Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis

A.P. Groenman -, T.W.P. Janssen, J. Oosterlaan

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objective To assess the prospective risk of developing substance-related disorders after childhood mental health disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD] or conduct disorder [CD], anxiety disorder, and depression) using meta-analysis. Method PubMed, Embase, and PsycInfo were searched for relevant longitudinal studies that described childhood (<18 years old) ADHD, ODD or CD, anxiety, or depression in relation to later alcohol-, nicotine-, or drug-related disorders or substance use disorders (SUDs) published in peer-reviewed journals in the English language from 1986 to May 2016. Two researchers conducted all review stages. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Results Thirty-seven studies including more than 762,187 participants were identified for quantitative analyses. These studies included 22,029 participants with ADHD, 434 participants with ODD or CD, 1,433 participants with anxiety disorder, and 2,451 participants with depression. Ninety-seven effects sizes were extracted for analyses. Meta-analysis showed a significantly increased risk for addiction in ADHD (n = 23, odds ratio [OR] 2.27, 95% CI 1.98–3.67; OR alcohol 2.15, 95% CI 1.56–2.97; OR drugs 1.52, 95% CI 1.52–5.27; OR nicotine 2.52, 95% CI 2.01–3.15; OR SUDs 2.61, 95% CI 1.77–3.84), ODD or CD (n = 8, OR 3.18, 95% CI 1.97–5.80; OR alcohol 1.73, 95% CI 1.51–2.00; OR drugs 4.24, 95% CI 1.3.21.5.59; OR nicotine 4.22, 95% CI 3.21–5.55; OR SUDs 4.86, 95% CI 3.09–7.56), and depression (n = 13, OR 2.03, 95% CI 1.47–2.81; OR alcohol 1.10, 95% CI 1.02–1.19; OR nicotine 2.56, 95% CI 1.89–3.48; OR SUDs 2.20, 95% CI 1.41–3.43), but not for anxiety disorders (n = 15, OR 1.34, 95% CI 0.90–1.55, not significant). Conclusion Childhood ADHD, ODD, CD, and depression increase the risk of developing substance-related disorders. Anxiety disorders do not seem to increase the risk for future substance-related disorders, although the findings are highly heterogeneous. These findings emphasize the need for early detection and intervention to prevent debilitating substance-related disorders in later life.
Original languageEnglish
Pages (from-to)556-569
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume56
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017

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Substance-Related Disorders
Psychiatry
Meta-Analysis
Odds Ratio
Attention Deficit and Disruptive Behavior Disorders
Conduct Disorder
Attention Deficit Disorder with Hyperactivity
Anxiety Disorders
Nicotine
Depression
Alcohols
Mental Disorders
Pharmaceutical Preparations
Observational Studies
Longitudinal Studies
Mental Health
Epidemiology
Language
Anxiety
Research Personnel

Cite this

@article{f2524bb5555d4322aac7a1ce254d9704,
title = "Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis",
abstract = "Objective To assess the prospective risk of developing substance-related disorders after childhood mental health disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD] or conduct disorder [CD], anxiety disorder, and depression) using meta-analysis. Method PubMed, Embase, and PsycInfo were searched for relevant longitudinal studies that described childhood (<18 years old) ADHD, ODD or CD, anxiety, or depression in relation to later alcohol-, nicotine-, or drug-related disorders or substance use disorders (SUDs) published in peer-reviewed journals in the English language from 1986 to May 2016. Two researchers conducted all review stages. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Results Thirty-seven studies including more than 762,187 participants were identified for quantitative analyses. These studies included 22,029 participants with ADHD, 434 participants with ODD or CD, 1,433 participants with anxiety disorder, and 2,451 participants with depression. Ninety-seven effects sizes were extracted for analyses. Meta-analysis showed a significantly increased risk for addiction in ADHD (n = 23, odds ratio [OR] 2.27, 95{\%} CI 1.98–3.67; OR alcohol 2.15, 95{\%} CI 1.56–2.97; OR drugs 1.52, 95{\%} CI 1.52–5.27; OR nicotine 2.52, 95{\%} CI 2.01–3.15; OR SUDs 2.61, 95{\%} CI 1.77–3.84), ODD or CD (n = 8, OR 3.18, 95{\%} CI 1.97–5.80; OR alcohol 1.73, 95{\%} CI 1.51–2.00; OR drugs 4.24, 95{\%} CI 1.3.21.5.59; OR nicotine 4.22, 95{\%} CI 3.21–5.55; OR SUDs 4.86, 95{\%} CI 3.09–7.56), and depression (n = 13, OR 2.03, 95{\%} CI 1.47–2.81; OR alcohol 1.10, 95{\%} CI 1.02–1.19; OR nicotine 2.56, 95{\%} CI 1.89–3.48; OR SUDs 2.20, 95{\%} CI 1.41–3.43), but not for anxiety disorders (n = 15, OR 1.34, 95{\%} CI 0.90–1.55, not significant). Conclusion Childhood ADHD, ODD, CD, and depression increase the risk of developing substance-related disorders. Anxiety disorders do not seem to increase the risk for future substance-related disorders, although the findings are highly heterogeneous. These findings emphasize the need for early detection and intervention to prevent debilitating substance-related disorders in later life.",
author = "{Groenman -}, A.P. and T.W.P. Janssen and J. Oosterlaan",
year = "2017",
month = "7",
day = "1",
doi = "10.1016/j.jaac.2017.05.004",
language = "English",
volume = "56",
pages = "556--569",
journal = "Journal of the American Academy of Child and Adolescent Psychiatry",
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number = "7",

}

Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis. / Groenman -, A.P.; Janssen, T.W.P.; Oosterlaan, J.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 56, No. 7, 01.07.2017, p. 556-569.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis

AU - Groenman -, A.P.

