Mental health problems affect a sizeable minority of Australian adolescents. Depression and substance use disorders are common mental disorders reported in this age group. Difficulties of this nature that manifest in adolescence will often continue into adulthood. This report describes a sample of adolescents referred to a public mental health service with respect to their psychiatric diagnoses, depressive symptoms, patterns of substance use and level of suicidality. Mood disorders and substance-use disorders were both prevalent in the sample of participants, with sizeable comorbidity reflected in the number ol participants meeting criteria for both of these diagnoses. Data revealed participants with a psychiatric diagnosis were significantly more likely to have made a suicide attempt than those with no diagnosis. High levels of depressive symptoms were associated with suicidality, illicit substance use, and the likelihood of having a psychiatric diagnosis. Heavy use of alcohol was prevalent in this group, but unrelated to the other variables of interest to the study. These results are discussed with respect to the importance of early detection of vulnerable students in a school setting.
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References
1.
Aalto-SetäläT., MarttunenM., Tuulio-HenrikssonA., PoikolainenK., & LonnqvistJ. (2002). Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. American Journal of Psychiatry, 159, 1235–1237.
2.
Allgood-MertonB., LewinsohnP.M., & HopsH. (1990). Sex differences and adolescent depression. Journal of Abnormal Psychology, 99, 55–63.
3.
Australian Institute of Health and Welfare. (1999). 1998 National Drug Strategy Household Survey First Result. Canberra, Australia: Author.
4.
American Psychiatric Association (APA). (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.
5.
BakerW., HomelP., FlahertyB., & TrebilcoP. (1987). The 1986 survey of drug use by secondary school students in New South Wales. Sydney, Australia: New South Wales Drug and Alcohol Authority.
6.
BermanA.L., & JobesD.A. (1995). Suicide prevention in adolescents (age 12–18). Suicide and Life-threatening Behavior, 25, 143–154.
7.
BrenerN.D., & CollinsJ.L. (1998). Co-occurrence of health-risk behaviors among adolescents in the United States. Journal of Adolescent Health, 22, 209–213.
8.
BrenerN.D., CollinsJ.L., KannL., WarrenC.W., & WilliamsB.I. (1995). Reliability of the Youth Risk Behavior Survey Questionnaire. American Journal of Epidemiology, 141, 575–580.
9.
Brooks-GunnJ., & PetersenA.C. (1991). Studying the emergence of depression and depressive symptoms during adolescence. Journal of Youth and Adolescence, 20, 115–119.
10.
ChenK., & KandelD.B. (1995). The natural history of drug use from adolescence to the mid-thirties in a general population sample. American Journal of Public Health, 85, 41–47.
11.
ClarkG.N., HawkinsW., MurphyM., SheeberL.B., LewinsohnP.M., & SeeleyJ.R. (1995). Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: A randomised trial of a group cognitive intervention. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 312–321.
12.
CompasB.E., Connor-SmithJ., & JaserS.S. (2004). Temperament, stress reactivity, and coping: Implications for depression in childhood and adolescence. Journal of Clinical Child and Adolescent Psychology, 33, 21–31.
13.
CormackS., KaleniukZ., SmithH., & BungeyJ. (1987). Survey of alcohol, tobacco and other drug use by South Australian schoolchildren, 1986: Final report. Adelaide, Australia: Drug and Alcohol Services Council.
14.
CormackS., PolsR., & ChristieP. (1992). Alcohol and drug use. In KoskyR., EshkevariH.S., & KneeboneG. (Eds.), Breaking out: Challenges in adolescent mental health in Australia (pp. 61–73). Canberra, Australia: R. Kosky, H.S. Eshkevari, & G. Kneebone.
15.
EatonW.W., BadawiM., & MeltonB. (1995). Prodromes and precursors: Epidemiologic data for primary prevention of disorders with slow onset. American Journal of Psychiatry, 152, 967–972.
16.
