Does ADHD Predict Substance-Use Disorders? A 10-Year Follow-up Study of Young Adults With ADHD - 10/08/11
, MaryKate Martelon, M.P.H., Gagan Joshi, M.D., Clancey Bateman, B.A., Ronna Fried, Ed.D., Carter Petty, M.A., Joseph Biederman, M.D.
Correspondence to Timothy E. Wilens, M.D., Massachusetts General Hospital, Pediatric Psychopharmacology Unit, 55 Parkman Street, YAW 6A, Boston, MA 02114Résumé |
Objective |
High rates of substance-use disorders (SUD) have been found in samples of adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Predictors of SUD in children with ADHD who are at risk for the development of SUDs remain understudied. The main aims of this study were to identify clinically meaningful characteristics of children that predicted the future development of SUDs and to see whether the role of these characteristics varied by sex.
Method |
Subjects were children and adolescents with (n = 268; mean age ± standard deviation = 10.9 ± 3.2 years) and without (n = 229; mean age 11.9 ± 3.3 years) DSM-III-R ADHD followed prospectively and blindly over a 10-year follow-up period onto young adult years. Subjects were assessed with structured diagnostic interviews for psychopathology and SUDs.
Results |
Over the 10-year follow-up period, ADHD was found to be a significant predictor of any SUD (hazards ratio 1.47; 95% confidence interval 1.07–2.02; p = .01) and cigarette smoking (2.38; 1.61–3.53; p < .01). Within ADHD, comorbid conduct disorder (2.74; 1.66–4.52; p < .01) and oppositional defiant disorder (2.21; 1.40–3.51; p < .01) at baseline were also found to be significant predictors of SUDs. Similar results were found for cigarette-, alcohol-, and drug-use disorders. There were few meaningful sex interaction effects. No clinically significant associations were found for any social or family environment factors or for cognitive functioning factors (p > .05 for all comparisons).
Conclusions |
These results indicate that ADHD is a significant risk factor for the development of SUDs and cigarette smoking in both sexes.
Le texte complet de cet article est disponible en PDF.Key Words : ADHD, substance-use disorders, longitudinal follow-up, conduct disorder
Plan
| This article can be used to obtain continuing medical education (CME) category 1 credit at www.jaacap.org. |
|
| An interview with the author is available by podcast at www.jaacap.org. |
|
| This study was funded by grant K24 DA016264 (T.W.) and in part by a grant from the United States Public Health Service (National Institute on Child Health and Human Development) and by grant 5R01 HD-36317-07 (J.B.) and in part by a grant from the Eli Lilly and Company Foundation and the Pediatric Psychopharmacology Philanthropy Fund. |
|
| Disclosure: Dr. Wilens has received grant support from Abbott, McNeil, Eli Lilly and Co., the National Institutes of Health–National Institute on Drug Abuse, Nextwave, Merck, and Shire. He has served on the speakers' bureau for Eli Lilly and Co., McNeil, Novartis, and Shire. He has served as a consultant to Abbott, AstraZeneca, McNeil, Eli Lilly and Co., the National Institutes of Health, Nextwave, Novartis, Merck, and Shire. He receives royalties from Guildford Press. Dr. Biederman has received research support from Abbott, Alza, AstraZeneca, Bristol Myers Squibb, Celltech, Cephalon, Eli Lilly and Co., Elminda, Esai, Forest, GlaxoSmithKline, Gliatech, Janssen, McNeil, Merck, the National Alliance for Research on Schizophrenia and Depression, the National Institute on Drug Abuse, New River, the National Institute of Child Health and Human Development, the National Institute of Mental Health, Novartis, Noven, Neurosearch, Organon, Otsuka, Pfizer, Pharmacia, the Prechter Foundation, Shire, the Stanley Foundation, UCB Pharma, and Wyeth. He has served on the speakers' bureau for Fundacion Areces, Medice Pharmaceuticals, and the Spanish Child Psychiatry Association. Dr. Joshi has received research support from Abbott, Bristol Myers Squibb, Cephalon, Eli Lilly and Co., GlaxoSmithKline, Johnson and Johnson, McNeil, Merck, the National Institute of Mental Health, New River, Novartis, Organon, Otsuka, Takeda, Pfizer, and Shire. He is a member of the National Institute of Mental Health Editorial Board. He has received the Ethel DuPont Fellowship Award. He has received the Pilot Research Award from the American Academy of Child and Adolescent Psychiatry. Ms. Martelon, Mr. Bateman, Ms. Fried, and Mr. Petty report no biomedical financial interests or potential conflicts of interest. |
Vol 50 - N° 6
P. 543-553 - juin 2011 Retour au numéro
Article précédent
- Criteria, Categories, and Continua: Autism and Related Disorders in DSM-5
- Francesca Happé
- Short-Term Persistence of DSM-IV ADHD Diagnoses: Influence of Context, Age, and Gender
- José J. Bauermeister, Héctor R. Bird, Patrick E. Shrout, Ligia Chavez, Rafael Ramírez, Glorisa Canino
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?