VU University Amsterdam, Department of Clinical Neuropsychology, Amsterdam, the Netherlands.
Addiction. 2013 Aug;108(8):1503-11. doi: 10.1111/add.12188. Epub 2013 Apr 22.
To examine the relationship between a childhood diagnosis of attention deficit hyperactivity disorder (ADHD) with or without oppositional defiant disorder (ODD)/conduct disorder (CD) and the development of later alcohol/drug use disorder [psychoactive substance use disorder (PSUD)] and nicotine dependence in a large European sample of ADHD probands, their siblings and healthy control subjects.
PARTICIPANTS, DESIGN AND SETTING: Subjects (n = 1017) were participants in the Belgian, Dutch and German part of the International Multicenter ADHD Genetics (IMAGE) study. IMAGE families were identified through ADHD probands aged 5-17 years attending out-patient clinics, and control subjects from the same geographic areas. After a follow-up period (mean: 4.4 years) this subsample was re-assessed at a mean age of 16.4 years.
PSUD and nicotine dependence were assessed using the Diagnostic Interview Schedule for Children, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test and Fagerström test for Nicotine Dependence.
The ADHD sample was at higher risk of developing PSUD [hazard ratio (HR) = 1.77, 95% confidence interval (CI) = 1.05-3.00] and nicotine dependence (HR = 8.61, 95% CI = 2.44-30.34) than healthy controls. The rates of these disorders were highest for ADHD youth who also had CD, but could not be accounted for by this comorbidity. We did not find an increased risk of developing PSUD (HR = 1.18, 95% CI = 0.62-2.27) or nicotine dependence (HR = 1.89, 95% CI = 0.46-7.77) among unaffected siblings of ADHD youth.
A childhood diagnosis of attention deficit hyperactivity disorder is a risk factor for psychoactive substance use disorder and nicotine dependence in adolescence and comorbid conduct disorder, but not oppositional defiant disorder, further increases the risk of developing psychoactive substance use disorder and nicotine dependence.
在一个大型欧洲 ADHD 先证者、其兄弟姐妹和健康对照受试者的样本中，研究儿童期注意力缺陷多动障碍（ADHD）伴有或不伴有对立违抗性障碍（ODD）/品行障碍（CD）的诊断与后来的酒精/药物使用障碍[精神活性物质使用障碍（PSUD）]和尼古丁依赖的发展之间的关系。
参与者、设计和设置：受试者（n=1017）为参加比利时、荷兰和德国部分国际多中心 ADHD 遗传学（IMAGE）研究的 ADHD 先证者。IMAGE 家族是通过 5-17 岁就诊于门诊的 ADHD 先证者以及来自同一地理区域的健康对照者确定的。在随访期（平均：4.4 年）后，该亚样本在平均年龄 16.4 岁时重新评估。
使用儿童诊断访谈表、酒精使用障碍识别测试、药物滥用筛查测试和尼古丁依赖 Fagerström 测试评估 PSUD 和尼古丁依赖。
ADHD 样本发生 PSUD 的风险更高[危险比（HR）=1.77，95%置信区间（CI）=1.05-3.00]和尼古丁依赖（HR=8.61，95%CI=2.44-30.34）比健康对照组。这些疾病的发生率在 ADHD 青少年中最高，他们也患有 CD，但这种共病并不能解释这些疾病。我们没有发现 ADHD 青少年未受影响的兄弟姐妹发生 PSUD（HR=1.18，95%CI=0.62-2.27）或尼古丁依赖（HR=1.89，95%CI=0.46-7.77）的风险增加。
儿童期注意力缺陷多动障碍的诊断是青少年时期精神活性物质使用障碍和尼古丁依赖的危险因素，共患品行障碍而非对立违抗性障碍进一步增加了精神活性物质使用障碍和尼古丁依赖的风险。
