title: Association of Lifetime Mental Disorders and Subsequent Alcohol and Illicit Drug Use: Results From the National Comorbidity Survey-Adolescent Supplement.
abstract: OBJECTIVE
  To estimate the association of prior lifetime mental disorders with transitions across stages of substance use in a cross-sectional, nationally representative sample of US adolescents.
  
  
  METHODS
  The sample includes 10,123 adolescents aged 13 to 18 years who participated in the National Comorbidity Survey-Adolescent Supplement (NCS-A), and who were directly interviewed with the Composite International Diagnostic Interview (CIDI) Version 3.0 that generates criteria for DSM-IV disorders.
  
  
  RESULTS
  Adolescents with prior lifetime mental disorders had high rates of both alcohol (10.3%) and illicit drug (14.9%) abuse, with or without dependence. Alcohol and drug abuse were highest among adolescents with prior anxiety disorders (17.3% and 20%, respectively) and behavior disorders (15.6% and 24%, respectively). Any prior disorder significantly increased the risk of transition from nonuse to first use, and from use to problematic use of either alcohol or illicit drugs. Multivariate models attenuated the magnitude of the risk of transition associated with each disorder, although prior weekly smoking and illicit drug use demonstrated significant risks of transitions across the 3 stages of alcohol or drug use, as did behavior disorders.
  
  
  CONCLUSIONS
  The findings provide the first evidence from a nationally representative sample that prior mental disorders represent risk factors for the transition from nonuse to use, and the progression to drug- and alcohol-related problems. Treatment of primary mental disorders is likely to be an important target for the prevention of secondary substance use disorders in youth.
authors.affiliation: Division of Epidemiology, Services and Prevention Research at the National Institute on Drug Abuse (NIDA), Rockville, MD.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Conway
authors.affiliation: École Pratique des Hautes Études (EPHE), Paris, the National Center for Scientific Research (CNRS), Paris, and University of Bordeaux, France.
authors.forename: Joel
authors.initials: J
authors.lastname: Swendsen
authors.affiliation: University of Paris Descartes, Paris.
authors.forename: Mathilde M
authors.initials: MM
authors.lastname: Husky
authors.affiliation: Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health (NIMH), Bethesda, MD.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: He
authors.affiliation: Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health (NIMH), Bethesda, MD. Electronic address: merikank@mail.nih.gov.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Merikangas
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology
chemical_list: D013287:Illicit Drugs
keywords: adolescence; alcohol use; comorbidity; drug use; epidemiology