Familial risk analyses of attention deficit hyperactivity disorder and substance use disorders.
OBJECTIVE
A robust and bidirectional comorbidity between attention deficit hyperactivity disorder (ADHD) and psychoactive substance use disorder (alcohol or drug abuse or dependence) has been consistently reported in the extant literature.


METHODS
First-degree relatives from a large group of pediatrically and psychiatrically referred boys with (112 probands, 385 relatives) and without (105 probands, 358 relatives) ADHD were comprehensively assessed by blind raters with structured diagnostic interviews. Familial risk analysis examined the risks in first-degree relatives for ADHD, psychoactive substance use disorder, alcohol dependence, and drug dependence after stratifying probands by the presence and absence of these disorders.


RESULTS
ADHD in the proband was consistently associated with a significant risk for ADHD in relatives. Drug dependence in probands increased the risk for drug dependence in relatives irrespective of ADHD status, whereas alcohol dependence in relatives was predicted only by ADHD probands with comorbid alcohol dependence. In addition, ADHD in the proband predicted drug dependence in relatives, and drug dependence in comparison probands increased the risk for ADHD in relatives. Both alcohol dependence and drug dependence bred true in families without evidence for a common risk between these disorders.


CONCLUSIONS
Patterns of familial risk analysis suggest that the association between ADHD and drug dependence is most consistent with the hypothesis of variable expressivity of a common risk between these disorders, whereas the association between ADHD and alcohol dependence is most consistent with the hypothesis of independent transmission of these disorders. Findings also suggest specificity for the transmission of alcohol and drug dependence.
Biederman
Joseph
J
Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, 55 Fruit St., Warren 705, Boston, MA 02114, USA. jbiederman@partners.org
Petty
Carter R
CR
Wilens
Timothy E
TE
Fraire
Maria G
MG
Purcell
Caitlin A
CA
Mick
Eric
E
Monuteaux
Michael C
MC
Faraone
Stephen V
SV
D000293:Adolescent; D017668:Age of Onset; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005190:Family; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000009:adverse effects; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*
D011619:Psychotropic Drugs