Adolescent substance use patterns and subsequent risk of mental and behavioural disorders, substance use…

Cohort studyThe Lancet. Public health· Jul 2025

Adolescent substance use patterns and subsequent risk of mental and behavioural disorders, substance use, and suicidal behaviour: a cohort study.

Elisabeth R Hansen, Sofie Kruckow, Sarah W Feldstein Ewing … Janne S Tolstrup

Adolescent MedicineCohort studyQ1IF 12.8

Early-onset multiple substance use linked to over 3-fold higher rate of later suicidal behaviour.

Adolescent substance use patterns and subsequent risk of mental and behavioural disorders, substance use, and suicidal behaviour: a cohort study.

Elisabeth R Hansen … Janne S Tolstrup

The Lancet · Jul 2025

Background

Despite growing knowledge of distinct patterns of substance use in adolescents, their associations with later adverse mental health and substance use outcomes remain poorly understood.

Purpose

We aimed to identify adolescent substance use patterns, describe adolescents with distinct patterns, and test the hypothesis that substance use patterns predict mental disorders, hospital contacts due to alcohol or drug use, and suicidal behaviour.

Methods

We used a school-based survey of 68 301 adolescents (mean age 17·8 [SD 0·99]) in upper-secondary education, to identify substance use patterns using latent class analysis.

n = 68 301 adolescents

HR 3·20

Results

HR 3·20

over 3 times higher rate of later suicidal behaviour

n = 68 301 adolescents

More results

Notably, the risks of most studied outcomes were consistently higher in the experimental substance use and early-onset multiple substance use groups.

Surprisingly, the frequent binge drinking group had a lower risk of any mental or behavioural disorder (0·83 [0·77-0·89) than the alcohol only group.

More results

The higher risk of all outcomes in the experimental and early-onset multiple substance use groups remained across the 8 years of follow-up.

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Conclusion · 1 of 2

Adolescents with high-risk substance use face an increased risk of adverse mental and substance use outcomes in young adulthood, and health and social disadvantages tend to cluster within this group.

Conclusion · 2 of 2

Targeted preventive efforts should prioritise these vulnerable young people.

Adolescent substance use patterns and subsequent risk of mental and behavioural disorders, substance use, and suicidal behaviour: a cohort study.

Adolescent substance use patterns and subsequent risk of mental and behavioural disorders, substance use, and suicidal behaviour: a cohort study.

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