Childhood ADHD and Risk for Substance Dependence in Adulthood: A Longitudinal, Population-Based Study

Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role. Objective: This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood. Method Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender. Results: A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49–138.88) and drug (adjusted OR 3.48, 95% CI 1.38–8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence. Conclusions: Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex

Anesthesia and Cognitive Performance in Children: No Evidence for a Causal Relationship. Are The Conclusions Justified By The Data?

CALL FOR ESSAYS for a volume on Asian Religions for a series titled Women and Religion in the World. This set explores the experiences of women and how their daily lives interface with a dynamic aspect of life and culture, that of religion. The design of this multi-volume, interdisciplinary work depicts a representation of contemporary selected experiences of women in six categories: Judaism, Christianity, Islam, Asian Religions, Indigenous Religions, and New Religions. The themes of (1) Woma..

Direct Medical Costs of Constipation From Childhood to Early Adulthood: A Population-based Birth Cohort Study

Although direct medical costs for constipation-related medical visits are thought to be high, to date there have been no studies examining if longitudinal resource utilization is persistently elevated in children with constipation. Our aim was to estimate the incremental direct medical costs and types of health care utilization associated with constipation from childhood to early adulthood

The Incidence of Clinically Diagnosed Versus Research-Identified Autism in Olmsted County, Minnesota, 1976-1997: Results From a Retrospective, Population-Based Study

Autism prevalence studies have often relied on administrative prevalence or clinical diagnosis as case-identification strategies. We report the incidence of clinical diagnoses of autism spectrum disorders (ASD), versus research-identified autism among residents of Olmsted County, Minnesota, age =21 years, from 1976-1997. The incidence of clinically diagnosed ASD (with 95% CI) was 1.5 per 100,000 (0.0-3.7) in 1980-1983 and 33.1 (22.8-43.3) in 1995-1997, a 22.1-fold increase. In contrast, the incidence of research-identified autism increased from 5.5 (1.4-9.5) per 100,000 to 44.9 (32.9-56.9), an 8.2-fold increase. Only 46.8% of research-identified cases received a clinical diagnosis of ASD. These findings demonstrate the potential for misleading interpretation of results from epidemiologic studies that rely on clinical diagnosis of autism to identify cases

Mediating and Moderating Role of Depression, Conduct Disorder or Attention-Deficit/Hyperactivity Disorder in Developing Adolescent Substance Use Disorders: A Population-Based Study.

OBJECTIVE:To evaluate the mediating/moderating effects of common internalizing /externalizing disorders on the association between ADHD and adolescent substance use disorders (SUD) in a population-based birth cohort. METHODS:Among 5718 children in the birth cohort, 343 ADHD incident cases and 712 matched controls were identified. Psychiatric diagnoses prior to age 19 were classified into DSM-IV categories. The association between ADHD and SUD was summarized (hazard ratios (HR), 95% CI). The effect of depression, CD/ODD, anxiety was evaluated separately. RESULTS:Assessment of the joint effects of ADHD and each psychiatric disorder did not support a moderating effect of these disorders on SUD on additive scale. However, the association between ADHD and SUD was partially explained by a mediating role of these psychiatric disorders. CONCLUSION:For clinicians our results emphasize that depression (or CD/ODD) confers greater risk for SUD than ADHD alone. Early detection/treatment of SUD among adolescents with depression (or CD/ODD) is crucial regardless of ADHD

Predicting Developmental Outcomes for Premature Infants: Neurobiologic Risk Score Versus Neurodevelopmental Risk Examination at Neonatal Intensive Care Unit Discharge

Prematurity is associated with poor neurodevelopmental outcomes, and laws mandate the provision of early intervention services to those infants with disability. However, it is often difficult to identify early which infants would benefit most from these services. The Neurobiologic Risk Score (NBRS) and the Neurodevelopmental Risk Exam (NRE) are instruments used to assess infants at near-term corrected age. These instruments have been shown to correlate with later developmental outcomes. However, the environment of the neonatal intensive care unit (NICU) has changed since the NBRS and NRE were first validated, and it is not known whether they are still able to accurately predict future developmental outcomes. The objective of this study was therefore to examine the ability of the NBRS and NRE, both alone and in combination with socio-economic variables, to predict future developmental outcomes in the contemporary NICU. The subjects were 219 neonates of less than 32 weeks\u27 gestational age discharged from the NICU between November 2001 and December 2006 who had undergone both the NBRS and NRE. Infants were assessed at chronological age 6, 12 and 24 months, with developmental quotients being assigned at these ages. Parental socio-economic data were also collected and analysed. The hypothesis was that the NBRS and NRE would be less effective at predicting neurodevelopmental outcomes in the contemporary NICU. The best measure of future developmental outcome is likely to need to include both neurobiological and socio-economic risk factors

Evaluation of the role of anxiety on the association between ADHD and SUD.

<p>Evaluation of the role of anxiety on the association between ADHD and SUD.</p