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Long-Term Outcomes of Adolescent Outpatient Treatment for Substance Use Problems: Exploring the Co-occurrence of Mental Health and Substance Use Problems Cover

Long-Term Outcomes of Adolescent Outpatient Treatment for Substance Use Problems: Exploring the Co-occurrence of Mental Health and Substance Use Problems

Open Access
|Dec 2024

Figures & Tables

Bivariate association and logistic regression analysis of risk factors in relation to the outcome group Mental Health Problems (MHP) and Substance Use Problems (SUP) three years after initiated treatment_ Odds ratio and confidence interval are reported (N=451)_

Psychosocial risk factorsno SUP/MHPSUP/MHP


Bivariate associationModel 1Model 2Bivariate associationModel 3Model 4


OR (95% CI)OR (95% CI)OR (95% CI)OR (95% CI)OR (95% CI)OR (95% CI)
1. Lack of occupation1.16 (0.65–2.08)0.92 (0.50–1.69)1.11 (0.58–2.16)1.06 (.52–2.15).90 (.43–1.91).97 (.44–2.12)
2. Problems at school2.75 (1.41–5.39)**2.51 (1.24–5.04)*2.53 (1.24–5.16)*1.15 (.60–2.22).94 (.47–1.91).91 (.45–1.85)
3. Placement in foster care/residential home0.82 (0.45–1.50)0.68 (0.36–1.26)0.70 (0.37–1.32)2.17 (1.19–3.98)*2.02 (1.07–3.80)*2.00 (1.06–3.76)*
4. Problems in childhood environment1.29 (0.80–2.08)1.00 (0.58–1.71)1.08 (0.62–1.88)1.74 (.96–3.18)1.48 (.76–2.86)1.47 (.76–2.85)
5. Early drug debut1.36 (0.80–2.32)1.34 (0.76–2.35)1.18 (0.66–2.10)1.40 (.75–2.62)1.17 (.61–2.26)1.17 (.60–2.27)
6. Delinquent peers1.09 (0.62–1.93)0.98 (0.55–1.78)1.24 (0.67–2.31).93 (.46–1.88).84 (.41–1.73).82 (.39–1.72)
7. Exposure to violence1.43 (0.88–2,33)1.11 (0.64–1.91)1.09 (0.62–1.93)1.48 (.82–2.67)1.18 (.62–2.28)1.16 (.59–2.25)
8. Depression1.99 (1.24–3.19)**1.81 (1.07–3.07)*2.00 (1.14–3.50)*1.30 (.73–2.29)1.05 (.55–1.99)1.01 (.52–1.96)
9. Violent behavior1.19 (0.69–2.05)0.84 (0.47–1.51)0.79 (0.43–1.44)1.42 (.76–2.66)1.40 (.71–2.76)1.43 (.73–2.82)
10. Traumatic events1.40 (0.87–2.25)1.07 (0.63–1.82)1.01 (0.58–1.74)1.27 (.72–2.24).96 (.51–1.81).93 (.49–1.77)
Covariates
  Sex1.72 (1.03–2.90)*1.46 (0.80–2.69)
  Age1.00 (0.90–1.11)0.97 (0.85–1.10)
Primary drug use frequency at intake0.44 (0.26–0.75)**1.43 (0.78–2.62)

Descriptives of outcome indicators: Mental Health Problems (MHP) and Substance Use Problems (SUP) three years after initiated treatment_

TotalGirlsBoys
N=451n=131n=320

%%%Chi-2p-value
Indication of mental health problems (MHP)33442810.470.00**
Outpatient treatment, psychiatry2230187.600.00**
In-patient treatment, psychiatry5640.560.45
Medical treatment, mental illness29412412.740.00**
Indications of Substance use problems (SUP)2820315.480.02*
Outpatient substance use care1617150.300.59
Inpatient substance use care7570.550.46
Medication for alcohol or drug use problems1110.020.88
Compulsory care2220.220.64
Substance use–related criminality1551913.920.00**

Categories of psychiatric diagnoses according to ICD-10 during follow-up three years after initiated treatment for the outcome groups_ Percentage distribution_

TotalSUP/no MHPno SUP/MHPSUP/MHP noSUP/no MHP
N=451n=69n=90n=58n=234

%%%%%Chi-2p - value
Diagnostic category 463.514<0.001
Assesment/observation4012100
Anxiety/depression14043400
Neurodevelopmental disorders12039350
Psychosis/bipolar etc206160
No diagnosis6710000100

Odds ratios and confidence intervals for the association between adolescent cumulative risk in relation to the outcome group Mental Health Problems (MHP) and Substance Use Problems (SUP) three years after initiated treatment (N=451)_

Cumulative riskno SUP/MHPSUP/MHP
OR (95 % CI)OR (95 % CI)
Model 5Model 7
0–2 risk factors (31%) Ref11
3–5 risk factors (49%)1.85 (1.03–3.34)*1.69 (0.84–3.43)
6–10 risk factors (21%)2.53 (1.29–4.97)**2.25 (1.01–5.00)*
Model 6Model 8
0–2 risk factors (31%) Ref11
3–5 risk factors (49%)1.93 (1.05–3.55)*1.61 (0.78–3.30)
6–10 risk factors (21%)2.74 (1.33–5.64)**2.09 (0.89–4.90)
Covariates
  Sex1.78 (1.08–2.93)*1.45 (0.81–2.60)
  Age1.02 (0.92–1.12)0.95 (0.85–1.07)
  Primary drug use frequency at intake0.47 (0.28–0.78)**1.09 (0.92–1.29)

The four outcome groups at three-year follow-up in relation to the situation at the start of treatment contact_

DescriptivesTotalSUP/no MHPNo SUP/MHPSUP/MHPno SUP/no MHP

N=451n=69n=90n=58n=234
%%%%%
Sex
  Girls297403830
  Boys7193606270
Age (mean)1717171717
Living with parents7284746071
Low level of education for parents (primary school)4102-4
Reading and writing difficulties1928182914
Upper secondary school eligibility6852746771
Lack of employment1817201918
Serious conflicts with parents3629363539
Arrested for crime6178486062
Hazardous Alcohol Consumption (AUDIT)4836505050
Primary drug
  Alcohol146181415
  Cannabis7786718175
  Other drugs9911510
Primairy drug use requency 2–3 days/week or more4955385749
Polydrug use3833374738
Anxiety or worry4938635746
Concentration problems5852676955
Suicide thoughts87898
Eating disorder86998
Self-harm behavior714128
Medication for Mental Health Problems219394013
Language: English
Published on: Dec 21, 2024
Published by: Psychiatric Research Unit
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2024 Karin Boson, Mats Anderberg, Peter Wenneberg, Sabina Vlasman, Sabina Kapetanovic, Mikael Dahlberg, published by Psychiatric Research Unit
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.