Concurrent and Mental Illness in the Adolescent PopulationConcurrent and Mental Illness in the Adolescent Population
Concurrent Disorders in the Adolescent Population
Last Updated (Monday, 08 September 2008 20:07) Sunday, 03 August 2008 20:50
Concurrent or co-occurring illnesses are evident in the adolescent population where studies show that 75-80% of adolescents receiving inpatient care for substance abuse have a co-occurring mental disorder. Adolescents who demonstrate behavioral or emotional problems are nearly four times as likely to have a substance-use disorder than are children without these problems.
- Nearly two-thirds of incarcerated youth with substance use disorders have at least one other mental health disorder.
- A number of studies have shown an association between conduct disorder, attention deficit hyperactivity disorder (ADHD), and substance abuse. For example, as many as 50% of substance abusing juvenile offenders have ADHD.
- Youth who have co-occurring conduct problems, ADHD, and substance use disorders have higher than normal rates of anxiety and depressive disorders, and the presence of ADHD in particular worsens the prognosis of both the substance use disorder and the conduct disorder, increasing the likelihood of these persisting into adulthood.
- Among the juvenile justice population, mood disorders such as depression appear to co-occur with substance abuse problems more frequently than among youth generally.
- Among incarcerated youth with substance use disorders, nearly one-third have a mood or anxiety disorder.
- Delinquents with substance abuse and behavioral disorders such as conduct disorder and ADHD engage in higher rates of crime and exhibit more alcohol and illicit drug use than do youth with mood disorders and are at higher risk for out-of-home placement and other poor outcomes.
- Many incarcerated youth are exposed to high levels of traumatic violence which may result in symptoms of posttraumatic stress as well as increased rates of substance abuse.
Drug Abuse Treatment in Adolescents with Co-Occurring Mental Health Problems
Adolescent substance abuse patients with co-occurring emotional and behavioral problems are more likely than peers without coexisting psychiatric conditions to relapse in the year following treatment, a NIDA-funded study has found. "We must improve identification of co-occurring psychiatric disorders among substance-abusing teens and move away from a 'one size fits all' approach to therapy, or treatment gains will remain limited for these vulnerable youth and their families.
Looking within the therapeutic process may help us discover what must happen to realize recovery from substance abuse. Effective components of therapy may vary for adolescents with different co-occurring mental health problems, and identifying such mechanisms of change may help us develop better interventions.
Although more male adolescents are identified as having co-occurring emotional and behavioral problems, female adolescents may be more severely affected by these combined disorders. In a study by Dr. Cynthia Rowe of the University of Miami School of Medicine in Florida found that although most (82 percent) of the study's participants were boys; however, girls were overrepresented in the group with the least favorable treatment outcomes.
There is a critical need for more research on differences in how boys and girls develop and manifest behavior problems. Troubled youth often have experienced family conflict and instability in relationships, but boys and girls may react differently. Studies indicate that females tend to turn their stress inward, developing anxiety and depression, which are often unnoticed by adults. Girls tend to act out in ways that don't necessarily grab the attention of adults—through sexual behavior, for example—whereas boys externalize in ways that are more obvious, such as fighting. "To improve identification and treatment outcomes of adolescents with co-occurring psychiatric disorders, we need to study gender differences in the root causes and expression of behavioral and emotional problems.”
Rowe, C.L.; Liddle, H.L.; Greenbaum, P.E.; and Henderson, C.E. Impact of psychiatric comorbidity on treatment of adolescent drug abusers. Journal of Substance Abuse Treatment 26(2):129-140, 2003.
http://www.drugabuse.gov/NIDA_notes/NNVol18N1/Substance.html