The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2
Open accessAbstract
Background Much is unclear about the association between attention-deficit/hyperactivity disorder (ADHD) and alcohol use (disorder). Research on this subject is hindered by the role of conduct disorder (CD). We investigate whether (1) childhood ADHD is associated with higher prevalence and earlier onset of alcohol initiation, regular alcohol use and alcohol use disorder (AUD) (2) CD mediates or modifies this association. Methods Data were derived from the baseline assessment of the Netherlands Mental Health Survey and Incidence Study-2, a general population study. ADHD and CD were assessed among respondents aged 18-44 (n=3309). ADHD, CD, and alcohol use (disorder) were assessed using the Composite International Diagnostic Interview 3.0. Results Lifetime prevalence was 2.9% for ADHD, 5.6% for CD, 94.3% for alcohol initiation, 85.7% for regular alcohol use and 19.0% for AUD; mean ages of onset were 6.7, 11.5, 14.8, 16.7 and 19.2 years, respectively. After correction for gender and age, ADHD was associated with a higher prevalence of all three stages of alcohol use, but not with earlier onset of these stages. The association between ADHD and prevalence of AUD was fully explained by a mediating role of CD. CD did not modify the associations between ADHD and prevalence and onset of alcohol use (disorder). Conclusions The mediating role of CD in the association between ADHD and AUD suggests a developmental pathway from ADHD to CD and subsequent AUD. Early interventions in children with ADHD may prevent CD and subsequent onset of AUD.
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Individuals with remitted ADHD have the same significantly elevated risk of some subsequent secondary disorders, such as alcohol use disorder, as those with active ADHD.
“Our retrospective finding that individuals with remitted ADHD have the same significantly elevated risk of some subsequent secondary disorders such as alcohol use disorder as those with active ADHD”
From The descriptive epidemiology of DSM-IV adult ADHD in the world health organization world mental health surveys (2017) · cites this paper as Tuithof et al. 2012
Section 3.1 reports that respondents with ADHD had a significantly elevated risk of developing alcohol use disorder before adjustment for conduct disorder. The paper does not compare remitted with active ADHD, so it cannot support the claim that their risks are the same. It also reports that the ADHD–alcohol use disorder association was no longer significant after adjustment for conduct disorder. Page numbers were not available in our copy. (LLM, conf=0.88)
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- Authors
- Tuithof, M., ten Have, M., van den Brink, W., Vollebergh, W., & de Graaf, R.
- Affiliations
- Trimbos Institute (NL)
- Utrecht University (NL)
- Corresponding author
- Tuithof, Marlous
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 123
- Issue
- 1-3
- Pages
- 115-121
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2037086099
- Cited by
- 36
- References
- 8
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 7 · 2013: 3 · 2012: 2
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, conduct disorder, alcoholism, alcohol initiation, mediation, developmental pathways, age of onset, childhood ADHD
- MeSH terms
- Adolescent, Age Factors, Alcoholism, Attention Deficit Disorder with Hyperactivity, Female, Health Surveys, Humans, Male, Netherlands, Regression Analysis, Age of Onset, Conduct Disorder, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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