EverettS.A., GiovinoG.A., WarrenC.W., CrossettL., & KannL. (1998). Other substance use among high school students who use tobacco. Journal of Adolescent Health, 23, 289–296.
17.
FergussonD.M., & HorwoodL.J. (2000). Cannabis use and dependence in a New Zealand birth cohort. New Zealand Medical Journal, 113, 225–242.
18.
FirstM.B., SpitzerR.L., GibbonM., & WilliamsJ.B.W. (2001). Structured clinical interview for DSM-IV-TR Axis I disorder: Patient edition (rev.). New York: Biometrics Research Department, New York State Psychiatric Institute.
19.
FombonneE., WostearG., CooperV., HarringtonR., & RutterM. (2001a). The Maudsley long-term follow-up of child and adolescent depression: 1. Psychiatric outcomes in adulthood. British Journal of Psychiatry, 179, 210–217.
20.
FombonneE., WostearG., CooperV., HarringtonR., & RutterM. (2001b). The Maudsley long-term follow-up of child and adolescent depression: 2. Suicidality, criminality and social dysfunction in adulthood. British Journal of Psychiatry, 179, 218–223.
21.
GlantzM.D., & PickensR.W. (1992). Vulnerability to drug abuse: Introduction and overview. In GlantzM. & PickensR. (Eds.), Vulnerability to drug abuse. Washington, DC: American Psychological Association.
22.
GrantB.E. (1998). Age at smoking onset and its association with alcohol consumption and DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiological Survey. Journal of Substance Abuse, 10, 59–73.
23.
HankinB.L., AbramsonL.Y., MoffittT.E., SilvaP.A., McGeeR., & AngellK.E. (1998). Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128–140.
24.
HarrisE.C., & BarracloughB. (1997). Suicide as an outcome for mental disorders: A metaanalysis. British Journal of Psychiatry, 170, 205–228.
25.
HawkinsJ.D., CatalanoR.F., & MillerJ.Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64–105.
26.
Health Department Victoria, Alcohol and Drug Services Unit. (1990). 1989 survey of alcohol, tobacco and other drug use among Victorian secondary school student. Melbourne, Australia: Author.
27.
JacksonK.M., SherK.J., CooperM.L., & WoodP.K. (2002). Adolescent alcohol and tobacco use: Onset, persistence and trajectories of use across two samples. Addiction, 97, 517–531.
28.
JohnsonV., & PandinaR.J. (1993). A longitudinal examination of the relationships among stress, coping strategies, and problems associated with alcohol use. Alcoholism: Clinical and Experimental Research, 17, 696–702.
29.
JohnstonL.D., O'MalleyP.M., & BachmanJ.G. (2000). Monitoring the future: National survey results on drug use, 1975–1999. Bethesda, MD: National Institute on Drug Abuse.
30.
KandelD.B., YamaguchiK., & ChenK. (1992). Stages of progression in drug involvement from adolescence to adulthood: Further evidence for the gateway theory. Journal of Studies on Alcohol, 53, 447–457.
31.
KaplowJ.B., CurranP.J., AngoldA., & CostelloE.J. (2001). The prospective relation between dimensions of anxiety and the initiation of adolescent alcohol use. Journal of Clinical Child Psychology, 30, 316–326.
32.
KaufmanJ., BirmaherB., BrentD., RaoU., & RyanN. (1996). Schedule for affective disorders and schizophrenia for school-aged children: Present and lifetime version (K-SADS-PL). Pittsburgh, PA: The Department of Psychiatry, The University of Pittsburgh School of Medicine.
33.
KesslerR.C., McGonagleK.A., ZhaoS., NelsonC.B., HughesM., & EshlemanS. (1994). Lifetime and 12 month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.
34.
KesslerR.C., & WaltersE.E. (1998). Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depression and Anxiety, 7(1), 3–14.
35.
KruegerR.F., CaspiA., MoffittT.E., & SilvaP.A. (1998). The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107(2), 216–227.
