ABSTRACT
OBJECTIVE: The aim of this study was to examine prevalence, patterns and predictors of substance use among a sample of adolescent psychiatric inpatients. METHODS: Participants included 25 minors aged 12-17 years admitted to an Austrian department of child and adolescent psychiatry. Lifetime use, initiation, frequency and quantity of substance use, sociodemographic, family and school-related data were collected by self-report measures. Substance use disorders were detected using CAGE (a screening instrument for problem drinking) and FTND (Fagerström Test For Nicotine Dependence). Clinical characteristics were extracted from medical records. RESULTS: Lifetime prevalence of any substance use (76%) and regular use (32%) were common. Prevalence was high for alcohol (76%), nicotine (44%) and illicit drug use (36%). Older age was associated with tobacco (p = 0.023), drug (p = 0.021) and cannabis use (p = 0.015) and regular use of psychotropic substances (p = 0.027). Family dysfunction predicted regular (p = 0.035) and cannabis use (p = 0.02). History of trauma prognosticated regular (p = 0.047) and tobacco use (p = 0.011). Use of any substance (p < 0.001) as well as regular use (p = 0.026) were significantly associated with peer substance use. Consuming adolescents were more likely to show academic failure, school absenteeism and behavioral problems. Alcohol (p = 0.02), drug (p = 0.017) and regular substance use (p = 0.007) were linked to suicidal ideation. A remarkable relationship between affective as well as externalizing disorders and alcohol, nicotine and drug use was found. CONCLUSIONS: Substance use is highly prevalent among youth with mental illnesses and associated with psychosocial consequences. These data highlight the need to carefully explore this population at high risk.
Subject(s)
Alcohol Drinking/epidemiology , Illicit Drugs , Marijuana Abuse/epidemiology , Mental Disorders/epidemiology , Psychotropic Drugs , Substance-Related Disorders/epidemiology , Tobacco Use Disorder/epidemiology , Adolescent , Adverse Childhood Experiences , Alcohol Drinking/psychology , Austria , Child , Comorbidity , Cross-Sectional Studies , Family Conflict , Female , Humans , Male , Marijuana Abuse/psychology , Mental Disorders/psychology , Pilot Projects , Risk Factors , Substance-Related Disorders/psychology , Tobacco Use Disorder/psychologyABSTRACT
A captive-bred white lion cub was presented with hindquarter pain, lameness and reluctance to move. Radiographs revealed generalised osteoapenia, multiple fractures, a severely collapsed pelvic girdle, bilateral lateral bowing of the scapulae and mild kyphosis of the caudal vertebrae. A double cortical line, a distinct sign of osteopaenia, was repeatedly seen on the pelvic limbs, most strikingly along both femurs. Based on radiographic findings and a history of an exclusive meat diet since weaning, a diagnosis of nutritional secondary hyperparathyroidism was made. The diet was changed to a commercial kitten food and the cub was given cage rest for 6 weeks. Signs of pain abated and the cub became more active. A guarded prognosis was given for full recovery, as changes to the pelvis were considered potentially irreversible.
