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Externalizing disorders and substance use: empirically derived subtypes in a population-based sample of adults

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) are common externalizing disorders of childhood. The common effects of these disorders on substance abuse need further investigation. The current study investigated the joint clusters of childhood/adolescence ADHD, CD, and ODD, and their influence on substance abuse/dependence in a population-based sample of adults.

Methods

The data were drawn from the PsyCoLaus study (n = 3,720) conducted in Lausanne, Switzerland. The population-based sample included 238 subjects meeting criteria for ADHD/ODD/CD diagnoses before the age of 15. Latent class analyses (LCA) were performed to derive comorbidity subtypes, which were subsequently characterized with respect to psychosocial correlates and substance use.

Results

The best fit in LCAs was achieved with three latent classes: an ADHD subtype (35.7 %); an externalizing multimorbid subtype (33.6 %) involving ODD, ADHD, and CD; and a third subtype with CD (30.7 %). The CD subtype showed the highest association with substance use. Apart from this, the externalizing multimorbid subtype was also significantly linked to substance use. The ADHD subtype had only elevated frequencies for alcohol dependence in comparison with subjects that had no history of ADHD, ODD, and CD during childhood or adolescence. Finally, important interactions between subtypes and sex were observed with regard to substance use.

Conclusions

This study provides evidence showing that subtyping the externalizing disorders, ADHD, ODD and CD, along their comorbidity patterns leads to important differences regarding substance use. This could have implications for the etiology, prevention, and treatment of substance use disorders.

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Acknowledgments

The CoLaus/PsyCoLaus study was supported by grants from the Swiss National Science Foundation (105993, 118308, 122661 and 139468) and two grants from GlaxoSmithKline Clinical Genetics.

Conflict of interest

All authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, PO Box 1930, CH-8021, Zurich, Switzerland

    Stephanie Rodgers, Mario Müller, Wulf Rössler & Vladeta Ajdacic-Gross

  2. Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland

    Wulf Rössler

  3. Department of Psychiatry, CHUV, Lausanne, Switzerland

    Enrique Castelao & Martin Preisig

  4. University of Sao Paulo, Institute of Psychiatry, Laboratory of Neuroscience (LIM27), São Paulo, Brazil

    Wulf Rössler

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  1. Stephanie Rodgers
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Correspondence to Stephanie Rodgers.

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Rodgers, S., Müller, M., Rössler, W. et al. Externalizing disorders and substance use: empirically derived subtypes in a population-based sample of adults. Soc Psychiatry Psychiatr Epidemiol 50, 7–17 (2015). https://doi.org/10.1007/s00127-014-0898-9

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  • DOI: https://doi.org/10.1007/s00127-014-0898-9

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