Sociopathy and drug use in a young psychiatric population

Recent studies have consistently demonstrated a higher than expected proportion of heavy drug users among young psychiatric patients. Careful reading of these reports fails to adduce what might account for this constant finding. In order to examine this question more closely, one hundred young psychiatric in patients (aged 15 to 25 years) were studied in detail. The following extensive data were obtained for each patient: demography (sex, age, race, marital status, occupation), clinical characteristics (prior psychiatric care, presenting complaint, duration of hospitalization, diagnosis, treatment, disposition), prior social problems (truancy, runaway, pregnancy out of wedlock, divorce or separation, vehicular accident while intoxicated, felony), and social resources on admission (employment, friends, family of origin). An extensive drug history consisted of types of drugs, duration and frequency of usage, and pattern of use over the previous twelve months. Based on specific criteria patients were divided into abstainers, occasional users, regular users, and heavy users. Forty nine of the patients were tabulated as heavy users. Compared to the other patients, heavy users were found to have more unemployment, more divorce and separation, more characterological and fewer neurotic diagnoses, more problematic prior social events, and fewer social resources at the time of admission. Unexpectedly, the two groups did not differ significantly for all other demographic and clinical parameters. The implications of these findings for the psychopathologic categorization and for the management of young in patients are noted.