Addictive behaviors, mental health, and quality of life in adolescents: Toward integrative assessment for early identification of vulnerability (2026)

OBJECTIVES: Addictive behaviors are frequently associated with anxiety and depressive disorders. Adolescence represents a critical period of heightened vulnerability to both types of disorders. In recent years, a significant global decline in adolescent mental health-especially among girls-has raised concerns about the short-term evolution of addictive behaviors. Despite available data, this relationship remains poorly understood, warranting further research to improve prevention and care strategies.
METHODS: This study analyzed data from a French cross-sectional observational study (DOPADO), which aimed to assess addictive behaviors among adolescents aged 13 to 18 years attending middle and high schools. Data were collected between 2018 and 2020 using electronic surveys, enabling the evaluation of past-12-month psychoactive substance use, associated risky behaviors, sociodemographic characteristics, anxiety and depressive symptoms, psychological distress, and quality of life.
RESULTS: Among 4844 adolescents, half exhibited anxiety and/or depressive symptoms. These were associated with higher levels of substance use, increased risky behaviors, and impaired quality of life. A Principal Component Analysis revealed 3 distinct profiles: one with preserved well-being, and 2 with significant impairment. These were characterized by higher anxiety-depressive symptoms (especially in the second cluster) and more pronounced addictive behaviors and risky use (notably in the third cluster).
CONCLUSIONS: Our study highlights robust associations between anxiety/depressive symptoms, addictive behaviors, and quality of life. Several distinct adolescent profiles emerged with respect to mental health and addictive behaviors, each characterized by specific patterns of quality of life and functioning, underscoring the importance of integrated assessment, prevention, and treatment strategies in adolescents. [Author's abstract]