Understanding Affective Symptoms and Substance Use in Older Adolescents in an Urban Context a Network Approach

Global urbanization may present mental health challenges for youth. We investigated relationships between affective symptoms, substance use, and urban characteristics in 17–18-year-old adolescents from the Amsterdam Born Children and their Development study (N = 1682). Objectively measured urban neighbourhood characteristics (e.g. safety, poverty) were obtained from the Geoscience and Health Cohort Consortium in addition to self-report assessments. Cross-sectional networks showed strong clustering between affective symptoms, substance use behaviours, and urban characteristics. Self-reported safety and drug-related nuisance were key bridge nodes between clusters. Higher levels of unsafety and urban hassles were linked to affective symptoms and substance use. Fatigue, sadness, and cannabis use were the most important symptoms. Objective social safety was also connected to perceptions of safety, drug-related nuisance, fatigue, sad mood, and cannabis use. These findings indicate a complex interplay between environment and individual health, with objective safety and social cohesion serving as key connectors between urban characteristics and mental health symptoms and substance use.