Longitudinal Associations Between Substance Use and Mental Health Outcomes in Swedish Adolescents-Results From the...

Adolescent mental health concerns are increasing, while substance use-though declining-remains a significant issue. To clarify the temporal dynamics between these two constructs during adolescence, we examined the reciprocal associations of substance consumption with stress and psychosomatic symptoms across ages 13-18.

In the longitudinal STudy of Adolescence Resilience and Stress (STARS) cohort in Western Sweden (n = 1,255, 62% female), we assessed the prevalence of substance use and conducted a cross-lagged panel analysis, using generalized structural equation models with an ordered logit link function. Over three timepoints (ages 13, 15, and 18), we evaluated if use of substances (low- and high-alcoholic beverages, cigarettes, and snus) was associated with subsequent self-reported stress and psychosomatic symptoms and vice versa.

The prevalence of all forms of substance use increased markedly with age. Substance use differed substantially between the sexes, with females consuming more cigarettes and high-alcoholic beverages while males used more snus, low-alcoholic beverages, and illicit drugs. Higher levels of stress and psychosomatic symptoms at age 13 were associated with increased odds of substance use at age 15, especially in females. The association was partially significant between ages 15 and 18. We did not observe any significant predictive relationship between substance use and subsequent stress or psychosomatic symptoms.

It is important to provide extra support to individuals facing mental health challenges when working toward reducing substance use.