The role of CD and depression in the development of addiction in youngsters with ADHD

抄録

Many epidemiologic and clinical studies have shown that attention-deficit/hyperactivity disorder (ADHD) is strongly associated with an increased risk of substance use disorder (SUD). The relationship between ADHD and SUD is discussed sometimes in the context of adolescents' delinquency or crimes. Conduct disorder (CD), one of the typical externalizing psychiatric disorders, plays an important role on leading ADHD patients to SUD. On the other hand, dysfunction of the brain reward system inherent in ADHD patients makes them have no confidence in themselves, which lead them to depressive disorder, one of the typical internalizing disorders. In such case, ADHD patients are likely to indulge in substance to relieve their depressive or anxiety symptoms, sometimes resulting in SUD. In sum, CD and depression play a mediating role to lead ADHD patients to SUD, while the direct association between CD or depression and SUD is much stronger than ADHD. Once ADHD is comorbid with SUD, patients suffering from both ADHD and SUD often confront catastrophic crisis such as suicide or homicide. Because ADHD is characterized by inattentiveness and impulsivity, any kinds of substances, regardless of legal or illegal, can deteriorate ADHD symptoms, leading ADHD patients to such catastrophic events. Some epidemiological evidence showed that ADHD patients with comorbid SUD suffered from synergistically increased risk of suicide. From a view point of suicide prevention, CD or mood disorders, as mediating factors from ADHD to SUD, should be carefully monitored and treated among ADHD patients.