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Though mental health and substance use concerns often co-occur, few studies have characterized patterns of co-occurrence among adolescents in clinical settings. The current investigation identifies and characterizes these patterns among adolescents presenting to an outpatient mental health service in Ontario, Canada. Data come from cross-sectional standardized patient intake assessments from 916 adolescents attending an outpatient mental health program (January 2019–March 2021). Latent profile analysis identified patterns of substance use (alcohol, cannabis, (e-) cigarettes) and emotional and behavioral disorder symptoms. Sociodemographic and clinical correlates of these patterns were examined using multinomial regression. Three profiles were identified including: 1) low substance use and lower frequency and/or severity (relative to other patients in the sample) emotional and behavioral disorder symptoms (26.2%), 2) low substance use with higher emotional and behavioral disorder symptoms (48.2%), and 3) high in both (25.6%). Profiles differed in sociodemographic and clinical indicators related to age, gender, trauma, harm to self, harm to others, and service use. Experiences of trauma, suicide attempts, and thoughts of hurting others increased the odds of adolescents being in the profile high in both substance use and symptoms compared to other profiles. These findings further document the high rates of substance use in adolescents in mental health treatment and the profiles generally map onto three out of four quadrants in the adapted four-quadrant model of concurrent disorders, indicating the importance of assessing and addressing substance use in these settings. [ABSTRACT FROM AUTHOR]

This study examines longitudinal behaviour change in six key lifestyle behaviours—sleep, physical activity (PA), sedentary recreational screen time, diet, alcohol use, and tobacco use—and associations with mental health in a large study of Australian adolescents. Change between baseline (Mage = 12.7, N = 6,639) and 3-year follow up (Mage = 15.7, N = 4445) was investigated. Generalised linear mixed effects regressions modelled associations between behaviour change and later psychological distress score adjusting for baseline behaviours, baseline psychological distress, social determinants, and school clustering. Changes over time in each of the behaviours were significantly associated with later psychological distress, whereby health-promoting behaviours were associated with reduced psychological distress and vice versa. When all behaviour changes were modelled together, significant effects remained for sleep, PA, vegetable consumption, junk food and SSB consumption, alcohol, and tobacco use. Results highlight the potential benefits of behaviour modification to reduce the progression of psychological distress in adolescence. [ABSTRACT FROM AUTHOR]