Background: Adolescents who consult for substance misuse problems are at increased risk for multiple adverse outcomes from ages 21 to 50.
Method: The sample included 180 adolescents who consulted a clinic for substance misuse and 251 of their parents. Adolescents and parents completed diagnostic interviews and independently completed questionnaires reporting on maltreatment of the adolescents. The adolescents completed questionnaires on substance misuse, illegal activities and relationships with others. Information was extracted from the criminal register. Twelve months later, 86% of the adolescents again completed a diagnostic interview, responded to questions about treatments they had received and completed questionnaires as before. In addition, information was extracted from health and social service files.
Results: Six problem domains were defined to include externalizing and internalizing disorders, substance misuse, and violent and non-violent self-reported offending. These were generally stable during the 12-month follow-up, but some adolescents did improve, while others developed new problems. Change in the number of problem domains over the 12-month period was predicted by the number of problem domains present at first contact with the clinic and negatively by treatment during the follow-up period.
Conclusion: Adolescents who consulted for substance misuse presented multiple mental health and psychosocial problems, which had been present for many years. The multiplicity of problems largely determined outcome 12 months later. Effective interventions are needed to target each problem domain. Identification and intervention with young children presenting mental health problems are needed to avoid the accumulation of problems observed in this sample of adolescents.