Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD.

TLDR

Risk for early substance use and abuse in children with ADHD is a concern that warrants further study of mediating mechanisms. The study prospectively monitored 142 children with ADHD into adolescence to evaluate their risk for elevated substance use compared to 100 same‑aged adolescents without ADHD. The study followed 142 children with ADHD and 100 controls prospectively into adolescence to assess substance use risk. Children with ADHD reported higher alcohol, tobacco, and illicit drug use than controls; within the ADHD group, childhood inattention severity and ODD/CD symptoms predicted multiple substance use outcomes, and persistent ADHD and adolescent CD were linked to elevated substance use.

Abstract

Children diagnosed with attention-deficit/hyperactivity disorder (ADHD; n = 142) were prospectively monitored into adolescence (13-18 years old) to evaluate their risk for elevated substance use relative to same-aged adolescents without ADHD (n = 100). Probands reported higher levels of alcohol, tobacco, and illicit drug use than did controls. Group differences were apparent for alcohol symptom scores but not for alcohol or marijuana disorder diagnoses. Within probands, severity of childhood inattention symptoms predicted multiple substance use outcomes: childhood oppositional defiant disorder/conduct disorder (ODD/CD) symptoms predicted illicit drug use and CD symptoms. Persistence of ADHD and adolescent CD were each associated with elevated substance use behaviors relative to controls. Further study of the mediating mechanisms that explain risk for early substance use and abuse in children with ADHD is warranted.