Adolescent Substance Abuse and Psychiatric Comorbidities
J Clin Psychiatry 2006;67(suppl 7):18-23
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Substance use disorders have a serious impact on adolescents because these disorders have high
prevalence rates and frequent associations with psychiatric disorders. Surveys of adolescent behaviors
and substance use show that alcohol is the most common substance abused by adolescents. Despite
the high rates of current alcohol use and binge drinking among adolescents, current diagnostic criteria
are problematic. Adolescents may have a developing problem with substance dependence but not
meet criteria for either substance abuse or dependence. At-risk adolescents, called "diagnostic orphans,"
may meet only 1 or 2 criteria for alcohol dependence and no abuse criteria and therefore do
not receive an alcohol use disorder diagnosis from the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, Text Revision. Adolescents with substance use disorders tend to have
higher rates of comorbid psychiatric disorders and are more likely to report a history of trauma and
physical and/or sexual abuse than adolescents without a substance use disorder. In addition, psychiatric
disorders in adolescents often predate the substance use disorder. Once the substance use disorder
develops, the psychiatric disorder may be further exacerbated.