Journal of Abnormal Child Psychology, Vol. 25, No. 2, 1997, pp. 121-132 Psychiatric Disorders Associated with Substance Use Among Children and Adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study Denise B. Kandel, 1' 9 Jeffrey G. Johnson, 2 Hector R. Bird, 3 Glorisa Canino, 4 Sherryl H. Goodman, 5 Benjamin B. Lahey, 6 Darrel A. Regier, 7 and Mary Schwab-Stone 8 Received July 18, 1995; revision received January 16, 1996; accepted February 29, 1996 The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consump- tion, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gen- der, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender. KEY WORDS: Substance use; psychiatric disorders; adolescents. 'Department of Psychiatry and School of Public Health, Columbia University, College of Physicians and Surgeons, New York, New York 10032, and Department of the Epidemiology of Substance Abuse, New York State Psychiatric Institute, New York, New York 10032. 2Biometrics Research, New York State Psychiatric Institute, New York, New York 10032. 3Department of Child Psychiatry, Columbia University, New York, New York 10032. 4Behavioral Sciences Institute, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico 00936. 5Department of Psychology, Emory University, Atlanta, Georgia 30322. 6Department of Psychology, University of Chicago, Chicago, Illi- nois 60637. 7Division of Epidemiology and Services Research, National Insti- tute on Mental Health, Bethesda, Maryland 20857. Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06520. 'Address all correspondence to Denise Kandel, Columbia Univer- sity, 722 West 168 Street, Box 20, New York, New York 10032. 121 <X»1-06Z7/9W40W>121$1ZS(VD C 1997 Plenum Publishing Corporation Only a minority of adolescents who experiment with substance use develop substance use disorders (SUDS) (Boyle & Offord, 1991; Kaminer & Buk- stein, 1989; Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993). Efforts have been made to identify factors that predict problematic substance use in ado- lescence, including family environment, emotional- behavioral problems, personality traits, and extent of prior experience with substance use (Block, Gjerde, & Block, 1991; Boyle et al., 1993; Brook, Brook, Gor- don, Whiteman, & Cohen, 1990; Hawkins, Catalano, & Miller, 1992; Kandel & Yamaguchi, 1993; New- comb & Bentler, 1988). The particular quantity/frequency levels of use that differentially predict the onset of SUDs among adolescents remain to be specified. While quantity and frequency of substance use have been found to