title: Development of Alcohol and Drug Use in Youth With Manic Symptoms.
abstract: OBJECTIVE
  This analysis examined alcohol and drug use over a 6-year follow-up of children in the Longitudinal Assessment of Manic Symptoms (LAMS) study.
  
  
  METHODS
  LAMS screened 6- to 12.9-year-old children visiting 9 child outpatient mental health (MH) clinics, using the Parent General Behavior Inventory 10-item mania scale. All children with scores ≥12 and a matched group with scores ≤12 were invited to enroll. Children were assessed every 6 months. Assessments included demographics, family, MH history, child diagnoses, child stress, and alcohol and drug use. Univariate, bivariate, and interval censored survival analyses were conducted.
  
  
  RESULTS
  Of those >9 years at baseline, 34.9% used alcohol at least once, with 11.9% regular users; 30.1% used drugs at least once, with 16.2% regular users. Predictors of any alcohol use were parental marital status, older age at study entry, a primary diagnosis of disruptive behavior disorders at baseline, and number of impactful child life events. Predictors of regular alcohol use included parental marital status, age, and sustained high mania symptoms over the first 24 months of follow-up. Predictors of any drug use were single parent, parental substance use, and stressful child life events. Predictors of regular drug use were parental marital status, stressful child life events, and a baseline disruptive behavior disorder diagnosis. Baseline medications decreased the risk of regular drug use.
  
  
  CONCLUSIONS
  Longitudinal data on youth with elevated manic symptoms suggest that comorbid disruptive behavior disorder, manic symptom burden, family environment, and stress are predictors of initiation and regular use of substances.
authors.affiliation: New York University School of Medicine, New York. Electronic address: Sarah.Horwitz@nyumc.org.
authors.forename: Sarah McCue
authors.initials: SM
authors.lastname: Horwitz
authors.affiliation: Statistical Research Consultants, LLC, Schaumburg, IL.
authors.forename: Amy
authors.initials: A
authors.lastname: Storfer-Isser
authors.affiliation: Johns Hopkins School of Medicine, Baltimore.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Young
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.affiliation: Case Western Reserve University, Cleveland.
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.affiliation: Center for Pediatric Behavioral Health, Cleveland Clinic, Cleveland.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Frazier
authors.affiliation: Ohio State University, Columbus.
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.affiliation: Ohio State University, Columbus.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fristad
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.affiliation: Johns Hopkins School of Medicine, Baltimore.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000453:epidemiology / Q000209:etiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology
keywords: bipolar disorders; manic symptoms; substance use