The study examined associations between antisocial behavior (ASB) before age 15 and eight adverse outcomes from age 21 to 50 among 1,623 men and 324 women who as adolescents consulted a clinic for substance misuse problems. Outcomes were documented using Swedish national registers and included death, hospitalization for physical illnesses related to substance misuse, mental illness, self-inflicted harm, substance misuse, convictions for violent and nonviolent crimes, and poverty. ASB before age 15 was associated with increased odds of all outcomes in adulthood except hospitalization for mental illness after adjusting for low family socioeconomic status, sex, Sex × ASB, and substance misuse in adulthood and with an increased number of adverse outcomes up to age 50. No gender differences were detected.

Introduction: Little is known about the long-term outcome of substance misuse by teenagers, this is especially true for gender specific consequences.Objectives: To examine the prevalence of death, physical illnesses related to substance misuse, mental illness, substance misuse, criminality, and poverty in adulthood among two cohorts of individuals who as adolescents had consulted for substance misuse problems, to estimate the effect of sex on adverse outcomes, and to compare cohort effects.Methods: Individuals who had consulted a substance misuse clinic as adolescents during 1968-1971 and 1980-1984 were followed until 2002. Adverse outcomes were documented using information from Swedish national registers.Results: In the older cohort followed to age 50, only one-in-five escaped all six adverse outcomes, while over half of subjects experienced at least two or more. Sex and the severity of adolescent substance misuse and delinquency were predictors of adverse outcomes. More women than men experienced physical illness and poverty in the older cohort while more men than women were convicted of criminal offences in both cohorts and presented continued substance misuse in the younger cohort. Men in the younger as compared to the older cohort had higher rates of substance misuse and criminal convictions.Conclusions: Adolescents seeking help for substance misuse problems are at elevated risk for Multiple adverse outcomes later in life. Outcomes differ for women and men and by severity of adolescent misuse and delinquency. Few cohort differences in adult outcomes exist. (C) 2008 Elsevier Ireland Ltd. All rights reserved.