Adolescent girls had more mental health-substance use comorbidity than boys

Among 863 Spanish adolescents, girls showed significantly more mental health problems and higher rates of comorbidity between substance use and mental health disorders, with depression predicting cannabis use disorder and obsessive-compulsive symptoms predicting alcohol use disorder.

Fernández-Artamendi, Sergio et al.·Psicothema·2021·Moderate EvidenceCross-Sectional
RTHC-03130Cross SectionalModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=863

What This Study Found

Girls presented significantly more mental health problems and higher prevalence of comorbidity between substance use and mental health disorders. Obsessive-compulsive symptoms and phobic anxiety predicted higher alcohol use disorder risk. Depression and the interaction between hostility and obsessive-compulsive disorder predicted higher cannabis use disorder risk.

Key Numbers

863 adolescents (53.7% girls, mean age 16.62); girls had higher comorbidity prevalence; obsessive-compulsive symptoms and phobic anxiety predicted AUD; depression and hostility x OCD interaction predicted CUD

How They Did This

Cross-sectional study of 863 Spanish general-population adolescents (53.7% girls, mean age 16.62). Computerized battery assessed substance use frequency, Brief Symptom Inventory, Cannabis Problems Questionnaire, Rutgers Alcohol Problem Index, and DSM-IV-TR criteria for alcohol and cannabis use disorders. Binary logistic regressions examined predictors.

Why This Research Matters

Understanding that girls face higher comorbidity rates and that specific mental health symptoms predict specific substance use disorders can guide targeted prevention and early intervention strategies.

The Bigger Picture

The finding that different mental health symptoms predict different substance use disorders (OCD/phobic anxiety for alcohol, depression/hostility for cannabis) suggests that substance-specific prevention approaches targeting underlying mental health vulnerabilities may be more effective than generic substance use prevention.

What This Study Doesn't Tell Us

Cross-sectional design cannot establish causal direction between mental health and substance use. Spanish general-population sample may not generalize. Self-reported measures. DSM-IV-TR criteria used rather than DSM-5.

Questions This Raises

  • ?Does treating specific mental health symptoms (depression, OCD) reduce the risk of developing the associated substance use disorder?
  • ?Would longitudinal data confirm the directional pathways suggested here?

Trust & Context

Key Stat:
Girls had significantly higher comorbidity between mental health and substance use disorders
Evidence Grade:
Adequate-sized cross-sectional study in a general population sample, but cannot determine causal direction.
Study Age:
Published in 2021.
Original Title:
Sex Differences in Comorbidity Between Substance Use and Mental Health in Adolescents: Two Sides of the Same Coin.
Published In:
Psicothema, 33(1), 36-43 (2021)
Database ID:
RTHC-03130

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Why did girls have more comorbidity?

The study documented the sex difference but did not establish causation. Girls presented with significantly more mental health problems overall, and the co-occurrence of mental health and substance use disorders was higher in girls than boys.

Which mental health problems predicted cannabis use disorder?

Depression and the interaction between hostility and obsessive-compulsive symptoms predicted higher cannabis use disorder risk. Interestingly, different symptoms predicted alcohol use disorder (obsessive-compulsive symptoms and phobic anxiety), suggesting substance-specific vulnerability pathways.

Read More on RethinkTHC

Cite This Study

RTHC-03130·https://rethinkthc.com/research/RTHC-03130

APA

Fernández-Artamendi, Sergio; Martínez-Loredo, Víctor; López-Núñez, Carla. (2021). Sex Differences in Comorbidity Between Substance Use and Mental Health in Adolescents: Two Sides of the Same Coin.. Psicothema, 33(1), 36-43. https://doi.org/10.7334/psicothema2020.297

MLA

Fernández-Artamendi, Sergio, et al. "Sex Differences in Comorbidity Between Substance Use and Mental Health in Adolescents: Two Sides of the Same Coin.." Psicothema, 2021. https://doi.org/10.7334/psicothema2020.297

RethinkTHC

RethinkTHC Research Database. "Sex Differences in Comorbidity Between Substance Use and Men..." RTHC-03130. Retrieved from https://rethinkthc.com/research/fernandez-artamendi-2021-sex-differences-in-comorbidity

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.