Community studies on adolescent substance use, abuse, or dependence and psychiatric co-morbidity

A literature review on community studies of adolescent substance use, abuse, or dependence (SU/A/D) and psychiatric comorbidity yielded 22 articles from 15 studies with information on rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. Results revealed that 60 % of youths with SU/A/D had a comorbid diagnosis, and conduct disorder (CD) and oppositional defiant disorder (not attention-deficit/hyperactivity disorder) were most commonly associ-ated with SU/A/D, followed by depression. Child psychopathology (particularly CD) was associated with early onset of substance use and abuse in later adolescence. The authors suggest that available data relevant to SU/A/D and psychiatric comorbidity can be used to better address such questions. The adult clinical and epidemiological literatures suggest that from 50 % to over 80 % of all types of substance abusers have also met criteria for at least one other psychiatric diagnosis (treating alcoholism and drug abuse as separate disorders) at some time in their lives (Helzer, 1988; Khantzian & Treece, 1985), with perhaps the highest rates of comorbidity being found in opiate abuser