A pilot study of 25 adolescent psychiatric inpatients found 76% lifetime substance use and 36% illicit drug use, with cannabis use predicted by older age and family dysfunction, and substance use linked to suicidal ideation and peer substance use.
Read this if you work with adolescents with mental health conditions or are interested in the overlap between youth substance use and psychiatric disorders.
76% lifetime substance use; cannabis linked to family dysfunction
What the researchers found
Researchers assessed substance use among 25 adolescents aged 12-17 admitted to an Austrian psychiatric inpatient unit.
Lifetime prevalence of any substance use was 76%, with regular use in 32%. Specific prevalences were alcohol (76%), nicotine (44%), and illicit drugs (36%, predominantly cannabis).
Older age predicted tobacco (p=0.023), drug (p=0.021), and cannabis use (p=0.015). Family dysfunction predicted regular substance use (p=0.035) and cannabis use specifically (p=0.02). History of trauma predicted regular use (p=0.047) and tobacco use (p=0.011).
Peer substance use was the strongest social predictor: it significantly predicted any substance use (p<0.001) and regular use (p=0.026).
Substance-using adolescents showed more academic failure, school absenteeism, and behavioral problems. Critically, alcohol (p=0.02), drug (p=0.017), and regular substance use (p=0.007) were linked to suicidal ideation.
Why it matters
Adolescent psychiatric inpatients represent one of the highest-risk populations for substance use problems. The links between substance use, suicidal ideation, family dysfunction, and trauma in this group highlight the need for comprehensive screening and integrated treatment.
The numbers in context
25 inpatients aged 12-17. Lifetime use 76%, regular use 32%. Alcohol 76%, nicotine 44%, illicit drugs 36%. Cannabis use predicted by age (p=0.015) and family dysfunction (p=0.02). Suicidal ideation linked to drug use (p=0.017) and regular use (p=0.007).
How the study worked
Cross-sectional pilot study of 25 adolescents aged 12-17 on an Austrian child and adolescent psychiatry inpatient unit. Self-report measures of substance use and sociodemographics, CAGE and FTND screening, clinical data from medical records.
What this study cannot tell us
Very small sample size (25 patients) severely limits statistical power and generalizability. Single inpatient unit in Austria may not reflect other settings or countries. Cross-sectional design cannot establish causation between substance use and psychiatric symptoms. Self-report data in an inpatient setting may be affected by social desirability.
How to read the evidence
Very small pilot study provides preliminary evidence on substance use patterns in adolescent psychiatric inpatients, requiring replication in larger samples.
When this study was published
Published in 2018 with Austrian data. Adolescent substance use patterns may differ across countries and have shifted since.
The bigger picture
This study adds to evidence that substance use screening should be routine in adolescent psychiatric settings. The finding that family dysfunction specifically predicts cannabis use suggests that family-level interventions may be important for this population.
Questions still open
- Would integrated substance use treatment in adolescent psychiatric settings improve outcomes? Does addressing family dysfunction reduce cannabis use in this population? Are these patterns consistent across larger, multi-site samples?
Common questions
How common is substance use among teens in psychiatric care?
What predicted cannabis use?
Read the original research
Substance use and misuse among children and youth with mental illness : A pilot study.
Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater, 32(1), 18-25
Citation
Herz, V; Franzin, N; Huemer, J; Mairhofer, D; Philipp, J; Skala, K. (2018). Substance use and misuse among children and youth with mental illness : A pilot study.. Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater, 32(1), 18-25. https://doi.org/10.1007/s40211-017-0231-4
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