Substance use common in young mental health patients

By Mark Cowen, senior medwireNews Reporter

Young people using mental healthcare services have a high frequency of alcohol, nicotine, and cannabis use, Australian study results show.

Use of these three substances was particularly high among young males and those with psychotic or bipolar disorders, report Daniel Hermens and colleagues from the University of Sydney.

"Reductions in the use of these substances need to be prioritised within services provided to these at-risk young people," the researchers comment.

They add: "Traditionally, mental health services have been separate to interventions that target substance use; however, there are growing suggestions that complex young people (with comorbid mental health and substance-use problems) would be most receptive to integrated rather than sequential or parallel approaches."

The findings come from a study of 2122 young people, aged 12-30years, who registered with the "headspace" mental healthcare program between 2007 and 2012.

The researchers found that 75.9%, 63.3%, and 57.9% of male patients reported lifetime use of alcohol, nicotine, and cannabis, respectively, with corresponding rates of 75.6%, 60.3%, and 51.3% among female patients.

The mean age at first use of these substances ranged from 14.0 to 15.6 years, with males being significantly younger than females at first use of cannabis (14.8 vs 15.6 years).

Among patients aged 12-17 years, rates for alcohol and cannabis use on at least a weekly basis were 12% and 7%, respectively, while corresponding rates among those aged 18-19 years were 39% and 14%, and among those aged 20-30 years the corresponding rates were 45% and 18%. Rates for daily nicotine use among the three age groups were 23%, 36%, and 41%, respectively.

Within the five most common diagnostic categories (depression, bipolar disorder, anxiety, psychosis, and behavioral/developmental disorders), patients with bipolar disorder were the most likely to report at least weekly use of alcohol (39.4%), while patients with psychosis were the most likely to report at least weekly use of nicotine (48.7%).

The group with the highest prevalence of weekly cannabis use was male psychosis patients (17.5%).

Hermens et al conclude in BMJ Open: "Frequent use of alcohol, nicotine or cannabis in young people seeking mental healthcare is common."

They add: "Given the comorbidity with significant mental health problems, these patterns of substance use are likely to contribute to increased risk of poor physical and/or mental health outcomes."

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