36.
LaurentJ., CatanzaroS.J., & CallanM.K. (1996). Stress, alcohol-related expectancies and coping preferences: A replication with adolescents of the Cooper et al. (1992) model. Journal of Studies on Alcohol, 58, 644–651.
37.
LewinsohnP.M., GotlibI.H., & SeeleyJ.R. (1995). Adolescent psychopathology: IV. Specificity of psychosocial risk factors for depression and substance abuse in older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1221–1229.
38.
LewinsohnP.M., RobertsR.E., SeeleyJ.R., RohdeP., GottlibI.H., & HopsH. (1994). Adolescent psychopathology: II. Psychosocial risk factors for depression. Journal of Abnormal Psychology, 103, 302–315.
39.
LewinsohnP.M., RohdeP., & BrownR.A. (1999). Level of current and past adolescent cigarette smoking as predictors of future substance use disorders in young adulthood. Addiction, 94, 913–921.
40.
MainousA.G., MartinC.A., OlerM.J., RichardsonE.T., & HaneyA.S. (1996). Substance use among adolescents: Fulfilling a need state. Adolescence, 37, 807–815.
41.
MartinA., & CohenD.J. (2000). Adolescent depression: Window of (missed?) opportunity. The American Journal of Psychiatry, 157, 1549–1551.
42.
MawbyL., NeillM., ChristieP., & CormackS. (1989). Survey of alcohol, tobacco and other drug use by South Australian schoolchildren, 1989: Final report. Adelaide, Australia: Drug and Alcohol Services Council.
43.
MerikangasK.R., AngstJ., EatonW., CaninoG., Rubio-StipecM., WackerH., et al. (1996). Comorbidity and boundaries of affective disorders with anxiety disorders and substance misuse: Results of an international task force. British Journal of Psychiatry, 30(Suppl.), 58–67.
44.
MoonL., MeyerP., & GrauJ. (1999). Australia's young people: Their health and wellbeing 1999. Canberra, Australia: Australian Institute of Health and Wellbeing.
45.
MurrayC.J.L., & LopezA.D. (1996). The global burden of disease: Summary. Cambridge, MA.: Harvard University Press.
46.
NewmanD.L., MoffittT.E., CaspiA., MagdolL., SilvaP.A., & StantonW.R. (1996a). Psychiatric disorder in a birth cohort of young adults: Prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. Journal of Consulting and Clinical Psychology, 64(3), 552–562.
47.
NewmanD.L., MoffittT.E., CaspiA., MagdolL., SilvaP.A., & StantonW.R. (1996b). Psychiatric disorder in a birth cohort of young adults: Prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. Journal of Consulting and Clinical Psychology, 64(3), 552–562.
48.
Parry-JonesW.L.L. (1995). The future of adolescent psychiatry. British Journal of Psychiatry, 166, 299–305.
49.
PattonG. (1996). An epidemiological case for a separate adolescent psychiatry?Australian and New Zealand Journal of Psychiatry, 30, 563–566.
50.
PattonG.C., HibbertM.E., RosierM.J., CarlinJ.B., CaustJ., & BowesG. (1995). Patterns of common drug use in teenagers. Australian Journal of Public Health, 19, 393–399.
51.
PineD.S., CohenE., CohenP., & BrookJ. (1999). Adolescent depressive symptoms as predictors of adult depression: Moodiness or mood disorder?American Journal of Psychiatry, 156, 133–135.
52.
PoikolainenK. (2002). Antecedents of substance use in adolescence. Current Opinion in Psychiatry, 15, 241–245.
53.
RadloffL.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 2(3), 385–401.
54.
ReyJ.M., SawyerM.G., ClarkJ.J., & BaghurstP.A. (2001). Depression among Australian adolescents. Medical Journal of Australia, 175, 19–23.
55.
