Adult outcomes of childhood disruptive disorders in offspring of depressed and healthy parents.
Adolescent
Adult
Antisocial Personality Disorder
/ epidemiology
Bipolar Disorder
/ epidemiology
Case-Control Studies
Child
Child of Impaired Parents
/ psychology
Conduct Disorder
/ epidemiology
Depressive Disorder, Major
/ epidemiology
Disruptive, Impulse Control, and Conduct Disorders
/ epidemiology
Female
Humans
Male
Odds Ratio
Substance-Related Disorders
/ epidemiology
Young Adult
Antisocial personality disorder
Attention deficit hyperactivity disorder
Conduct disorder
Disruptive disorders
Externalizing disorder
Longitudinal studies
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 02 2019
01 02 2019
Historique:
received:
13
08
2018
revised:
03
10
2018
accepted:
05
10
2018
pubmed:
20
10
2018
medline:
26
3
2019
entrez:
20
10
2018
Statut:
ppublish
Résumé
Longitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders. Offspring (N = 267) of parents with or without major depression (MDD), but no ASPD or bipolar disorders were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested. Eighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AOR = 3.42, p < 0.0001), bipolar disorder (AOR = 3.10, p = 0.03), and substance use disorders (AOR = 5.69, p < 0.0001) by age 18, as well as poorer school performance and global functioning. DDs continued to predict MDD and substance use outcomes in adulthood, even after accounting for presence of the corresponding disorder in childhood (MDD: hazards ratio, HR = 3.25, p < 0.0001; SUD, HR = 2.52, p < 0.0001). Associations were similar among the offspring of parents with and without major depression. DDs did not predict adulthood ASPD in either group. Associations are largely accounted for by conduct disorder (CD), as there were few offspring with ADHD, and oppositional defiant disorder (ODD) was not diagnosed at the time this study began. If there is no familial risk for ASPD, bipolar disorder or substance use, childhood DDs do not lead to ASPD in adulthood; however, the children still have poorer prognosis into midlife. Early treatment of children with DD, particularly CD, while carefully considering familial risk for these disorders, may help mitigate later adversity.
Sections du résumé
BACKGROUND
Longitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders.
METHOD
Offspring (N = 267) of parents with or without major depression (MDD), but no ASPD or bipolar disorders were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested.
RESULTS
Eighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AOR = 3.42, p < 0.0001), bipolar disorder (AOR = 3.10, p = 0.03), and substance use disorders (AOR = 5.69, p < 0.0001) by age 18, as well as poorer school performance and global functioning. DDs continued to predict MDD and substance use outcomes in adulthood, even after accounting for presence of the corresponding disorder in childhood (MDD: hazards ratio, HR = 3.25, p < 0.0001; SUD, HR = 2.52, p < 0.0001). Associations were similar among the offspring of parents with and without major depression. DDs did not predict adulthood ASPD in either group.
LIMITATIONS
Associations are largely accounted for by conduct disorder (CD), as there were few offspring with ADHD, and oppositional defiant disorder (ODD) was not diagnosed at the time this study began.
CONCLUSION
If there is no familial risk for ASPD, bipolar disorder or substance use, childhood DDs do not lead to ASPD in adulthood; however, the children still have poorer prognosis into midlife. Early treatment of children with DD, particularly CD, while carefully considering familial risk for these disorders, may help mitigate later adversity.
Identifiants
pubmed: 30340098
pii: S0165-0327(18)31782-8
doi: 10.1016/j.jad.2018.10.086
pmc: PMC6434691
mid: NIHMS1011565
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
107-112Subventions
Organisme : NIMH NIH HHS
ID : R01 MH036197
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH114967
Pays : United States
Informations de copyright
Copyright © 2018. Published by Elsevier B.V.
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