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ABSTRACT: Background
Attention-deficit/hyperactivity disorder (ADHD) is associated with substance use disorders (SUD; alcohol and/or drug dependence) and nicotine dependence. This study aims to advance our knowledge about the association between SUD, nicotine dependence, and the course of ADHD (persistent versus remittent ADHD and late-onset ADHD).Methods
ADHD, SUD, and nicotine dependence were longitudinally assessed (mean age at study entry 11.3?years, mean age at follow-up 21.1?years) using structured psychiatric interviews and multi-informant questionnaires in a subsample of the Dutch part of the International Multicenter ADHD Genetics study. Individuals with persistent ADHD (n?=?62), remittent ADHD (n?=?12), late-onset ADHD (n?=?18; age of onset after 12?years), unaffected siblings (n?=?50), and healthy controls (n?=?47) were assessed. Hazard ratios (HR) with 95% confidence intervals (CIs) were estimated by Cox regression and adjusted for clustered family data, gender, follow-up length, and current age.Results
Individuals with persistent ADHD were at significantly higher risk of development of SUD relative to healthy controls (HR?=?4.56, CI 1.17-17.81). In contrast, levels of SUD in those with remittent ADHD were not different from healthy controls (HR?=?1.00, CI .07-13.02). ADHD persisters had also higher prevalence rates of nicotine dependence (24.2%) than ADHD remitters (16.7%) and healthy controls (4.3%). A similar pattern was found in initially unaffected siblings who met ADHD criteria at follow-up ("late-onset" ADHD); they had also a higher prevalence of SUD (33%) compared to stable unaffected siblings (20%) and were at significantly increased risk of development of nicotine dependence compared to healthy controls (HR?=?13.04, CI 2.08-81.83).Conclusions
SUD and nicotine dependence are associated with a negative ADHD outcome. Results further emphasize the need for clinicians to comprehensively assess substance use when diagnosing ADHD in adolescents and adults.
SUBMITTER: Ilbegi S
PROVIDER: S-EPMC6307241 | biostudies-literature | 2018 Dec
REPOSITORIES: biostudies-literature
Ilbegi Shahrzad S Groenman Annabeth P AP Schellekens Arnt A Hartman Catharina A CA Hoekstra Pieter J PJ Franke Barbara B Faraone Stephen V SV Rommelse Nanda N J NNJ Buitelaar Jan K JK
Journal of neurodevelopmental disorders 20181227 1
<h4>Background</h4>Attention-deficit/hyperactivity disorder (ADHD) is associated with substance use disorders (SUD; alcohol and/or drug dependence) and nicotine dependence. This study aims to advance our knowledge about the association between SUD, nicotine dependence, and the course of ADHD (persistent versus remittent ADHD and late-onset ADHD).<h4>Methods</h4>ADHD, SUD, and nicotine dependence were longitudinally assessed (mean age at study entry 11.3 years, mean age at follow-up 21.1 years) u ...[more]