Psychological Impairment in Adolescents with Substance Use Disorder: A Cross-Sectional Study

Open Access

Abstract

Background: Substance use disorder (SUD) among adolescents is an emerging public health concern that is frequently associated with adverse psychological outcomes, including depression, anxiety, and stress. Evidence regarding the psychological consequences of adolescent SUD in Bangladesh remains limited, highlighting the need for context-specific research. Aim of the study: To assess psychological impairment among adolescents with substance use disorder and determine its association with socio-demographic and substance use-related characteristics. Methods & Materials: This cross-sectional analytical study was conducted under the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between March 2020 and September 2021. Data were collected from the Central Drug Addiction Treatment Centre (CDC), Dhaka, and Ashokti Punorbashon Nibash (APON), Manikganj. A total of 44 adolescents aged 11-19 years with substance use disorder diagnosed according to DSM-5 criteria were enrolled using purposive sampling. Psychological impairment was assessed using the validated Bangla version of the Depression Anxiety Stress Scale-21 (DASS-21). Data were analyzed using SPSS version 27.0. Descriptive statistics were used to summarize the findings, while Chi-square test or Fisher's exact test was applied to assess associations. A p-value <0.05 was considered statistically significant. Result: The mean age of the participants was 16.48±2.32 years, with 79.55% aged 15-19 years and 88.64% being male. Most participants were from urban areas (70.45%), and 45.45% belonged to low socioeconomic status. The majority (52.27%) initiated substance use between 14 and 16 years of age, while 47.73% had a duration of substance use of 1-3 years. Depression, anxiety, and stress were present in 72.73%, 81.82%, and 65.91% of participants, respectively. Moderate-to-severe psychological impairment was common across all three domains. Depression and anxiety were significantly associated with age (p=0.041 and p=0.047, respectively). Residence, socioeconomic status, age of first substance use, and duration of substance use showed significant associations with depression, anxiety, and stress (all p<0.05), whereas gender was not significantly associated with any psychological impairment (p>0.05). Conclusion: Psychological impairment was highly prevalent among adolescents with substance use disorder, with anxiety being the most common manifestation. Earlier initiation and longer duration of substance use, lower socioeconomic status, and rural residence were significantly associated with greater psychological impairment. These findings emphasize the importance of integrating routine psychological assessment and early mental health interventions into adolescent substance use treatment programs.