From adolescent mental health to substance use – a study combining Norwegian quality registries

Background

Both substance use disorders and mental disorders are major social and health concern, often starting in early adolescents. However, few studies have investigated the use and mobility between mental health and substance use clinical services in this period. This study aims to describe key characteristics on receiving treatment from Child and Adolescent Mental Health Services” (CAMHS) prior to inculcation in the Norwegian “National quality register for the treatment of harmful substance use or addiction” (KVARUS).

Methods

Stavanger University Hospital serves around 7 % of Norway. KVARUS-data was merged with CAMHS-data. We compared patients receiving CAMHS treatment before inclusion in KVARUS vs those not receiving treatment on key variables like gender, age on inclusion in KVARUS and level of education.

Results

478 patients were included in KVARUS by Stavanger University Hospital, 315 males (65.9 %) and 163 females (34.1 %). 88 males (27.9 %) had a history in CAMHS. 94 females (57.7 %) had a history in CAMHS (X2 = 40.27, p < 0.01). 30.8% of CAMHS patients had F9x diagnoses, 29.7% had F3x and 18.7% F4x (ICD-10). The patients with a CAMHS history entered KVARUS four years younger (20.7 years vs. 24.8 years, t = 11.96, df = 476, p < 0.01). There was no significant difference on education regarding CAMHS history.

Conclusions

Just over one in three had a history of CAMHS treatment prior to inclusion in KVARUS. Of the women in KVARUS over half had a history in CAMHS, for men only one in four. Participants with a CAMHS-history were included four years younger. Causal conclusions may not be drawn. However, these large gender differences and a four year lower average inclusion age is still interesting. This may be the result of a more burdened population, but may also be the result of early intervention in CAMHS affecting the trajectory on harmful substance use and addiction.

Key messages

• Substance use is a major problem in adolescence. Longitudinal data from Norwegian CAMHS combined with substance registry data indicates a twofold proportion of female detection in CAMHS.

• The patients with CAMHS history entered KVARUS four years younger on average. 30.8% of CAMHS patients had an ICD10 F9x diagnoses, 29.7% had F3x and 18.7% F4x (ICD-10).