title: Association Between Substance Use Diagnoses and Psychiatric Disorders in an Adolescent and Young Adult Clinic-Based Population.
abstract: OBJECTIVE
  Adolescents with substance use disorders are more likely to have a current psychiatric disorder. However, when compared with the adult literature, there is relatively limited information regarding the specific co-occurrence of certain mental health diagnoses and substance use disorders in adolescents. The objectives of this study were to build on the previous literature regarding mental health diagnoses and different types of substance use disorders in adolescents, as well as explore the differences, if any, between groupings of mental health diagnosis and type of substance used.
  
  
  METHODS
  Data were extracted from the clinical records of 483 individuals aged 11-24 years referred for an evaluation at the Adolescent Substance Abuse Program at Boston Children's Hospital. According to DSM-IV-Text Revision criteria, individuals received diagnoses of substance abuse or dependence and any additional psychiatric disorders. Problematic use was included within the sample for greater power analysis. A multivariable logistic regression model estimated the association between psychiatric diagnosis and substance use while adjusting for covariates including age and gender.
  
  
  RESULTS
  Multiple significant associations were found, including having any anxiety-related diagnosis and opioid use (odds ratio [OR] = 2.23, p < .001), generalized anxiety disorder and opioids (OR = 3.42, p = .008), cocaine and post-traumatic stress disorder (OR = 3.61, p = .01), and marijuana and externalizing behavior disorders (OR = 2.10, p = .024).
  
  
  CONCLUSIONS
  Our study found multiple significant associations between specific substances and certain co-occurring psychiatric disorders. The use of office screening systems to efficiently identify these youths should be a part of routine medical and psychiatric care.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Electronic address: Justine.Welsh@Emory.edu.
authors.forename: Justine Wittenauer
authors.initials: JW
authors.lastname: Welsh
authors.affiliation: Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: John R
authors.initials: JR
authors.lastname: Knight
authors.affiliation: Center for Multicultural Mental Health Research, Health Equity Research Lab, Cambridge, Massachusetts; Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts.
authors.forename: Sherry Shu-Yeu
authors.initials: SS
authors.lastname: Hou
authors.affiliation: Public Consulting Group, Boston, Massachusetts.
authors.forename: Monica
authors.initials: M
authors.lastname: Malowney
authors.affiliation: Division of Developmental Medicine, Adolescent Substance Abuse Program, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Patricia
authors.initials: P
authors.lastname: Schram
authors.affiliation: Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Lon
authors.initials: L
authors.lastname: Sherritt
authors.affiliation: Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts.
authors.forename: J Wesley
authors.initials: JW
authors.lastname: Boyd
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic; D019966:Substance-Related Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055815:Young Adult
keywords: Drugs of abuse; Generalized anxiety disorder; Opioids; Psychiatric disorders; Transitional age