Background: Evidence suggests that externalizing and internalizing symptoms are expressed early in life and are associated with problematic drinking in young adulthood. However, few studies have examined their role during childhood and adolescence in predicting alcohol problems later in life. Objectives: To examine the role of childhood and adolescent externalizing and internalizing symptoms in predicting alcohol use disorders in young adulthood. Methods: We searched five electronic databases (PubMed, Scopus, PsycINFO, Web of Sciences and Embase) for studies which diagnosed alcohol use disorders through either the International Classification of Diseases or American Psychiatric Association – Diagnostic and Statistical Manual of Mental Disorders criteria and followed up children or adolescents into the transition to young adulthood. We performed a meta-analysis and obtained pooled odds ratio estimates with 95% confidence intervals using random-effects models. Results: A total of 12 longitudinal studies met eligibility criteria and were included in the meta-analysis. All measured the outcome using Diagnostic and Statistical Manual of Mental Disorders criteria. The majority were of good quality and were conducted in the United States. A total of 19,407 participants (50% female) were included in this meta-analysis. Of these, n = 2337 (12%) had diagnoses of alcohol use disorders/alcohol dependence. Participant ages ranged from birth to 36 years. Internalizing symptoms increased the risk of young adult alcohol use disorders by 21% (odds ratio = 1.21; 95% confidence interval = [1.05, 1.39]), with no strong evidence of publication bias. Subgroup analysis suggested significantly lower heterogeneity than for externalizing studies. Externalizing symptoms increased the risk of alcohol use disorders by 62% (odds ratio = 1.62, 95% confidence interval = [1.39, 1.90]). We found some evidence of publication bias and significant heterogeneity in the studies. Conclusion: Our findings highlight the contribution of early behavioural problems to the development of alcohol use disorders in young adulthood and the need for timely scrutiny of and intervention on early behavioural problems.

The persistent difficulty in conceptualizing the relationship between addictive and other mental disorders stands out among the many challenges faced by the field of Psychiatry. The different philosophies and schools of thought about, and the sheer complexity of these highly prevalent clinical conditions make progress inherently difficult, not to mention the profusion of competing and sometimes contradictory terms that unnecessarily exacerbate the challenge. The lack of a standardized term adds confusion, fuels stigma, and contributes to a “wrong door syndrome” that captures the difficulty of not only diagnosing but also treating addictive and other mental disorders in an integrated manner. The World Association on Dual Disorders (WADD) proposes the adoption of the term “Dual Disorder” which, while still arbitrary, would help harmonize various clinical and research efforts by rallying around a single, more accurate, and less stigmatizing designation.

Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults. We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains. Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted.

Aims: To describe (i) self‐reported changes in drug use and (ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/ 3,4‐methylenedioxymethamphetamine (MDMA) and other illicit stimulants in Australia following COVID‐19 and associated restrictions.Design: Annual interviews with cross‐sectional sentinel samples conducted face‐to‐face in 2016–19 and via video conferencing or telephone in 2020. Data were collected via an interviewer‐administered structured questionnaire.Setting: Australian capital cities.Participants: Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word‐of‐mouth (n ~ 800 each year).Measurements: Key outcome measures were self‐reported illicit drug market indicators (price, purity and availability) and, in 2020 only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change.Findings: For most drugs, participants reported either no change or a reduction in their use since COVID‐19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use (n = 552, 70% of those reporting recent use), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as ‘high’ in purity decreased compared with 2016–19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53–0.99], as did perceiving them as ‘easy’ to obtain (aOR = 0.42, CI = 0.26–0.67). The odds of perceiving cocaine and methamphetamine crystal as ‘easy’ to obtain also decreased (aOR = 0.67, CI = 0.46–0.96 and aOR = 0.12, CI = 0.04–0.41, respectively).Conclusions: After COVID‐19‐related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization.