Rafael A González1,2, María C Vélez-Pastrana3, Matthijs Blankers4,5,6, Amanda Bäcker7, Maija Konstenius7, Martin Holtmann8, Frances R Levin9, Moritz Noack8, Sharlene Kaye10, Zsolt Demetrovics11, Geurt van de Glind12,13, Wim van den Brink6, Arnt Schellekens12,13. 1. National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom, Rafael.Gonzalez@slam.nhs.uk. 2. Centre for Psychiatry, Imperial College London, London, United Kingdom, Rafael.Gonzalez@slam.nhs.uk. 3. PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, USA. 4. Arkin Mental Health Care, Department of Research, Amsterdam, The Netherlands. 5. Trimbos institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. 6. Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. 7. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 8. LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany. 9. New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA. 10. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. 11. Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. 12. Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands. 13. Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands.
Abstract
AIMS: This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS: We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS: Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS: ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
AIMS: This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS: We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS: Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS:ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
Authors: Geurt Van de Glind; Christoffer Brynte; Arvid Skutle; Sharlene Kaye; Maija Konstenius; Frances Levin; Frieda Mathys; Zsolt Demetrovics; Franz Moggi; Josep Antoni Ramos-Quiroga; Arnt Schellekens; Cleo Crunelle; Geert Dom; Wim van den Brink; Johan Franck Journal: Eur Addict Res Date: 2020-06-29 Impact factor: 3.015