BACKGROUND Co-occurring mental health and substance use (SU) disorders among adolescents are common, with two-thirds of adolescents who seek SU treatment also requiring support for mental health. Primary care physicians play a key role in the pharmacological treatment of mental health disorders among adolescents, however, little is known about the impact of these treatments on SU outcomes. OBJECTIVES This systematic review summarizes the evidence regarding commonly used pharmacotherapy interventions for mental health and their impact on adolescent SU. METHODS Literature searches were conducted across five databases as part of a larger systematic review of adolescent SU interventions. Studies were screened for eligibility by two researchers, and study data were extracted regarding study design, patient and treatment characteristics and results. Risk of bias analyses and qualitative syntheses were completed to evaluate the strength of the evidence and the impact of pharmacotherapy on SU outcomes. RESULTS Ten randomized controlled trials exploring seven pharmacotherapies met criteria for inclusion. All studies had low to moderate risk of bias. Four studies evaluated pharmacotherapy for co-occurring depression and SU, three evaluated attention deficit hyperactivity disorder and SU, and three evaluated bipolar disorder and SU. Five of the 10 studies also included a behavioural intervention. We found no evidence that pharmacotherapy for co-occurring mental health diagnoses impacted SU. CONCLUSION Family medicine clinicians prescribing pharmacotherapy for mental health should be aware that additional interventions will likely be needed to address co-occurring SU.

中文翻译：

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针对青少年同时发生的物质使用和心理健康障碍的药物治疗干预：系统评价。


背景 青少年中同时发生的心理健康和物质使用（SU）障碍很常见，寻求 SU 治疗的青少年中三分之二也需要心理健康支持。初级保健医生在青少年心理健康障碍的药物治疗中发挥着关键作用，然而，人们对这些治疗对 SU 结果的影响知之甚少。目的 本系统综述总结了有关心理健康常用药物治疗干预措施及其对青少年 SU 影响的证据。方法 在五个数据库中进行文献检索，作为对青少年 SU 干预措施进行更大规模系统评价的一部分。两名研究人员对研究资格进行了筛选，并提取了有关研究设计、患者和治疗特征及结果的研究数据。完成偏倚风险分析和定性综合，以评估证据的强度以及药物治疗对 SU 结果的影响。结果 探索七种药物疗法的十项随机对照试验符合纳入标准。所有研究均存在低至中等偏倚风险。四项研究评估了同时发生的抑郁症和 SU 的药物治疗，三项研究评估了注意力缺陷多动障碍和 SU，三项研究评估了双相情感障碍和 SU。 10 项研究中有 5 项还包括行为干预。我们没有发现任何证据表明针对同时发生的心理健康诊断的药物治疗会影响 SU。结论 为心理健康开出药物治疗的家庭医学临床医生应该意识到，可能需要额外的干预措施来解决同时发生的 SU。