Substance Use Disorders and Psychiatric Illness Among Transitional Age Youth Experiencing Homelessness

Abstract

Objective Transitional age youth experiencing homelessness (TAY-EH) bear a high burden of substance use disorders (SUD) and psychopathology. However, limited data exist on the co-occurrence and interactions between these diagnoses in this marginalized group. This study sought to identify rates of single and co-occurring SUD and psychiatric diagnoses among a sample of TAY-EH and to investigate associations between psychopathology and prevalence/severity of SUD in this group. Method TAY-EH accessing a low-threshold social service agency in a large metropolitan area completed psychosocial and diagnostic interviews to assess for SUD and psychopathology. Analyses examined rates of single and co-occurring disorders and associations between burden of psychopathology and presence/severity of SUD. Results 140 TAY-EH completed the assessment; the majority were youth of color (54% Black/African American, 16% Latinx). Fifty-seven percent identified as male. Rates of single and co-occurring psychiatric disorders and specific SUDs (cannabis use disorder (CUD) and alcohol use disorder (AUD)) were notably high. An increasing number of psychiatric diagnoses was significantly associated with elevated CUD/AUD prevalence and severity. Mood, anxiety, Attention Deficit-Hyperactivity, and antisocial personality disorders were significantly associated with elevated CUD/AUD prevalence and severity, as was suicidality (p <0.05 for all). Conclusion This study reveals a complex overlay of SUD and psychopathology facing TAY-EH, with a significant association between co-occurring psychopathology and severity of CUD/AUD. To our knowledge, this is the first study to examine associations between specific psychopathology and severity of SUD among TAY-EH. Further research into the mechanistic and temporal links between these conditions is needed to inform tailored treatment interventions.

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