Pills as Aids? Substance Use, School Satisfaction, Sleep Quality, Body Image, and Mental Well-Being Among Korean Adolescents

Abstract

Background: With growing concerns about the abuse of prescription and over-the-counter (OTC) medications, such as medications for attention-deficit/hyperactivity disorder (ADHD), diet pills, and sleep aids, among adolescents in South Korea, this study aimed to investigated how these substances affect key aspects of adolescent well-being, specifically school satisfaction, body image, and sleep quality, and their association with mental health outcomes. Methods: A two-wave longitudinal survey was conducted with Korean female high school students (Wave 1: n = 494; Wave 2: n = 189). Linear regression analyses were used to evaluate the effects of ADHD medications, diet pills, and sleep aids on changes in school satisfaction, body image, and sleep quality, respectively. We also examined the relationship between these outcomes and mental health indicators, including depression, anxiety, stress, and somatic symptoms. Results: In line with the Self-Medication Hypothesis, which suggests that substances may fail to alleviate stress or improve well-being, the use of ADHD medications was associated with a decrease in school satisfaction, diet pill use was not significantly associated with changes in body image, and sleep aid use was not significantly associated with changes in sleep quality. Poor school satisfaction, body image, and sleep quality were associated with negative mental health outcomes. Conclusion: These findings suggest that ADHD medications, diet pills, and sleep aids may not effectively improve school satisfaction, body image, or sleep quality, and could potentially exacerbate mental health challenges.