Substance use and quality of life among adolescents in developing countries

Dejan Stevanovic, Department of Psychiatry, General Hospital Sombor, Sombor, Serbia

Olayinka Atilola, Department of Psychiatry, University College Hospital Ibadan, Ibadan, Nigeria 

Yatan Pal Singh Balhara, Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Mohamad Avicenna, Faculty of Psychology, State Islamic University Syarif Hidayatullah, Jakarta, Indonesia

Hasan Kandemir, Department of Child and Adolescents psychiatry, Harran University, Sanliurfa, Turkey

Panos Vostanis




Health-risk behaviours, such as alcohol, drugs and tobacco use and high risk sexual behaviors have significant impacts on adolescents' health and quality of life (QOL). This study evaluated the relationships between different substances use and QOL among adolescents living in developing countries.


In total, 1844 adolescents participated from secondary schools in India, Indonesia, Nigeria, Serbia, and Turkey (957 (51.9%) males, age mean 15.6 (1.3) years). The Pediatric Quality of Life InventoryTM (PedsQL) was used for QOL assessments, the Strengths and Difficulties Questionnaire (SDQ) was administered to assess mental health problems, and the CRAFFT self-report questionnaire was administered for eliciting problematic alcohol/drug use.


Of all adolescents surveyed, 32.4% reported substance use. Of those reporting alcohol/drugs use, the rate of occasional user was 16.5%, while the substance abuse and dependence rates were 7.9% and 5.3% respectfully.  There were statistically significant differences among four diagnostic CRAFFT groups (no use, occasional use, abuse, and dependence) on the PedsQL total and across physical, emotional, and school domain (p < 0.001). Adolescents who showed alcohol/drug abuse and dependence had significantly lower scores in the PedsQL total and across the Physical and School functioning domain than those who occasional use substances. The highest difference was found in the School functioning domain for those who showed alcohol/drug dependence (d = 0.81).


Substance use has negative impact on in QOL general and main QOL domains, but substance abuse and dependence have more profound impacts especially on school functioning domain among adolescents living in developing countries.

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