Long-term outcomes of adolescents treated for substance misuse.
BACKGROUND
Little is known about the long-term outcome of substance misuse by teenagers, this is especially true for gender specific consequences.


OBJECTIVE
To examine the prevalence of death, physical illnesses related to substance misuse, mental illness, substance misuse, criminality, and poverty in adulthood among two cohorts of individuals who as adolescents had consulted for substance misuse problems, to estimate the effect of sex on adverse outcomes, and to compare cohort effects.


METHODS
Individuals who had consulted a substance misuse clinic as adolescents during 1968-1971 and 1980-1984 were followed until 2002. Adverse outcomes were documented using information from Swedish national registers.


RESULTS
In the older cohort followed to age 50, only one-in-five escaped all six adverse outcomes, while over half of subjects experienced at least two or more. Sex and the severity of adolescent substance misuse and delinquency were predictors of adverse outcomes. More women than men experienced physical illness and poverty in the older cohort while more men than women were convicted of criminal offences in both cohorts and presented continued substance misuse in the younger cohort. Men in the younger as compared to the older cohort had higher rates of substance misuse and criminal convictions.


CONCLUSIONS
Adolescents seeking help for substance misuse problems are at elevated risk for multiple adverse outcomes later in life. Outcomes differ for women and men and by severity of adolescent misuse and delinquency. Few cohort differences in adult outcomes exist.
Larm
Peter
P
Research Centre for Adolescents Psycho-social Health, Section of Alcohol & Drug Dependence Research, Department of Clinical Neuroscience, Karolinska Institutet, S:t Göran's Hospital, Box 500, 112 81 Stockholm, Sweden. peter.larm@sll.se <peter.larm@sll.se>
Hodgins
Sheilagh
S
Larsson
Agne
A
Samuelson
Yasmina Molero
YM
Tengström
Anders
A
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D015897:Comorbidity; D003415:Crime / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data; D015995:Prevalence; D012720:Severity of Illness Index; D017678:Sex Distribution; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome