title: Substance use disorders in adolescents with attention deficit hyperactivity disorder: a 4-year follow-up study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
authors.affiliation: VU University Amsterdam, Department of Clinical Neuropsychology, Amsterdam, the Netherlands.
authors.forename: Annabeth P
authors.initials: AP
authors.lastname: Groenman
authors.forename: Jaap
authors.initials: J
authors.lastname: Oosterlaan
authors.forename: Nanda
authors.initials: N
authors.lastname: Rommelse
authors.forename: Barbara
authors.initials: B
authors.lastname: Franke
authors.forename: Herbert
authors.initials: H
authors.lastname: Roeyers
authors.forename: Robert D
authors.initials: RD
authors.lastname: Oades
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Sergeant
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019955:Conduct Disorder / Q000150:complications* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015995:Prevalence; D011619:Psychotropic Drugs; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology
chemical_list: D011619:Psychotropic Drugs
keywords: Age of onset; attention deficit hyperactivity disorder; conduct disorder; familial association; nicotine dependence; oppositional defiant disorder; psychoactive substance use disorder