title: Age of onset of substance use and psychosocial problems among individuals with substance use disorders.
abstract: Substance use is generally initiated in adolescence or early adulthood and is commonly associated with several physical, psychological, emotional and social problems. The objective of this study is to assess the age of onset of substance use differences on psychosocial problems among individuals with substance use disorders (SUDs) residing in drug rehabilitation centers.
  
  
  
  A descriptive cross sectional research design was carried out. Probability Proportional to Size (PPS) sampling technique was used to select the drug rehabilitation centers and all the respondents meeting the inclusion criteria of the selected seven rehabilitation centers were taken as a sample and comprised of 221 diagnosed individuals with SUDs. A semi structured self administered questionnaires were used to collect the information regarding demographic and substance use related characteristics. A standard tool Drug Use Screening Inventory-Revised (DUSI-R) was used to assess the psychosocial problems among individuals with SUDs. Data were analyzed using both descriptive and inferential statistics. Multivariate general linear model (MANOVA and MANCOVA) was used to evaluate differences in psychosocial problems between early vs late onset substance users.
  
  
  
  The age of onset of substance use was significantly associated with psychosocial problems. The mean psychosocial problem scores were higher in early onset substance user (17 years or younger) than late onset substance user (18 years or higher) in various domains of DUSI-R even after controlling confounding factors. The two groups (early vs late) differed significantly in relation to age, gender, occupational status, current types of substance use, frequency of use, mode of substance use and relapse history.
  
  
  
  The study indicated that early onset substance users are at higher risk for psychosocial problems in various areas of life such as Behavior Pattern, Psychiatric disorder, Family system, Peer relationship, Leisure/Recreation and Work adjustment compared to late onset substance users. It highlights the need for early prevention, screening, and timely intervention among those individuals.
authors.affiliation: Department of Nursing, Nepal Medical College, Jorpati, Kathmandu, Nepal. anju_pk@hotmail.com.
authors.forename: Anju
authors.initials: A
authors.lastname: Poudel
authors.affiliation: Department of Nursing, Nepal Medical College, Jorpati, Kathmandu, Nepal.
authors.forename: Sital
authors.initials: S
authors.lastname: Gautam
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D012307:Risk Factors; D012940:Social Problems / Q000523:psychology*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Age of initiation; Early onset; Late onset; Psychosocial problems; Substance use