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Beth E. Molnar, ScD, Kaja LeWinn, SM, and Stephen Buka, ScD. Dept. of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, SPH-3, Boston, MA 02115, (617)432-2433, bmolnar@hsph.harvard.edu
Background. Substance abuse among youth remains a significant public health problem, despite significant attention to treatment and prevention. Comorbidity has been shown to be pervasive, with more than half (54%) of those ages 15-54 in the National Comorbidity Survey who had one diagnosable mental or addictive disorder having at least one co-occurring disorder (Kessler et al., 1994). Given that research on comorbid disorders has been primarily conducted with adults, similar studies are needed for adolescents, using a developmental framework and examining the degree to which comorbidity has origins in childhood. Methods. Data are from the Project on Human Development in Chicago Neighborhoods, a multi-level, prospective study of a multi-ethnic, urban sample. Data from 1,328 youth (ages 15-18 at baseline) will be analyzed to show the effects of prior psychiatric disorders on development of DSM-IV substance abuse and dependence, estimated using discrete-time survival analysis, controlling for relevant individual/neighborhood covariates. Results. Preliminary analyses found abuse of alcohol and marijuana was highly prevalent, peaking at 35% for alcohol. Diagnoses of depression were found in as high as 22% of females and 9% of males. Mean age of onset for depression in youth at baseline was 13.0 years, and17.8 years for alcohol abuse, suggesting that interesting patterns of comorbidity will emerge with further analyses. Conclusions. We contend that this study will provide an important foundation for future research on causal mechanisms of substance abuse and dependence in urban settings, and will stimulate creative new thinking about interventions to prevent substance abuse among adolescents.
Learning Objectives:
Keywords: Child and Adolescent Mental Health, Co-morbid
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.