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Few longitudinal studies exist using general population\u2010based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims\/Objectives<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33\u2009years (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096278, 49.5% male). ADHD\/ODD\u2010case status at age 16\u2009years was defined using parent\u2010rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut\u2010off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD\/ODD case status. Cox\u2010regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD\/ODD case statuses and subsequent SUD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In all, 552 participants (8.8%) presented with ADHD case status at the age of 16\u2009years, and 154\/6278 (2.5%) were diagnosed with SUD during the follow\u2010up. ADHD case status was associated with SUD during the follow\u2010up (HR\u2009=\u20093.84, 95% CI 2.69\u20135.50). 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\u2009=\u20092.60, 95% CI 1.70\u20133.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ADHD 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13588","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T06:23:27Z","timestamp":1689056607000},"page":"277-287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Attention deficit hyperactivity and oppositional defiant disorder symptoms in adolescence and risk of substance use disorders\u2014A general population\u2010based birth cohort study"],"prefix":"10.1111","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3259-2122","authenticated-orcid":false,"given":"Antti","family":"Mustonen","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Psychiatry Sein\u00e4joki Central Hospital  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for Child Psychiatry, INVEST Research Flagship University of Turku  Turku Finland"},{"name":"The Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuula","family":"Hurtig","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Medicine, Psychiatry University of Oulu  Oulu Finland"},{"name":"Clinic of Child Psychiatry Oulu University Hospital  Oulu Finland"},{"name":"Medical Research Center Oulu Oulu University Hospital and University of Oulu  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu\u2010Helmi","family":"Halt","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Medicine, Psychiatry University of Oulu  Oulu Finland"},{"name":"Medical Research Center Oulu Oulu University Hospital and University of Oulu  Oulu Finland"},{"name":"Department of Psychiatry Oulu University Hospital  Oulu 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