title: Mortality in individuals with disruptive behavior disorders diagnosed by specialist services - A nationwide cohort study.
abstract: Disruptive behavior disorders (DBDs), inclusive of oppositional defiant disorder (ODD) and conduct disorder (CD), are associated with outcomes likely to increase risk of mortality. Using Danish National Registers, a total of 1.92 million individuals including 9495 individuals with DBDs diagnosed by specialist services were followed from their first birthday to 2013. Those with and without DBDs were compared using mortality rate ratios (MRRs) estimated using Poisson regression and adjusted for calendar period, age, sex, family history of psychiatric disorders, maternal age at time of birth, paternal age at time of birth, parental education status, and parental employment status. Over the course of follow up, which totalled 24.9 million person-years, 5580 cohort members died including 78 individuals with DBDs. The mortality rate per 10,000 person-years was 9.66 for individuals with DBDs compared to 2.22 for those with no diagnosis. This corresponded to a fully adjusted MRR of 2.57 (95% confidence interval 2.04-3.20). Comorbid substance use disorder and attention-deficit/hyperactivity disorder resulted in the highest MRR across all categories. These findings demonstrate the excess mortality associated with DBDs.
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland 4029, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia. Electronic address: james.scott@health.qld.gov.au.
authors.forename: James G
authors.initials: JG
authors.lastname: Scott
authors.affiliation: National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Giørtz Pedersen
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland 4029, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia; School of Public Health, University of Queensland, Herston, Queensland 4006, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Erskine
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Services, Aabenraa, Region of Southern Denmark, Denmark.
authors.forename: Aida
authors.initials: A
authors.lastname: Bikic
authors.affiliation: The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
authors.forename: Ditte
authors.initials: D
authors.lastname: Demontis
authors.affiliation: Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia; National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; Queensland Brain Institute, University of Queensland, St Lucia, QLD 4076, Australia.
authors.forename: John J
authors.initials: JJ
authors.lastname: McGrath
authors.affiliation: National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; CIRRAU - Centre For Integrated Register-Based Research at Aarhus University, Aarhus, Denmark; Department for Child and Adolescent Psychiatry, Hospital of Telemark, Telemark, Kragerø, Norway.
authors.forename: Søren
authors.initials: S
authors.lastname: Dalsgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology; D012306:Risk; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D055815:Young Adult
keywords: Conduct disorder; Deaths; Disruptive behavior disorders; Epidemiology; Mortality; Oppositional defiant disorder; Registries