Journal of the American Academy of Child & Adolescent Psychiatry
New researchAssociation of Lifetime Mental Disorders and Subsequent Alcohol and Illicit Drug Use: Results From the National Comorbidity Survey–Adolescent Supplement
Section snippets
Sample and Procedure
The NCS-A is a cross-sectional, nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States.37 The survey was administered by trained lay interviewers from the Institute for Social Research at the University of Michigan. The NCS-A was carried out in a dual-frame sample that included a household subsample and a school subsample.38, 39, 40 The overall NCS-A adolescent response rate combining the 2 subsamples was 75.6%.38 The
Prevalence of Alcohol and Drug Use Stages Among Adolescents With Prior Mental Disorders
In all, 37.7% of adolescents experienced at least 1 mental disorder before the first use of alcohol, 47.6% before regular alcohol use, and 66.6% before alcohol abuse with or without dependence. The percentage of adolescents for whom the prior disorder persisted into the year of onset for each of these stages was respectively 11.3%, 9.4%, and 7.8%. For drug use categories, 41.2% of adolescents met criteria for at least 1 mental disorder before having the opportunity to use drugs, 53.8% before
Discussion
Despite converging evidence that most lifetime cases of substance use disorders are likely to begin in adolescence1, 5, 7, 45 and that prior mental disorders constitute a major risk factor for these conditions,22, 23, 24, 25, 30, 31, 32, 33, 34, 35 the majority of information for these forms of lifetime comorbidity in nationally representative samples has been acquired from adult respondents. Moreover, information on patterns of substance use in representative samples of adolescents has
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This article is discussed in an editorial by Dr. Karen M. Abram on page 265.
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This work was supported by the Intramural Research Program of the National Institute of Mental Health (Z01MH002808-08). The National Comorbidity Survey Adolescent Supplement (NCS-A) and the larger program of related NCS surveys are supported by the National Institute of Mental Health (U01-MH60220). The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or US government.
Ms. He served as the statistical expert for this research.
Disclosure: Drs. Conway, Swendsen, Husky, Merikangas, and Ms. He report no biomedical financial interests or potential conflicts of interest.