Substance use was common among adolescent psychiatric inpatients and linked to suicidal ideation and peer use

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.

Herz, V et al.·Neuropsychiatrie : Klinik·2018·Preliminary EvidenceCross-Sectional
RTHC-01688Cross SectionalPreliminary Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Preliminary Evidence
Sample
N=25

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
76% lifetime substance use; cannabis linked to family dysfunction
Evidence Grade:
Very small pilot study provides preliminary evidence on substance use patterns in adolescent psychiatric inpatients, requiring replication in larger samples.
Study Age:
Published in 2018 with Austrian data. Adolescent substance use patterns may differ across countries and have shifted since.
Original Title:
Substance use and misuse among children and youth with mental illness : A pilot study.
Published In:
Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater, 32(1), 18-25 (2018)
Database ID:
RTHC-01688

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

How common is substance use among teens in psychiatric care?

In this small sample, 76% had used any substance in their lifetime and 32% were regular users. Cannabis was the most common illicit drug, used by 36% of patients.

What predicted cannabis use?

Older age (p=0.015) and family dysfunction (p=0.02) were the strongest predictors of cannabis use specifically. Peer substance use predicted substance use more broadly.

Read More on RethinkTHC

Cite This Study

RTHC-01688·https://rethinkthc.com/research/RTHC-01688

APA

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

MLA

Herz, V, et al. "Substance use and misuse among children and youth with mental illness : A pilot study.." Neuropsychiatrie : Klinik, 2018. https://doi.org/10.1007/s40211-017-0231-4

RethinkTHC

RethinkTHC Research Database. "Substance use and misuse among children and youth with menta..." RTHC-01688. Retrieved from https://rethinkthc.com/research/herz-2018-substance-use-and-misuse

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.