Mediating and Moderating Role of Depression, Conduct Disorder or Attention-Deficit/Hyperactivity Disorder in Developing Adolescent Substance Use Disorders: A Population-Based Study.
Mediating and Moderating Role of Depression, Conduct Disorder or Attention-Deficit/Hyperactivity Disorder in Developing Adolescent Substance Use Disorders: A Population-Based Study.
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DOI：
10.1371/journal.pone.0157488
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Katusic SK
中科院分区：
文献类型：
--
作者：
Yoshimasu K;Barbaresi WJ;Colligan RC;Voigt RG;Weaver AL;Katusic SK
在一个基于人群的出生队列中，评估常见内化/外化障碍对ADHD和青少年物质使用障碍（SUD）之间关联的中介/调节作用。在出生队列的5718名儿童中，确定了343例ADHD事件病例和712例匹配对照。19岁之前的精神病诊断被归类为DSM-IV类别。总结了ADHD和SUD之间的相关性（风险比（HR），95% CI）。分别对抑郁、CD/ODD、焦虑进行疗效评定。ADHD和每种精神疾病的联合效应评估不支持这些疾病对SUD的加性量表的调节作用。然而，ADHD和SUD之间的关联部分解释了这些精神疾病的中介作用。对于临床医生，我们的研究结果强调，抑郁症（或CD/ODD）比单独的ADHD带来更大的SUD风险。无论是否患有ADHD，早期发现/治疗青少年抑郁症（或CD/ODD）的SUD都至关重要。
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. 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. 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. 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.