AU - Janssen, T.W.P.

AU - Oosterlaan, J.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective To assess the prospective risk of developing substance-related disorders after childhood mental health disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD] or conduct disorder [CD], anxiety disorder, and depression) using meta-analysis. Method PubMed, Embase, and PsycInfo were searched for relevant longitudinal studies that described childhood (<18 years old) ADHD, ODD or CD, anxiety, or depression in relation to later alcohol-, nicotine-, or drug-related disorders or substance use disorders (SUDs) published in peer-reviewed journals in the English language from 1986 to May 2016. Two researchers conducted all review stages. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Results Thirty-seven studies including more than 762,187 participants were identified for quantitative analyses. These studies included 22,029 participants with ADHD, 434 participants with ODD or CD, 1,433 participants with anxiety disorder, and 2,451 participants with depression. Ninety-seven effects sizes were extracted for analyses. Meta-analysis showed a significantly increased risk for addiction in ADHD (n = 23, odds ratio [OR] 2.27, 95% CI 1.98–3.67; OR alcohol 2.15, 95% CI 1.56–2.97; OR drugs 1.52, 95% CI 1.52–5.27; OR nicotine 2.52, 95% CI 2.01–3.15; OR SUDs 2.61, 95% CI 1.77–3.84), ODD or CD (n = 8, OR 3.18, 95% CI 1.97–5.80; OR alcohol 1.73, 95% CI 1.51–2.00; OR drugs 4.24, 95% CI 1.3.21.5.59; OR nicotine 4.22, 95% CI 3.21–5.55; OR SUDs 4.86, 95% CI 3.09–7.56), and depression (n = 13, OR 2.03, 95% CI 1.47–2.81; OR alcohol 1.10, 95% CI 1.02–1.19; OR nicotine 2.56, 95% CI 1.89–3.48; OR SUDs 2.20, 95% CI 1.41–3.43), but not for anxiety disorders (n = 15, OR 1.34, 95% CI 0.90–1.55, not significant). Conclusion Childhood ADHD, ODD, CD, and depression increase the risk of developing substance-related disorders. Anxiety disorders do not seem to increase the risk for future substance-related disorders, although the findings are highly heterogeneous. These findings emphasize the need for early detection and intervention to prevent debilitating substance-related disorders in later life.

AB - Objective To assess the prospective risk of developing substance-related disorders after childhood mental health disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD] or conduct disorder [CD], anxiety disorder, and depression) using meta-analysis. Method PubMed, Embase, and PsycInfo were searched for relevant longitudinal studies that described childhood (<18 years old) ADHD, ODD or CD, anxiety, or depression in relation to later alcohol-, nicotine-, or drug-related disorders or substance use disorders (SUDs) published in peer-reviewed journals in the English language from 1986 to May 2016. Two researchers conducted all review stages. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Results Thirty-seven studies including more than 762,187 participants were identified for quantitative analyses. These studies included 22,029 participants with ADHD, 434 participants with ODD or CD, 1,433 participants with anxiety disorder, and 2,451 participants with depression. Ninety-seven effects sizes were extracted for analyses. Meta-analysis showed a significantly increased risk for addiction in ADHD (n = 23, odds ratio [OR] 2.27, 95% CI 1.98–3.67; OR alcohol 2.15, 95% CI 1.56–2.97; OR drugs 1.52, 95% CI 1.52–5.27; OR nicotine 2.52, 95% CI 2.01–3.15; OR SUDs 2.61, 95% CI 1.77–3.84), ODD or CD (n = 8, OR 3.18, 95% CI 1.97–5.80; OR alcohol 1.73, 95% CI 1.51–2.00; OR drugs 4.24, 95% CI 1.3.21.5.59; OR nicotine 4.22, 95% CI 3.21–5.55; OR SUDs 4.86, 95% CI 3.09–7.56), and depression (n = 13, OR 2.03, 95% CI 1.47–2.81; OR alcohol 1.10, 95% CI 1.02–1.19; OR nicotine 2.56, 95% CI 1.89–3.48; OR SUDs 2.20, 95% CI 1.41–3.43), but not for anxiety disorders (n = 15, OR 1.34, 95% CI 0.90–1.55, not significant). Conclusion Childhood ADHD, ODD, CD, and depression increase the risk of developing substance-related disorders. Anxiety disorders do not seem to increase the risk for future substance-related disorders, although the findings are highly heterogeneous. These findings emphasize the need for early detection and intervention to prevent debilitating substance-related disorders in later life.

U2 - 10.1016/j.jaac.2017.05.004

DO - 10.1016/j.jaac.2017.05.004

M3 - Article

VL - 56

SP - 556

EP - 569

JO - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

SN - 0890-8567

IS - 7

ER -