title: Prevention of substance use in children/adolescents with mental disorders: a systematic review.
abstract: OBJECTIVE
  WE CONDUCTED A SYSTEMATIC REVIEW TO ANSWER THE QUESTION: Among youth ≤18 years of age with a mental disorder, does substance use prevention compared to no prevention result in reduced rates of substance use/abuse/disorder (SUD)? The review was requested by the Ontario Ministry of Health and Long-term Care through the Canadian Institutes for Health Research Evidence on Tap program.
  
  
  METHODS
  A four-step search process was used: Search 1 and 2: Randomized controlled trials (RCTs) that evaluated a SUD prevention intervention in individuals with a mental disorder who were: 1) ≤18 years; or, 2) any age. Search 3: Observational studies of an intervention to prevent SUD in those with mental disorder. Search 4: RCTs that evaluated a SUD primary prevention skills-based intervention in high-risk youth ≤18 years.
  
  
  RESULTS
  Searches 1 and 2: one RCT conducted in youth was found; Search 3: two observational studies were found. All three studies reported statistically significant reductions in substance use. Search 4: five RCTs were found with mixed results. Methodological weaknesses including inadequate study power may explain the results.
  
  
  CONCLUSIONS
  Little is known about effective interventions to prevent SUD in youth with a mental disorder. Effective SUD primary prevention programs exist and should be evaluated in this high-risk group.
authors.affiliation: McMaster University, Hamilton, Ontario.
authors.forename: Nadia
authors.initials: N
authors.lastname: Salvo
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bennett
authors.forename: Amy
authors.initials: A
authors.lastname: Cheung
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Chen
authors.forename: Maureen
authors.initials: M
authors.lastname: Rice
authors.forename: Brian
authors.initials: B
authors.lastname: Rush
authors.forename: Heather
authors.initials: H
authors.lastname: Bullock
authors.forename: Anne
authors.initials: A
authors.lastname: Bowlby
keywords: Mental health disorder; concurrent disorder; prevention; substance use disorder; systematic review