drugs were abused by 84 people (46.15%), cannabis by 68 (37.36%) and stimulants by 43 (23.63%). The variables of gender, place of residence, and father’s occupation and parents’ education level were identified as predictors of substance use disorder in children and adolescents. At the same time, 42.50% substances and alcohol abusing people had at least one comorbid psychiatric disorder and the highest comorbidity was observed in oppositional defiant disorder, attention deficit and hyperactivity disorder and separation anxiety disorder (p≤0.05).&#x0D; Conclusion: The findings can be used in the prevention and treatment of substance use disorder and promotion of mental health in children and adolescents by focusing on the psychiatric comorbidities of people with substance use disorder.

Substance-Use Disorders in Children and Adolescents.

The most common substance use disorders in childhood and adolescence have to do with alcohol and cannabis. These disorders begin as early as puberty, are often accompanied by other mental disorders, and, if untreated, very frequently persist into adulthood. This review is based on pertinent publications retrieved by a selective search in PubMed on substance use disorders in children and adolescents. Substance use disorders are among the commonest mental disorders in childhood and adolescence. In Germany, approximately 10% of adolescents have tried cannabis at least once. The prognosis is negatively affected by individual (bio-)psychological traits, mental comorbidities, laws that facilitate consumption, socioeconomic disadvantage, consuming peers, and parental substance use disorders. A timely diagnosis, motivation by the pediatrician, and referral to specialized child and adolescent psychiatric services helps assure that those affected receive appropriate treatment, with the goal of abstinence from the substance as well as improvement in emotional regulation, affectivity, and attention. According to studies from the English-speaking countries and considering all treatment forms, treatment is completed by approximately 60% to 65% of children and adolescents; 20% to 40% of these patients are abstinent six months after the end of treatment. No studies of this type have been carried out to date in Germany. As the results of treatment are generally poor, there is a major need for research on the treatment and care of children and adolescents with substance use disorders. In particular, the interfaces between outpatient and inpatient care need further improvement.

Substance Use Disorders in Children and Adolescents

Background: Exposure to addictive substances commonly occurs during childhood and adolescence and it adds more adverse consequences in life course. However, evidence is scarce for management of substance use disorders in this population. Methods: We searched for published literature of previous 10 years on PubMed, Cochrane database, and Google Scholar until June 2021. The literature found relevant was organized into various subheadings like epidemiology, etiology, screening, and prevention and treatment. Results: Alcohol and tobacco remain the most commonly used substances amongst children and adolescents the world over, closely followed by cannabis. High-risk populations including street children are most severely afflicted. There are a multitude of risk factors ranging from biological to psychosocial, most importantly parental drug use and adverse experience in childhood. Public health initiatives including school, family, and community interventions have shown promising results. Early screening for substance use is beneficial with special attention on externalizing disorders. Studies on pharmacological treatment remain sparse while psychosocial interventions employing different modalities such as behavioural- and contingency-related techniques have shown initial promise. Conclusions: Adolescents and children are more prone to substance use and associated risk-taking behavior. There is a vital need for well-designed studies for assessing risk and protective factors, comprehensive screening, prevention, and intervention modalities in children and adolescents including street children and other high-risk population.

1.16 Substance Use and Mental Health in Children in South Bronx: Craft Survey

According to 2020 statistics from NIDA, the lifetime prevalence of illicit substance use disorder (SUD) in eighth graders is 21.3%, which increases up to 46.6% in 12th graders. SUD is the second most common mental health complaint in children to the emergency room (ER). The ER can be used as a screening site for prevalence of this disorder. We conducted a CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) survey to determine the prevalence of SUD in children and adolescents with mental health disorders (CA-MHD). A cross-sectional quality improvement (QI) study was done on children presenting to the Child and Adolescent Psychiatric ER of South Bronx, NY with mental health complaints, between April and June 2021. Participants were screened for concomitant substance use disorder with the CRAFFT questionnaire and a structured survey to observe reasons for using a substance, effects on mood and functionality, and help/treatment received for substance use. Our data comprised 151 patients (61 males and 90 females) with 63 children (42%) and 88 adolescents (58%) presented. With respect to ethnicity, 89 were Hispanics (59%), 57 were African Americans (38%), and 4 were other ethnicities (3%). Forty-two participants (28%) endorsed substance use. Marijuana was the most commonly used substance (29 patients), followed by alcohol (10), and other illicit substances (3). Eight participants denied the use of marijuana, but their urine drug screen was positive for cannabinoids. Patients using drugs were asked about seeking help in the past for substance issues; however, all reported they have not taken any help nor do they want to take any help in the future. Commonly identified reasons for substance use in descending order are frustration due to personal issues, loneliness, and feeling sad. Participants reported that substance use helped them in remaining calm amid work and forgetting about the problems. SUD is prevalent among CA-MHD presenting to the ER, with cannabis being the most used substance in this age group. The majority of substance users identified interpersonal problems to be the trigger for substance use; hence, interpersonal therapy can be useful in ameliorating this pattern. More studies are required to delineate the exact efficacy. Presently, this study is still ongoing, and in the future, we will have more comprehensive and bigger data sets.

Parents' Personality Disorders as Predictor of Substance Use Disorder in Children and Adolescents.

This study investigated how the parents' personality disorders may be related to substance use disorder in children and adolescents. The study was a cross-sectional study in which 28,540 children and adolescents (aged 6 to 18 years) and their parents participated between 2015 and 2016. The diagnosis of substance use was made using the Kiddie Schedule for Affective Disorders and Schizophrenia--Present and Lifetime Version (K-SADS-PL) interview and the personality disorders were assessed using Millon Clinical Multiaxial Inventory - Third Edition (MCMI-III). The parents were also surveyed for their personality assessed with MCMI. The results showed that the paranoid personality disorder in father (odds ratio [OR] = 8.34, 95% CI, P = 0.042) and borderline personality disorder in mother (OR = 4.6, 95% CI, P = 0.049) increase the chance of substance use in children. The findings suggest that in designing preventive programs for substance use, the personality characteristics of the parents need to be taken into account.

How can schools be integrated in promoting well-being, preventing mental health problems and averting substance-use disorders in urban populations?

Mental health and substance use problems are among the most prevalent and challenging problems faced by both high-income and low-income countries worldwide. This review will focus on summarizing scattered evidence of school-based interventions to promote well-being and prevent mental health problems and substance use disorders in children and adolescents. We focus on two main areas of research: promotion of healthy school climate and prevention of bullying. Choosing among available interventions might be challenging, both because of the difficulties in assessing their efficacy and tailoring interventions to specific needs, but also because of the scarcity of intervention in low-resource settings. We provide some guidance on principles encompassed by the available evidence that can be used for policymakers and local communities aiming to integrate mental health promotion and prevention into their schools. Developing, implementing, scaling and sustaining school-based interventions is a necessity of our field if we want to move closer to sustainable development goals.

Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review

Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review Adolescence is a vulnerable period for substance use disorders (SUD) as indicated by epidemiological studies. Research demonstrates the family's role for the etiology of SUD and provides a rationale for interventions based on family-associated risk and resilience factors. In this article, we summarize published results for family-based interventions from 2008-2018. Taken together, prevention programs can be effective when they focus on the promotion of broader developmental competencies and familial resources, rather than narrowly addressing substance use. Moreover, programs could benefit from targeting youth and parents as done in the "Strengthening Families Program 10-14"; most existing programs however target parents and do not include the adolescents. Family-based treatment programs with an evidence base are Multisystemic Therapy, Functional Family Therapy, Multidimensional Family Therapy and Brief Strategic Family Therapy. Overall, the effects of family-based interventions are small-to-middle sized but vary significantly across populations. Across the field of family-based interventions, there is a need for more knowledge on effective components and differential effects. The results could be improved by translational research such as on the emerging concept of mindfulness. Moreover, there is a need for implementation research and the effectiveness of service delivery programs on the community level in Germany.

Disclosure, Stigma, and Social Support among Young People Receiving Treatment for Substance Use Disorders and their Caregivers: A Qualitative Analysis.

Relational processes (i.e., disclosure, stigma, social support) experienced by youth with substance use disorders (SUDs) and their caregivers may act as barriers to, or facilitators of, recovery but are understudied. Single-session qualitative semi-structured interviews were conducted with 19 patients and 15 caregivers recruited by clinicians from a SUD program. There was variability in disclosure experiences, including how many people knew about patients' SUD diagnosis and treatment, whether patients or caregivers primarily disclosed to others, and feelings about others knowing about one's or one's child's SUD treatment. After disclosing, patients and caregivers experienced stigmatizing (e.g., social rejection) and supportive (e.g., understanding, advice) reactions from others. Disclosures may have important implications for relationship and recovery-related outcomes. Moreover, some child-caregiver pairs have significant disagreements regarding disclosure of SUD treatment. Addressing relational processes within treatment by encouraging patients and caregivers to share the disclosure decision-making process may support the recovery of youth with SUDs.

Psychosocial interventions among children and adolescents.

Substance use disorders in children and adolescents are a significant cause of concern as they can have long term implications in practically every sphere. The etiological factors that contribute to substance use disorders are complex and the formulation must amalgamate and synthesize all the different factors including the predisposing, perpetuating, precipitating and protective factors in order to plan management. Interventions must stem from this comprehensive formulation and must be child-focused, multidisciplinary, multisystemic, with strong family participation and community involvement. The treating team must actively collaborate with the young person and help him/her understand the rationale for treatment in order for them to engage in it. Assessment and treatment of comorbidities are an important part of intervention package. Skill training for problem solving, emotional regulation, social skills, and communication are an essential part of the treatment for substance use disorders in adolescents. Relapse prevention strategies, including how to seek help when there is a lapse must be part and parcel of the interventions delivered to the young person. Substance use disorder interventions must be part of a larger plan that addresses other areas of concern in the young person's life. While there are few studies, and so a relatively weak and preliminary evidence base for pharmacotherapeutic interventions, early evidence shows that their combination with psychosocial interventions may have a synergistic effect on substance use reduction. Substance use disorders affect the entire family and the community at large and thus must be treated holistically, but by individualising the treatment to suit the needs of that particular child and family.

New frontiers in building mental, emotional and behavioral health in children and youth: Introduction to the special section.

The passage of the Patient Protection and Affordable Care Act (ACA; 2010) has had tremendous influence on behavioral health in the United States (Alker & Chester, 2015). Shortly after its passage, the editors of this special section became interested in examining the provisions of the ACA related to care for mental, emotional, and behavioral disorders in children and youth and synthesizing their implications in the context of other contemporary trends in children's behavioral health promotion. We first developed a white paper with the goal of increasing our own understanding of these issues and their possible influence on the status quo of designing, implementing, financing, and evaluating behavioral health services for children and their families. From our discussions came the idea of developing a special section in the American Journal of Orthopsychiatry featuring input from researchers who have been exploring these issues and who have tangible and relevant examples of "new frontiers" in building mental, emotional, and behavioral health for children and youth. The result is the current special section, the purpose of which is to highlight the importance of prevention in behavioral health and to explore examples of efforts that have used a broad public health approach to prevention and early intervention in mental, emotional, and substance use disorders in children and youth. Before introducing the seven articles in this special section, we describe in detail our foundational thinking about building mental, emotional, and behavioral health for children and youth, as expressed in our initial white paper on this topic. (PsycINFO Database Record

Extensive, Early-Onset, Poly-Substance use Disorder in Childhood

Background: Severe substance use disorder in children is rare. Objective: To scrutinize the beginning severe substance use disorder in the period of childhood. Method: To report and discuss an admitted patient with an extensive, and early-onset, history of poly-substance use and mental disorder at age of eight. Results: The current report displays severe substance use disorder which occurred in childhood. Discussion: This report illuminates that substance use disorder in childhood can induce severe psychiatric disorders in adolescence and early adulthood. So, these findings can add new data to the literature. Conclusions: It can be concluded that extensive, early-onset poly substance abuse in childhood induce severe psychiatric disorders in the adolescence and adulthood.

A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth.

Mental and substance use disorders are common and often persistent, with many emerging in early life. Compared to adult mental and substance use disorders, the global burden attributable to these disorders in children and youth has received relatively little attention. Data from the Global Burden of Disease Study 2010 was used to investigate the burden of mental and substance disorders in children and youth aged 0-24 years. Burden was estimated in terms of disability-adjusted life years (DALYs), derived from the sum of years lived with disability (YLDs) and years of life lost (YLLs). Globally, mental and substance use disorders are the leading cause of disability in children and youth, accounting for a quarter of all YLDs (54.2 million). In terms of DALYs, they ranked 6th with 55.5 million DALYs (5.7%) and rose to 5th when mortality burden of suicide was reattributed. While mental and substance use disorders were the leading cause of DALYs in high-income countries (HICs), they ranked 7th in low- and middle-income countries (LMICs) due to mortality attributable to infectious diseases. Mental and substance use disorders are significant contributors to disease burden in children and youth across the globe. As reproductive health and the management of infectious diseases improves in LMICs, the proportion of disease burden in children and youth attributable to mental and substance use disorders will increase, necessitating a realignment of health services in these countries.

