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. 2016 Jun 13;11(6):e0157488.
doi: 10.1371/journal.pone.0157488. eCollection 2016.

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

Kouichi Yoshimasu  1   2 , William J Barbaresi  3 , Robert C Colligan  4 , Robert G Voigt  5 , Amy L Weaver  6 , Slavica K Katusic  1
Affiliations

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

Kouichi Yoshimasu et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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