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Predictors, clinical characteristics, and outcome of conduct disorder in girls with attention-deficit/hyperactivity disorder: a longitudinal study

Published online by Cambridge University Press:  24 April 2007

MICHAEL C. MONUTEAUX ,
STEPHEN V. FARAONE ,
LARA MICHELLE GROSS  and
JOSEPH BIEDERMAN
MICHAEL C. MONUTEAUX*
Affiliation:
The Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
STEPHEN V. FARAONE
Affiliation:
Departments of Psychiatry and Neuroscience & Physiology, SUNY Upstate Medical University, USA
LARA MICHELLE GROSS
Affiliation:
The Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
JOSEPH BIEDERMAN
Affiliation:
The Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: Michael C. Monuteaux, Sc.D., Pediatric Psychopharmacology Program, 55 Fruit Street, Warren 705, Boston MA 02114, USA. (Email: [email protected])
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Abstract

Background

Research on the overlap between attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) in males has provided useful information on the etiology, correlates, course, and nosology of this co-morbid condition. However, it is unclear how these results extend to females. Our aim was to examine the predictors, clinical characteristics, and functional outcome of CD in a sample of female youth with and without ADHD.

Method

We conducted a blind, 5-year prospective longitudinal study of girls with (n=140) and without (n=122) ADHD, aged 6–18 years at baseline. At the 5-year follow-up, 123 (88%) and 112 (92%) of the ADHD and control children respectively were reassessed at a mean age of 16·7 years. Psychiatric disorders were assessed using blind structured diagnostic interviews.

Results

Baseline ADHD was a significant risk factor for lifetime CD throughout childhood and adolescence [hazard ratio (HR) 5·8, 95% confidence interval (CI) 2·9–11·5, p<0·001]. Among ADHD girls, childhood-onset (<12 years) CD was predicted by paternal antisocial personality disorder (ASPD), while adolescent-onset CD (⩾12 years) was predicted by family conflict. In addition, lifetime CD significantly predicted academic, psychiatric and sexual behavior problems in girls with ADHD at follow-up.

Conclusions

ADHD is a significant risk factor for CD in girls. CD is associated with increased risk for academic, psychiatric and sexual behavior problems compared to ADHD girls without CD. Given that the therapeutic approaches indicated by ADHD and CD differ, these findings highlight the importance of improved efforts aimed at early identification and treatment of CD in girls with ADHD.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 12 , December 2007 , pp. 1731 - 1741
Copyright
Copyright © Cambridge University Press 2007

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