Is ADHD a risk factor independent of conduct disorder for illicit substance use? A meta-analysis and metaregression investigation

J Atten Disord. 2013 Aug;17(6):459-69. doi: 10.1177/1087054711435362. Epub 2012 Feb 17.

Abstract

Objective: To investigate meta-analytically if the association between ADHD and illicit substance use (ISU) is maintained when controlling for conduct disorder/oppositional-defiant disorder (CD/ODD).

Method: A systematic literature review was conducted through Medline from 1980 to 2008. Data extracted and selections made by one author were reviewed by another.

Results: Fifteen articles presented odds ratios (ORs) for the development of ISU in individuals with ADHD controlling for CD/ODD. In total, the study covered results for more than 1,000 individuals. The combined OR for studies that included in their analysis exclusively ISU was 1.35 (0.90-2.03), p = .15, heterogeneity = 55%. Lack of control for socioeconomic status was related with a weaker association between ADHD and ISU.

Conclusion: The existing data do not indicate that ADHD increases the risk of ISU beyond the effects of CD/ODD. However, the combination of all existing data is limited in power to detect a small increase in chance.

Keywords: ADHD; comorbidity; conduct disorder; drug; substance.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Comorbidity
  • Conduct Disorder / epidemiology*
  • Humans
  • Odds Ratio
  • Regression Analysis
  • Risk Factors
  • Substance-Related Disorders / epidemiology*