Alexandre Paim Diaz1, Connie Svob2, Ruixin Zhao3, Baxter DiFabrizio3, Virginia Warner3, Marc J Gameroff2, Jamie Skipper3, Jay Gingrich4, Jonathan Posner2, Priya J Wickramaratne5, Myrna M Weissman6, Ardesheer Talati7. 1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, United States; New York State Psychiatric Institute, New York, United States; Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Santa Catarina, Brazil. 2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, United States; New York State Psychiatric Institute, New York, United States. 3. New York State Psychiatric Institute, New York, United States. 4. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, United States; New York State Psychiatric Institute, New York, United States; Sackler Institute for Developmental Psychobiology, Columbia University, New York, United States. 5. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, United States; Mailman School of Public Health, Columbia University, New York, United States; New York State Psychiatric Institute, New York, United States. 6. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, United States; Mailman School of Public Health, Columbia University, New York, United States; New York State Psychiatric Institute, New York, United States; Sackler Institute for Developmental Psychobiology, Columbia University, New York, United States. 7. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, United States; New York State Psychiatric Institute, New York, United States; Sackler Institute for Developmental Psychobiology, Columbia University, New York, United States. Electronic address: adi.talati@nyspi.columbia.edu.
Abstract
BACKGROUND: Longitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders. METHOD: Offspring (N = 267) of parents with or without major depression (MDD), but no ASPD or bipolar disorders were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested. RESULTS: Eighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AOR = 3.42, p < 0.0001), bipolar disorder (AOR = 3.10, p = 0.03), and substance use disorders (AOR = 5.69, p < 0.0001) by age 18, as well as poorer school performance and global functioning. DDs continued to predict MDD and substance use outcomes in adulthood, even after accounting for presence of the corresponding disorder in childhood (MDD: hazards ratio, HR = 3.25, p < 0.0001; SUD, HR = 2.52, p < 0.0001). Associations were similar among the offspring of parents with and without major depression. DDs did not predict adulthood ASPD in either group. LIMITATIONS: Associations are largely accounted for by conduct disorder (CD), as there were few offspring with ADHD, and oppositional defiant disorder (ODD) was not diagnosed at the time this study began. CONCLUSION: If there is no familial risk for ASPD, bipolar disorder or substance use, childhood DDs do not lead to ASPD in adulthood; however, the children still have poorer prognosis into midlife. Early treatment of children with DD, particularly CD, while carefully considering familial risk for these disorders, may help mitigate later adversity.
BACKGROUND:Longitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders. METHOD: Offspring (N = 267) of parents with or without major depression (MDD), but no ASPD or bipolar disorders were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested. RESULTS: Eighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AOR = 3.42, p < 0.0001), bipolar disorder (AOR = 3.10, p = 0.03), and substance use disorders (AOR = 5.69, p < 0.0001) by age 18, as well as poorer school performance and global functioning. DDs continued to predict MDD and substance use outcomes in adulthood, even after accounting for presence of the corresponding disorder in childhood (MDD: hazards ratio, HR = 3.25, p < 0.0001; SUD, HR = 2.52, p < 0.0001). Associations were similar among the offspring of parents with and without major depression. DDs did not predict adulthood ASPD in either group. LIMITATIONS: Associations are largely accounted for by conduct disorder (CD), as there were few offspring with ADHD, and oppositional defiant disorder (ODD) was not diagnosed at the time this study began. CONCLUSION: If there is no familial risk for ASPD, bipolar disorder or substance use, childhood DDs do not lead to ASPD in adulthood; however, the children still have poorer prognosis into midlife. Early treatment of children with DD, particularly CD, while carefully considering familial risk for these disorders, may help mitigate later adversity.
Authors: Myrna M Weissman; Priya Wickramaratne; Yoko Nomura; Virginia Warner; Daniel Pilowsky; Helen Verdeli Journal: Am J Psychiatry Date: 2006-06 Impact factor: 18.112
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Authors: Bradley S Peterson; Virginia Warner; Ravi Bansal; Hongtu Zhu; Xuejun Hao; Jun Liu; Kathleen Durkin; Phillip B Adams; Priya Wickramaratne; Myrna M Weissman Journal: Proc Natl Acad Sci U S A Date: 2009-03-27 Impact factor: 11.205