Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada.
Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
Drug Alcohol Depend. 2022 Nov 1;240:109647. doi: 10.1016/j.drugalcdep.2022.109647. Epub 2022 Sep 30.
While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions.
A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety.
Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types.
The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health.
尽管物质使用和心理健康症状在青少年中经常同时出现，但很少有基于人群的研究来检查共同出现的模式，以提供针对性的预防和早期干预。
对 68 所中学的 11994 名学生进行了多层次潜在剖面分析，以：1）确定同时存在物质使用和心理健康症状的不同模式；2）根据学生的特征确定学校类型；3）探讨学生特征和学校类型的学校相关因素，包括学校氛围、归属感和安全性。
确定了五种学生特征和三种学校类型。在学生中，57.6%的学生处于低物质使用和低心理健康特征，22.5%的学生处于高心理健康但低物质使用特征，9.7%的学生处于重度饮酒和大麻使用特征，3.7%的学生处于重度饮酒和吸烟特征，6.5%的学生处于高物质使用和高心理健康特征。积极的学校氛围、归属感和安全感增加了学生处于低特征的可能性，归属感对女性的影响更大。在学校中，28%的学校学生物质使用和共病心理健康症状水平较低，57%的学校学生物质使用和共病心理健康症状水平中等，15%的学校学生物质使用和共病心理健康症状水平较高。农村学校在高风险学校类型中所占比例不成比例。
确定的学生物质使用和心理健康症状特征可以作为针对性预防和早期干预的目标。研究结果支持针对学校氛围、归属感和安全性的基于学校的干预措施，这些措施可能对物质使用和心理健康都有好处。
