This study extends existing research on the relationship between psychoactive substance use among young people and violent behaviour, by evaluating the possible effect of the modification of parenting in a nationally representative sample of 14,685 Italian students drawn from the 2019 wave of the ESPAD Italia survey (51% male; mean age about 17 years). Parental dimensions considered in the study were rule-setting, monitoring, and emotional support, as well as the possible absence of a parent. Relative risk ratios and binary logistic regressions were used to estimate the associations separately for adolescents (15–17) and young adults (18–19). Overall, parental rule-setting, perceived parental monitoring, and emotional support were protective factors for substance use, and the strength of this relationship increased with the frequency of use. Among adolescents, the absence of a parent represented a risk factor. In both age groups, the odds of engaging in violent behaviour was increased among those reporting alcohol intoxication and substance use and the greater the frequency of use, the greater the increase in the odds. As parental monitoring and emotional support decreased, the odds of engaging in violent behaviour increased (except in the case of lower parental support among young adults), while the opposite applies to parental rule-setting. The odds of engaging in violent behaviour were increased among those reporting the absence of a parent only in the adolescent age group. Parental rule-setting was found to have an effect only among adolescents, increasing the odds of violent behaviour among frequent drinkers. Our results might be helpful to signal adolescents who would be more prone to adopt violent behaviour in order to target prevention policies.

Background: Studies have highlighted 2 different groups of cocaine users (CUs): “socially integrated” (stable living conditions, regular employment, use cocaine alone or in combination with other psychoactive substances) and “socially marginalized” (socioeconomic and health problems, former or current heroin users, many injecting cocaine). These differences are also found in the elevated mortality risk for CUs, higher among subjects with cocaine and heroin use. This study targeted residents in Northern Italy who turned to a public treatment center for drug addiction following problems caused by primary cocaine use between 1982 and 2016. Objectives: To estimate mortality risk for subjects who have never used heroin (CUs) compared to that of subjects who have used heroin (HCUs). Method: Retrospective cohort study. We selected 1,993 subjects; 18,015 Person Years (PY). Results: Over time, the quota of subjects injecting cocaine and using heroin decreased, while patients not using heroin increased. Both new patients and crude mortality rates (CMR) decreased during the years 2009–2012 and increased in the following period. CMRs were 5.55 per 1,000 PY, higher for HCUs, men and subjects aged over 44 years. Standardized mortality rates were 3.49, higher for women, injecting cocaine and HCUS. Among CUs, most of the deaths were from injury excluding drug related and tumors; among HCUs, from drug-related causes and diseases of the cardiovascular system. Conclusion: The study results show a change in the characteristics of SERD clients being treated for primary cocaine use, which are reflected both in mortality risk and causes of death. After a long period of a decrease, mortality risk increased in the period after the economic recession. Aspects concerning the effects of the economic recession on the problematic consumption of cocaine and on the risk of death are discussed.

The aim of this study was to examine mortality risk and causes of death for natives and non-natives in a cohort of heroin population of treated in Northern Italy. Crude Mortality Rates (CMRs) were 12.78 per 1,000 Person Years (PY), Standardized Mortality Rate (SMR) was 9.93. Mortality has been decreasing over time, was higher for patients who accessed the treatment services before 2001 and has been increasing with age. CMRs and SMRs were higher among natives, while non-natives were distinguished by higher CMRs and SMRs for suicide. The natives were at greater risk of death than non-natives both injecting and non-injecting, but the mortality risk was not statistically significant in the different periods of first admission. Among non-native patients, older on average, there was a lower proportion of injecting, and a higher quota of people unemployed than among Italian natives. We highlight differences between the various areas of origin concerning consumption patterns and risk of death. The results of the study highlight a particular sub-population of heroin users, the non-natives, who as compared with the Italians, have less invasive consumption styles, reach the health services later but benefit from fewer medical controls.

Background: Adolescence is a critical developmental stage marked by vulnerability to psychological difficulties. While family relationships, peer bonds, prosocial behaviors, and health-risk factors have been linked to adolescent mental health, few studies have examined their joint effects in clinical pediatric populations. This study assessed demographic, clinical, relational, and behavioral predictors of psychological difficulties in Italian adolescents. Methods: A cross-sectional sample of 177 adolescents (aged 11–14 years) from a pediatric clinic completed the Strengths and Difficulties Questionnaire (SDQ). The Total Difficulties (SDQ TD) score was the main outcome. Associations were tested with ordinary least squares (OLS) and confirmed using robust MM regression. Bootstrap confidence intervals and Benjamini–Hochberg corrections were applied. Sensitivity analyses excluded the Peer Problems subscale to address part–whole overlap. Results: Higher friendship satisfaction was consistently associated with fewer psychological difficulties, confirming its role as a strong protective factor. Prosocial behavior and male sex were also linked to fewer difficulties in initial analyses, though these associations were less stable after correction. Sensitivity analyses further supported the protective value of friendship satisfaction, even when accounting for overlap with peer problems. Despite relatively low overall levels of psychological difficulties, nearly one-quarter of adolescents met the clinical cut-off for eating disorder risk. Conclusions: Friendship satisfaction was the strongest protective factor, while prosocial behavior and sex showed weaker consistency. Findings suggest that distinct aspects of peer relationships jointly shape adolescents’ psychological outcomes. Interventions promoting social functioning may support mental health in clinical youth populations.