title: Adaptive functioning, psychopathology and service use among 18-year-old boys with drunkenness-related alcohol use.
abstract: OBJECTIVE
  To study the associations between drunkenness frequency and adaptive functioning, psychopathology and service use among 18-year-old Finnish boys in a nation-wide population-based study.
  
  
  METHODS
  Information about drunkenness frequency within the previous six months was collected from the Finnish boys born in 1981 (n = 2306) at the boys' obligatory military call-up in 1999. Self-report questionnaires were used to study demographic factors, adaptive functioning, risk behaviour, life events, and mental health service use. Psychopathology and adaptive functioning was assessed with the Young Adult Self-Report (YASR) questionnaire.
  
  
  RESULTS
  Of the boys, 85% reported drunkenness within the previous 6 months. Most of the subjects were occasionally drunk: 39% reported drunkenness less than a month, and 35% less than once a week, while 10% reported being frequently drunk once a week or more often. Occasional drunkenness was associated with better adaptive functioning and psychosocial well-being in general. Refraining from drunkenness was associated with suicidal ideation and internalizing problems in the YASR scale. Frequent drunkenness associated with daily smoking, illicit drug use, and externalizing problems in the YASR scale, especially delinquent behaviour. In the multivariate analysis, number of friends, having a regular relationship and cigarette smoking had a linear association with frequency of drunkenness, while drunkenness-related alcohol use was less common among those with poor friendship quality. Among the participants, entering substance use treatment was rare (0.2%). Frequent drunkenness was found to be common among mental health service users.
  
  
  CONCLUSIONS
  Among late-adolescent boys, occasional drunkenness is a normative alcohol use pattern and associates with social competence and good psychosocial functioning. Late-adolescent boys refraining from drunkenness in addition to those with frequent drunkenness may be in a need of mental health assessment. As entering substance use treatment is infrequent, establishing integrated services with multi-professional co-operation for late-adolescent males with frequent drunkenness is emphasized.
authors.affiliation: Addiction Clinic at Turku Psychiatric Services, 20700 Turku, Finland. solja.niemela@utu.fi
authors.forename: Solja M
authors.initials: SM
authors.lastname: Niemelä
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
authors.forename: Kari
authors.initials: K
authors.lastname: Poikolainen
authors.forename: Henrik
authors.initials: H
authors.lastname: Elonheimo
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Lauri
authors.initials: L
authors.lastname: Sillanmäki
authors.forename: Petteri
authors.initials: P
authors.lastname: Multimäki
authors.forename: Kai
authors.initials: K
authors.lastname: Parkkola
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D003710:Demography; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires