Does ADHD Predict Substance-Use Disorders? A 10-Year Follow-up Study of Young Adults With ADHD

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 50; no. 6; pp. 543 - 553
• Main Authors: Wilens, Timothy E., M.D, Martelon, MaryKate, M.P.H, Joshi, Gagan, M.D, Bateman, Clancey, B.A, Fried, Ronna, Ed.D, Petty, Carter, M.A, Biederman, Joseph, M.D
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.06.2011; Elsevier; Elsevier BV
• Subjects: Addictive behaviors; ADHD; Adolescent; Adolescents; Adult and adolescent clinical studies; Age Factors; Alcoholism - diagnosis; Alcoholism - epidemiology; Alcoholism - psychology; At Risk Persons; Attention Deficit and Disruptive Behavior Disorders - diagnosis; Attention Deficit and Disruptive Behavior Disorders - epidemiology; Attention Deficit and Disruptive Behavior Disorders - psychology; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit disorders. Hyperactivity; Attention Deficit Hyperactivity Disorder; Biological and medical sciences; Case-Control Studies; Child; Child clinical studies; Child of Impaired Parents - psychology; Child psychology; Children; Comorbidity; conduct disorder; Conduct Disorder - diagnosis; Conduct Disorder - epidemiology; Conduct Disorder - psychology; Drug use; Family Environment; Female; Follow-Up Studies; Followup Studies; Gender; Gender Differences; Humans; Incidence; Interaction; Interviews; longitudinal follow-up; Male; Medical sciences; Miscellaneous; Pediatrics; Predictor Variables; Proportional Hazards Models; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Risk Factors; Sex Factors; Smoking; Smoking - epidemiology; Smoking - psychology; Social behavior disorders. Criminal behavior. Delinquency; Social Influences; Studies; Substance Abuse; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; substance-use disorders; United States; Young Adult; Young Adults; United States; ADHD; longitudinal follow-up; conduct disorder; substance-use disorders; Human; Follow up study; Young adult; Conduct disorder; Substance abuse; Attention disorder with hyperactivity; Predictive factor; Social behavior disorder
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2011.01.021

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.