Evidence map›Paper›PMID 37431766›Full record

ArticleActa psychiatrica Scandinavica2023

Attention deficit hyperactivity and oppositional defiant disorder symptoms in adolescence and risk of substance use disorders-A general population-based birth cohort study.

Antti Mustonen, Alina Rodriguez, James G Scott, Miika Vuori, Tuula Hurtig, Anu-Helmi Halt, Jouko Miettunen, Anni-Emilia Alakokkare, Solja Niemelä

Open access · hybridAbstract read
In one paragraph

Article in Acta psychiatrica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Exploring Transdiagnostic Mechanisms of Youth Externalizing Psychopathology: A Longitudinal Person-Centered Approach.Clinical psychological science : a journal of the Association for Psychological Science · 2026
    Article
  4. Article
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Antti MustonenFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0002-3259-2122
Alina RodriguezDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.
James G ScottChild Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.ORCID 0000-0002-0744-0688
Miika VuoriResearch Center for Child Psychiatry, INVEST Research Flagship, University of Turku, Turku, Finland.
Tuula HurtigResearch Unit of Clinical Medicine, Psychiatry, University of Oulu, Oulu, Finland.
Anu-Helmi HaltResearch Unit of Clinical Medicine, Psychiatry, University of Oulu, Oulu, Finland.
Jouko MiettunenResearch Unit of Population Health, University of Oulu, Oulu, Finland.
Anni-Emilia AlakokkareResearch Unit of Population Health, University of Oulu, Oulu, Finland.
Solja NiemeläDepartment of Psychiatry, University of Turku, Turku, Finland.
Oulu University Hospital · FIUniversity of Turku · FIQueen Mary University of London · GBTampere University · FIThe University of Queensland · AUUniversity of Oulu · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExternalizing symptoms are associated with risk of future substance use disorder (SUD). Few longitudinal studies exist using general population-based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms. AIMS/

objectivesWe aimed to study the associations between adolescent ADHD symptoms and subsequent SUD and additionally examine whether the risk of SUD is influenced by comorbid oppositional defiant disorder (ODD) symptoms.

methodsThe Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33 years (n = 6278, 49.5% male). ADHD/ODD-case status at age 16 years was defined using parent-rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut-off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD/ODD case status. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD/ODD case statuses and subsequent SUD.

resultsIn all, 552 participants (8.8%) presented with ADHD case status at the age of 16 years, and 154/6278 (2.5%) were diagnosed with SUD during the follow-up. ADHD case status was associated with SUD during the follow-up (HR = 3.84, 95% CI 2.69-5.50). After adjustments for sex, family structure, and parental psychiatric disorder and early substance use the association with ADHD case status and SUD remained statistically significant (HR = 2.60, 95% CI 1.70-3.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms.

conclusionsADHD in adolescence was associated with incident SUD in those with and without symptoms of ODD. The association of ADHD and SUD persisted even after adjustment for a wide range of potential confounds. This emphasizes the need to identify preventative strategies for adolescents with ADHD so as to improve health outcomes.

Indexed as

Attention Deficit Disorder with HyperactivitySubstance-Related DisordersAdolescentAdultAttention Deficit and Disruptive Behavior DisordersBirth CohortCohort StudiesComorbidityFemaleHumansMaleADHDadolescentbirth cohortODDSWAN

Identifiers

PMID37431766
PMCPMC10953420
OpenAlexW4383872111

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.