ReyJ.M., SawyerM.G., RaphaelB., PattonG.C., & LynskeyM. (2002). Mental health of teenagers who use cannabis. British Journal of Psychiatry, 180, 216–221.
56.
ReynoldsW.M. (1994). Depression in adolescents: Contemporary issues and perspectives. In OllendickT.H., & PrinzR.J. (Eds.), Advances in clinical child psychology (Vol. 16). New York: Plenum Press.
57.
RobertsR.E., AndrewsJ.A., LewinsohnP.M., & HopsM. (1990). Assessment of depression in adolescents using the Centre for Epidemiologic Studies Depression Scale. Psychological Assessment, 2(2), 122–128.
58.
RohdeP., LewinsohnP.M., KahlerC.W., SeeleyJ.R., & BrownR.A. (2001). Natural course of alcohol use disorders from adolescence to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 83–90.
59.
RossH.E., & IvisF. (1999). Binge eating and substance use among male and female adolescents. International Journal of Eating Disorders, 26, 245–260.
60.
SaundersJ.B., & BradyK.T. (2002). The scientific basis for the prevention and treatment of substance misuse. Current Opinion in Psychiatry, 15, 231–234.
61.
SawyerM.G., ArneyF.M., BaghurstP.A., ClarkJ.J., GraetzB.W., KoskyR.J., et al. (2000). The mental health of young people in Australia. Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care.
62.
ShafferD., ScottM., WilcoxH., MaslowC., HicksR., LucasC., et al. (2004). The Columbia SuicideScreen: Validity and reliability of a screen for youth suicide and depression. Journal of the American Academy of Child and Adolescent Psychiatry, 43(1), 71–79.
63.
SuominenK., IsometsaE., MartunnenM., OstamoA., & LonnqvistJ. (2004). Health care contacts before and after attempted suicide among adolescent and young adult versus older suicide attempters. Psychological Medicine, 34, 313–321.
64.
ThomasB.S. (1996). A path analysis of gender differences in adolescent onset of alcohol, tobacco and other drug use (ATOD), reported ATOD use and adverse consequences of ATOD use. Journal of Addictive Diseases, 15, 33–52.
65.
WeinbergN.Z., RahdertE., ColliverJ.D., & GlantzM.D. (1998). Adolescent substance abuse: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 252–261.
66.
WillsT.A., McNamaraG., VaccaroD., & HirkyA.E. (1996). Escalated substance use: A longitudinal grouping analysis from early to middle adolescence. Journal of Abnormal Psychology, 105, 166–180.
67.
WillsT.A., SandyJ.M., & YaegerA.M. (2002). Stress and smoking in adolescence: A test of directional hypotheses. Health Psychology, 21, 122–130.
68.
WindleM., & BarnesG.M. (1998). Similarities and differences in correlates of alcohol consumption and problem behaviors among male and female adolescents. The International Journal of the Addictions, 23, 707–728.
69.
WindleM., & WindleR.C. (1996). Coping strategies, drinking motives, and stressful life events among middle adolescents: Associations with emotional and behavioural problems with academic functioning. Journal of Abnormal Psychology, 105, 551–560.
70.
WindleM., & WindleR.C. (2001). Depressive symptoms and cigarette smoking among middle adolescents: Prospective associations and intrapersonal and interpersonal influences. Journal of Consulting and Clinical Psychology, 69, 215–226.
71.
WittchenH.U., KesslerR.C., PfisterH., & LiebM. (2000). Why do people with anxiety disorders become depressed? A prospective longitudinal community study. Acta Psychiatrica Scandinavica, 102(Suppl. 406), 14–23.
72.
WittchenH.U., NelsonC.B., & LachnerG. (1998). Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Medicine, 28, 109–126.
73.
WuP., HovenC.W., BirdH.R., MooreR.E., CohenP., AlegriaM., et al. (1999). Depressive and disruptive disorders and mental health service utilization in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1081–1092.
