title: Detection and outcomes of substance use disorders in adolescents seeking mental health treatment.
abstract: OBJECTIVE
  To compare detection rates, service use, and outcomes of substance use disorder (SUD) in adolescents seeking mental health treatment.
  
  
  METHODS
  Adolescents (n = 237) and their parents or caregivers completed parallel, self-administered versions of the Adolescent Treatment Outcomes Module (ATOM) at intake and 6-month follow-up. SUD was assessed using the Diagnostic Interview Schedule for Children (DISC).
  
  
  RESULTS
  Although 42 (16.6%) adolescents seeking mental health treatment met DISC criteria for any SUD at baseline, clinicians detected only 19 of these (kappa = 0.51). Sensitivity and specificity were high for a screening tool for adolescent SUD (95.2 and 82.0, respectively). Adolescents with undetected SUD were less likely to receive SUD services and to have more legal problems at 6-month follow-up compared to adolescents with detected SUD.
  
  
  CONCLUSIONS
  SUD rates may be high in adolescents seeking mental health treatment, confirming the need for routine screening in this population. Results confirm that a large gap exists between the need for and access to SUD treatments, which may contribute to poorer outcomes for all adolescents with SUD.
authors.affiliation: Centers for Mental Healthcare Research, Dept. of Psychiatry, University of Arkansas for Medical Sciences, 5800 W. 10th Street Suite 605, Little Rock, AR 72205, USA. kramerteresal@uams.edu
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Kramer
authors.forename: James M
authors.initials: JM
authors.lastname: Robbins
authors.forename: Susan D
authors.initials: SD
authors.lastname: Phillips
authors.forename: Terri  L
authors.initials: T
authors.lastname: Miller
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Burns
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome