Marshall, Tyler and Reeson, Matthew and Loverock, Alexandra and Lewis, Ariana E and King, Ian and Ilyas, Raffay and Dixon, Celine Caruso and Viste, Dylan and Azer, Brandon and Chow, Ethan and Safi, Fahad and Kennedy, Megan and Abba-Aji, Adam and Greenshaw, Andrew J (2025) Evidence-based interventions for youth with concurrent mental health and substance use disorders: a scoping review. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, Early online, 7067437241300957. https://doi.org/10.1177/07067437241300957.
External website: https://journals.sagepub.com/doi/10.1177/070674372...
BACKGROUND: Mental health and substance use disorders typically onset during youth and commonly co-occur. Integrated treatment of two or more co-existing mental health and substance use disorders (i.e., concurrent disorders) is increasingly prevalent in real-world clinical settings. However, the depth of the evidence base on best practices remains unclear.
OBJECTIVES: This scoping review aimed to identify, map and summarize peer-reviewed studies of interventions for concurrent disorders in youth.
METHODS: Six electronic health databases were systematically searched, in addition to a hand search of the reference lists of relevant systematic reviews. Only peer-reviewed studies of interventions treating concurrent disorders (i.e., simultaneous treatment of two or more disorders) in youth (10-29 years old) were eligible. Two independent reviewers conducted screening and data extraction. Results were charted according to studies employing pharmacological and non-pharmacological interventions.
RESULTS: Thirty peer-reviewed studies were included, 19 (63.3%) were randomized controlled trials (RCTs). Most studies enrolled participants with an unspecified substance use disorder (n=17, 56.7%), while alcohol use was the primary substance use disorder in seven (23.3%) studies, followed by cannabis use disorder in six (20.0%) studies. Mood disorders (e.g., depression, dysthymia) were the most common concurrent mental health disorders comprising 15 (50%) studies, followed by nine (30.0%) studies of behavioural disorders (e.g., ADHD) and five (16.7%) studies of unspecified psychiatric disorders. Eighteen (60.0%) studies (n=1,699 participants) investigated the effectiveness of various non-pharmacological interventions, while 12 (40.0%) studies examined pharmacotherapies (n=765 participants).
CONCLUSION: Although several RCTs were identified, substantial clinical and methodological heterogeneity was evident among the studies (e.g., patients with multiple disorders, and multi-faceted interventions). Smaller systematic reviews focused on specific interventions (e.g., behavioural therapies) and concurrent disorders (e.g., depression and substance use) may be warranted. Due to considerable heterogeneity, more RCTs are needed before conducting larger systematic reviews or meta-analyses.
G Health and disease > Substance use disorder (addiction)
G Health and disease > Substance related disorder > Substance related mental health disorder > Dual diagnosis / comorbidity (mental health)
HJ Treatment or recovery method > Treatment outcome
J Health care, prevention, harm reduction and treatment > Treatment and maintenance > Treatment factors
J Health care, prevention, harm reduction and treatment > Type of care > Mental health care (Psychiatry / Psychology)
T Demographic characteristics > Adolescent / youth (teenager / young person)
VA Geographic area > International
Repository Staff Only: item control page