Psychiatric comorbidity among inpatient substance abusing adolescents

We studied the association between type, severity and sequencing of psychopathology and these same dimensions of substance involvement among inpatient substance-abusing adolescents with comorbid psychiatric disorders. Adolescents (N = 140, 54% female; 15.9 years) meeting DSM-III-R criteria for a substance use disorder and at least one other Axis I psychiatric disorder were interviewed while inpatients in an adolescent psychiatric facility. Findings point to associations between externalizing disorders and a history of regular use of cigarettes, alcohol, and stimulants among comorbid adolescents. When sequencing of psychopathology was examined, different substance use patterns were observed. Severity of depressive disorders was associated with more substance withdrawal symptoms; externalizing symptomatology was related to more substance dependence symptoms, and ADHD severity was associated with more alcohol dependence symptoms. Findings may have important clinical implications such as the need to assess comorbidity early and to develop treatment plans based on type of comorbid psychiatric disorder.