Substance use disorders in adolescents with attention deficit hyperactivity disorder: a 4-year follow-up study

Authors

  • Annabeth P. Groenman,

    1. VU University Amsterdam, Department of Clinical Neuropsychology, Amsterdam, the Netherlands
    2. Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, the Netherlands
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  • Jaap Oosterlaan,

    1. VU University Amsterdam, Department of Clinical Neuropsychology, Amsterdam, the Netherlands
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  • Nanda Rommelse,

    1. Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
    2. Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
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  • Barbara Franke,

    1. Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
    2. Radboud University Nijmegen Medical Centre, Department of Human Genetics, Nijmegen, the Netherlands
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  • Herbert Roeyers,

    1. Ghent University, Department of Experimental Clinical Health Psychology, Ghent, Belgium
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  • Robert D. Oades,

    1. University Clinic for Child and Adolescent Psychiatry, Biopsychology Group, Essen, Germany
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  • Joseph A. Sergeant,

    1. VU University Amsterdam, Department of Clinical Neuropsychology, Amsterdam, the Netherlands
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  • Jan K. Buitelaar,

    1. Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, the Netherlands
    2. Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
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  • Stephen V. Faraone

    Corresponding author
    • SUNY Upstate Medical University, Department of Psychiatry and Behavioral Sciences, Syracuse, NY, USA
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Correspondence to: Stephen V. Faraone, Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA. E-mail: sfaraone@childpsychresearch.org

Abstract

Aim

To examine the relationship between a childhood diagnosis of attention deficit hyperactivity disorder (ADHD) with or without oppositional defiant disorder (ODD)/conduct disorder (CD) and the development of later alcohol/drug use disorder [psychoactive substance use disorder (PSUD)] and nicotine dependence in a large European sample of ADHD probands, their siblings and healthy control subjects.

Participantsdesign and setting

Subjects (n = 1017) were participants in the Belgian, Dutch and German part of the International Multicenter ADHD Genetics (IMAGE) study. IMAGE families were identified through ADHD probands aged 5–17 years attending out-patient clinics, and control subjects from the same geographic areas. After a follow-up period (mean: 4.4 years) this subsample was re-assessed at a mean age of 16.4 years.

Measurements

PSUD and nicotine dependence were assessed using the Diagnostic Interview Schedule for Children, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test and Fagerström test for Nicotine Dependence.

Findings

The ADHD sample was at higher risk of developing PSUD [hazard ratio (HR) = 1.77, 95% confidence interval (CI) = 1.05–3.00] and nicotine dependence (HR = 8.61, 95% CI = 2.44–30.34) than healthy controls. The rates of these disorders were highest for ADHD youth who also had CD, but could not be accounted for by this comorbidity. We did not find an increased risk of developing PSUD (HR = 1.18, 95% CI = 0.62–2.27) or nicotine dependence (HR = 1.89, 95% CI = 0.46–7.77) among unaffected siblings of ADHD youth.

Conclusions

A childhood diagnosis of attention deficit hyperactivity disorder is a risk factor for psychoactive substance use disorder and nicotine dependence in adolescence and comorbid conduct disorder, but not oppositional defiant disorder, further increases the risk of developing psychoactive substance use disorder and nicotine dependence.

Ancillary