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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EAttention deficit hyperactivity disorder (ADHD) and associated comorbidities are known to be risk factors for substance abuse in adolescence and young adulthood, but few studies have examined the early childhood risk factors that may predispose to this behavior. In a 10-year follow-up of children with ADHD, the occurrence of substance use disorder was increased compared with controls, especially among ADHD youth with early conduct disorder.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPersonality Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESubstance-Related Disorders Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EChild \u0026amp; Adolescent Neurodevelopmental Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EADHD and associated comorbidities are known to be risk factors for substance abuse in adolescence and young adulthood, but few studies have examined the early childhood risk factors that may predispose to this behavior. In a 10-year follow-up of children with attention deficit hyperactivity disorder (ADHD), the occurrence of substance use disorder (SUD) was increased compared with controls, especially among ADHD youth with early conduct disorder, according to a study from by Timothy E. Wilens, MD, Massachusetts General Hospital and Harvard Medical School, Boston, MA.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003E\u201cWe hypothesized that early delinquency and academic or cognitive dysfunction will predict later SUD in two cohorts of ADHD children, followed for an average of 10 years. We examined early predictors for later SUD,\u201d said Dr. Wilens.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe study compared 257 youths with ADHD to 225 youths without ADHD. All subjects were aged 6 to 17 years at baseline and were followed for approximately 10 years. Study subjects were assessed in a blinded manner using DSM-IV Schedule for Affective Disorders and Schizophrenia for School-Aged Children, epidemiological edition (KSADS-E), or Structured Clinical Interview for DSM Disorders (SCID), cognitive measures, Family and Environmental Scale (FES), and Social Adjustment Inventory for Children and Adolescents (SAICA) rating scales. Psychopathology and SUD were determined by structured interview.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAt baseline, the subjects had a mean age of 11 years, and 50% of the study population was male. Most were Caucasian from middle-class families. The subjects and controls were similar except that ADHD subjects were significantly more likely to have a parental history of alcohol use disorders (p\u0026lt;0.001) and drug use disorders (p=0.003).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EInvestigators found that children with ADHD were 1.5 times more likely to develop a SUD compared with controls. Within ADHD, comorbid oppositional defiant disorder and conduct disorder were significant predictors of any SUD, after adjusting for gender (hazard ratio [HR], 2.31; p\u0026lt;0.001) and parental history of SUD (HR, 3.0; p\u0026lt;0.001).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EWithin the population of ADHD youths who developed drug use disorders, comorbid major depressive disorder was a further significant predictor, essentially doubling the risk (p=0.006). Analysis showed that boys who received extra help in school were approximately half as likely to develop a SUD (p=0.02).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003E\u201cIn general, gender did not predict risk for SUD, and we found no significant associations between baseline cognitive or academic dysfunction and later SUD in our ADHD youth,\u201d Dr. Wilens said. \u201cNo significant results were found for social or family environment factors, cognitive factors, or any school functioning factors.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003E\u201cDr. Wilens and colleagues showed that there are children with ADHD that are at risk for substance abuse, but most of them have a diagnosis of conduct disorder, which translates into juvenile delinquency later. Many ADHD children want to be good. For the child with conduct disorder, \u2018being good\u2019 is not a priority. This work says that ADHD plus conduct disorder equals a very serious problem,\u201d commented R. Scott Benson, MD, APA Council on Communications.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EThe study suggests that the vast majority of ADHD children will not abuse drugs later, but if a child has more severe, oppositional behavior, that child may be at risk of developing serious substance abuse issues. The challenge for psychiatrists is to find ways to treat these comorbidities.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/4\/12.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmsc1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}