Adolescent inhalant use, abuse and dependence.

AIMS To compare adolescent inhalant users without DSM-IV inhalant use disorders (IUDs) to youth with IUDs (i.e. abuse or dependence) across demographic, psychosocial and clinical measures. DESIGN Cross-sectional survey with structured psychiatric interviews. SETTING Facilities (n = 32) comprising the Missouri Division of Youth Services (MDYS) residential treatment system for juvenile offenders. Participants Current MDYS residents (n = 723); 97.7% of residents participated. Most youth were male (87%) and in mid-adolescence (mean = 15.5 years, standard deviation = 1.2, range = 11-20); more than one-third (38.6%, n = 279) reported life-time inhalant use. MEASUREMENTS Antisocial behavior, temperament, trauma-exposure, suicidality, psychiatric symptoms and substance-related problems. FINDINGS Among life-time inhalant users, 46.9% met criteria for a life-time DSM-IV IUD (inhalant abuse = 18.6%, inhalant dependence = 28.3%). Bivariate analyses showed that, in comparison to non-users, inhalant users with and without an IUD were more likely to be Caucasian, live in rural or small towns, have higher levels of anxiety and depressive symptoms, evidence more impulsive and fearless temperaments and report more past-year antisocial behavior and life-time suicidality, traumatic experiences and global substance use problems. A monotonic relationship between inhalant use, abuse and dependence and adverse outcomes was observed, with comparatively high rates of dysfunction observed among inhalant-dependent youth. Multivariate regression analyses showed that inhalant users with and without an IUD had greater levels of suicidal ideation and substance use problems than non-users. CONCLUSIONS Youth with IUDs have personal histories characterized by high levels of trauma, suicidality, psychiatric distress, antisocial behavior and substance-related problems. A monotonic relationship between inhalant use, abuse and dependence and serious adverse outcomes was observed.