Parental warmth and risks of substance use in children with attention-deficit/hyperactivity disorder

Objective: The study examined factors in the risk trajectory for substance use disorder (SUD) over a 10–12-year period in children with attention-deficit/hyperactivity disorder (ADHD). Method: N = 145 children between the ages of 7 and 16 with ADHD and healthy controls (HCs) were assessed every 2 years for 10–12 years as part of a larger, longitudinal investigation. Onset of SUD was examined using Cox proportional hazards modeling, and included child and parent psychopathology, and parental warmth as well as other key factors. Results: Low paternal warmth and maternal SUD were predictors of SUD in n = 59 ADHD participants after adjusting for gender, child oppositional defiant disorder (ODD), paternal SUD, maternal/paternal ADHD, maternal/paternal major depressive disorder, maternal/paternal anxiety and low maternal warmth in the Cox model. Conclusions: Longitudinal study findings suggest that in addition to the established risk of ADHD and maternal SUD in development of child SUD, low paternal warmth is also associated with onset of SUD. This was evident after controlling for pertinent parent and child psychopathology. These findings suggest that paternal warmth warrants further investigation as a key target for novel interventions to prevent SUD in children with ADHD. More focused investigations examining paternal parenting factors in addition to parent and child psychopathology in the risk trajectory from ADHD to SUD are now warranted.

Does ADHD Predict Substance-Use Disorders? A 10-Year Follow-up Study of Young Adults With ADHD

High rates of substance-use disorders (SUD) have been found in samples of adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Predictors of SUD in children with ADHD who are at risk for the development of SUDs remain understudied. The main aims of this study were to identify clinically meaningful characteristics of children that predicted the future development of SUDs and to see whether the role of these characteristics varied by sex. Subjects were children and adolescents with (n = 268; mean age ± standard deviation = 10.9 ± 3.2 years) and without (n = 229; mean age 11.9 ± 3.3 years) DSM-III-R ADHD followed prospectively and blindly over a 10-year follow-up period onto young adult years. Subjects were assessed with structured diagnostic interviews for psychopathology and SUDs. Over the 10-year follow-up period, ADHD was found to be a significant predictor of any SUD (hazards ratio 1.47; 95% confidence interval 1.07-2.02; p = .01) and cigarette smoking (2.38; 1.61-3.53; p < .01). Within ADHD, comorbid conduct disorder (2.74; 1.66-4.52; p < .01) and oppositional defiant disorder (2.21; 1.40-3.51; p < .01) at baseline were also found to be significant predictors of SUDs. Similar results were found for cigarette-, alcohol-, and drug-use disorders. There were few meaningful sex interaction effects. No clinically significant associations were found for any social or family environment factors or for cognitive functioning factors (p > .05 for all comparisons). These results indicate that ADHD is a significant risk factor for the development of SUDs and cigarette smoking in both sexes.

Do Executive Function Deficits Predict Later Substance Use Disorders Among Adolescents and Young Adults?

There is increasing interest regarding the risk and overlap of executive function deficits (EFDs) in stable cigarette smoking and substance use disorders (SUD). Therefore, we examined whether earlier EFD was a risk factor for subsequent cigarette smoking and SUD and further explored the relationship between EFD and SUD. We assessed 435 subjects at the 5-year follow-up (232 subjects with attention-deficit/hyperactivity disorder [ADHD], mean age ± SD: 15.4 ± 3.43 years; and 203 controls: 16.3 ± 3.42 years) and again 4 to 5 years later as part of a prospective family study of youth with ADHD. Individuals were assessed by structured psychiatric interview for psychopathology and SUD. EFD was categorically defined in an individual who had abnormal results on at least two of six neuropsychological tests of executive functioning. At the final follow-up period, ADHD was found to be a significant predictor of stable cigarette smoking (p < .01) and SUD into late adolescence and young adult years (p < .01). However, EFDs were not associated with an increase in subsequent substance use outcomes. New-onset stable cigarette smoking, but not SUD, was associated with subsequent EFD (p < .01). Our results do not support the hypothesis that EFDs predicts later stable cigarette smoking or SUD in children with ADHD growing up. However, stable cigarette smoking is associated with subsequent EFD.

Pharmacologic Treatment for Substance Use Disorders in Children and Adolescents

Pharmacologic Treatment for Substance Use Disorders in Children and Adolescents