title: Temporal association between childhood psychopathology and substance use disorders: findings from a sample of adults with opioid or alcohol dependency.
abstract: Adults with substance use disorders (SUD; alcohol or drug abuse or dependence) were evaluated to determine if childhood-onset psychopathology preceded the onset of SUD. Using structured psychiatric interviews, we assessed 47 clinically referred adults with SUD (27 with opioid dependence and 20 with alcohol dependence), with attention to childhood-onset psychopathology. A sequence of psychopathology and SUD was reconstructed using mean diagnosis onset data. Sixty-two percent of the 47 SUD adults (mean age 39.3+/-6.6 years) had early-onset SUD (defined as < or = 18 years) and 38% had late-onset SUD (> or = 19 years at onset). Psychopathology preceded the onset of SUD in 56% of adults. Attention deficit/hyperactivity disorder, multiple anxiety, and disruptive disorders typically preceded the onset of SUD; in contrast, mood disorders (specifically depressive and bipolar disorders) followed the onset of SUD. The majority of clinically referred adults with SUD had psychopathology that began in childhood, frequently preceding the onset of their SUD. These findings further highlight the importance of targeting antecedent disorders for preventive and early intervention programs aimed at reducing the risk for SUD.
authors.affiliation: Pediatric and Adult Psychopharmacology Clinic, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, ACC 725, Boston, MA 02114, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Hahesy
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Van Patten
authors.forename: Thomas
authors.initials: T
authors.lastname: Spencer
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology* / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D019263:Dysthymic Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors