Home > Independent predictors of mortality in adolescents ascertained for conduct disorder and substance use problems, their siblings and community controls.

Border, Richard and Corley, Robin P and Brown, Sandra A and Hewitt, John K and Hopfer, Christian J and McWilliams, Shannon K and Rhea, Sally Ann and Shriver, Christen L and Stallings, Michael C and Wall, Tamara L and Woodward, Kerri E and Rhee, Soo Hyun . (2018) Independent predictors of mortality in adolescents ascertained for conduct disorder and substance use problems, their siblings and community controls. Addiction, 113 (11)

URL: https://onlinelibrary.wiley.com/doi/full/10.1111/a...

BACKGROUND AND AIMS: Adolescents with conduct and substance use problems are at increased risk for premature mortality, but the extent to which these risk factors reflect family- or individual-level differences and account for shared or unique variance is unknown. This study examined common and independent contributions to mortality hazard in adolescents ascertained for conduct disorder (CD) and substance use disorder (SUD), their siblings and community controls, hypothesizing that individual differences in CD and SUD severity would explain unique variation in mortality risk beyond that due to clinical/control status and demographic factors.

DESIGN: Mortality analysis in a prospective study (Genetics of Antisocial Drug Dependence Study) that began in 1993. Multi-site sample recruited in San Diego, California and Denver, Colorado, USA.

PARTICIPANTS: A total of 1463 clinical probands were recruited through the juvenile correctional system, court-mandated substance abuse treatment programs and correctional schools, along with 1399 of their siblings, and 904 controls.

MEASUREMENTS: Mortality and cause-of-death were assessed via National Death Index search (released October, 2017).

FINDINGS: There were 104 deaths documented among 3766 (1168 female) adolescents and young adults (average age 16.79 years at assessment, 32.69 years at death/censoring). Mortality hazard for clinical probands and their siblings was 4.99 times greater than that of controls (95% confidence interval = 2.40-10.40; P < 0.001). After accounting for demographic characteristics, site, clinical status, familial dependence and shared contributions of CD and SUD, CD independently predicted mortality hazard, whereas SUD severity did not.

CONCLUSIONS: In the United States, youth with conduct and substance use disorders and their siblings face far greater risk of premature death than demographically similar community controls. In contrast to substance use disorder severity, conduct disorder is a robust predictor of unique variance in all-cause mortality hazard beyond other risk factors.

Item Type:Evidence resource
Drug Type:Alcohol or other drugs in general
Intervention Type:AOD disorder, AOD disorder harm reduction
Subjects:F Concepts in psychology > Emotion (anxiety, emotional pain)
F Concepts in psychology > Attitude and behaviour
F Concepts in psychology > Specific attitude and behaviour > risk-taking behaviour
J Health care, prevention and rehabilitation > Risk and protective factors > Risk factors
L Social psychology and related concepts > Marital relations > Family and kinship > Family structure > Family support
P Demography, epidemiology, and history > Population dynamics > Substance related mortality / death
T Demographic characteristics > Adolescent / youth (teenager / young person)
VA Geographic area > United States

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