By Charnicia E. Huggins
NEW YORK, Dec 20 (Reuters Health) - People diagnosed with behavior problems during their early elementary school years may have a higher risk of becoming dependent on alcohol during adolescence, new study results suggest.
"Certain behavior problems in childhood such as conduct disorder, whose symptoms are best characterized by violation of societal rules along with being aggressive, may increase the risk of developing significant problems with adolescent alcohol use," Dr. Samuel Kuperman, of the University of Iowa Hospitals and Clinics, told Reuters Health.
Using data from an ongoing study on the genetics of alcoholism, Kuperman and his colleagues investigated the relationship between behavior problems and later alcohol dependence in 54 teenagers.
Nearly three quarters of the teens, all of whom had been diagnosed with alcohol dependence at age 14, had been diagnosed earlier in life with conduct disorder, attention-deficit/hyperactivity disorder (ADHD) or both, Kuperman and his colleagues report in the December issue of the American Journal of Psychiatry.
ADHD was diagnosed an average of 8 years before alcohol dependence, while conduct disorder was diagnosed about 6 years previously, on average.
Among teenagers with both conduct disorder and alcohol dependence, "there appeared to be a chronological progression," the authors state.
These youth developed conduct disorder at about age 8, according to Kuperman. Approximately 4 years later, they used alcohol for the first time, then tobacco, followed by marijuana one year later. Shortly after that, the teens began exhibiting signs of alcohol dependence and using other street drugs, the researchers found.
"The implication may be that successful treatment of children at any point in this progression may help reduce the risk for problematic drinking as these children become adolescents," Kuperman said.
All but one of the teenagers reported using at least one other substance in addition to alcohol, such as tobacco or marijuana, and 24 adolescents reported using street drugs as well, the report indicates.
In almost 9 out of 10 cases, alcohol use preceded marijuana use among the adolescents who reported using both substances. Among the 25 teens who reported using street drugs in addition to alcohol, alcohol use occurred about 2 years before street drug use.
"While it would be easy to assume that conduct disorder causes all later symptoms, the only statement that can be substantiated is that there is a relationship among all these behavior problems," Kuperman said. "It is not clear what causes this sequence to be started and more research needs to be done to determine whether this is related to familial, school, societal, or genetic predispositions or to a combination of all these factors."
The study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism.
SOURCE: American Journal of Psychiatry 2001;158:2022-2026.