Substance use disorders and psychiatric comorbidities and their sex differences in adolescents treated at an addiction psychiatric outpatient clinic

Background: Substance use disorders (SUDs) among adolescents are frequently associated with other psychiatric disorders. The diagnostic criteria of the SUDs are problematic for adolescents, who may have a developing problem with substance dependence but not meeting the criteria for either substance abuse or dependence. There is a scarcity of studies about the sex differences and the associations of the SUDs and psychiatric comorbidity in adolescents. Methods: Structured background information, clinical data, and EuroADAD assessments were gathered from 359 adolescents (12-19 years) who were treated at a tertiary level outpatient clinic for adolescents with psychiatric and substance abuse problems between 2006 and 2010. Referring conditions were either suspected/probable dual diagnosis or intoxication requiring treatment in an emergency department. The mean age was 15.8 years and 52.6% were girls. The diagnoses were assessed during the treatment period by the treating clinician. Sex differences in psychiatric diagnoses and substance use patterns were examined in bivariate analyses. Results: third of the girls (31.7%) had depression as their primary diagnosis (9.4% of the boys). The most common primary diagnosis for boys (34.1%) was conduct disorder (21.7% of the girls). 53.4% of the girls were diagnosed for both psychiatric and substance use disorders (51.8% of the boys). Alcohol use disorders were the most common SUDs for girls (29.6%) and polysubstance use disorders for boys (23.5%). Conclusions: In this clinical and thus selected group of adolescents, the girls had higher rates of depression and alcohol use disorders, and the boys conduct disorder and polysubstance use disorders.