ADHD, Conduct Disorder Tied to Later Substance Use Problems

But conduct disorder appears to mediate link between ADHD, substance use disorders
By Monica Smith
HealthDay Reporter

WEDNESDAY, Oct. 6 (HealthDay News) -- Children with attention-deficit/hyperactivity disorder (ADHD) may be at risk for adulthood substance use disorders (SUDs), particularly if they have conduct disorder (CD) as well, according to research published in the October issue of the Archives of Pediatrics & Adolescent Medicine.

David W. Brook, M.D., of the New York University School of Medicine in New York City, and colleagues assessed ADHD, CD, and SUDs in a community sample of individuals drawn in 1975 and followed to a mean of 37 years of age to determine the relationship between ADHD in adolescence and SUDs in adulthood, and whether CD has a mediating effect on this relationship.

The researchers found that the odds ratio for adolescent ADHD as related to adult SUDs was 1.9; the odds ratio for adolescent CD as related to adult SUDs was 3.5. However, they write that the relationship between ADHD and SUDs was indirect, as CD appeared to serve as a mediator between the two.

"For pediatricians, because ADHD generally develops earlier than CD, ADHD may be an important diagnostic cue for later CD and perhaps, ultimately, SUDs. At the same time, CD, because of its proximal effect on SUDs, serves as a major risk factor for SUDs. Given the clinical and public health importance of the progression of ADHD, CD, and SUDs, further research about the specific mechanisms explaining this developmental pattern is indicated. From a clinical perspective, early interventions should focus on CD, particularly in children with ADHD, because this may put the youngsters at risk for later SUDs," the authors write.

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