Am J Psychiatry 1992; 149:761-767
Copyright © 1992 by American Psychiatric Association
Predicting substance use in late adolescence: results from the Ontario Child Health Study follow-up
MH Boyle, DR Offord, YA Racine, P Szatmari, JE Fleming and PS Links
Department of Psychiatry, McMaster University, Hamilton, Ont., Canada.
OBJECTIVE: The purpose of this study was to evaluate the relationship
between use of tobacco, alcohol, marijuana, and hard drugs (substance use)
and psychiatric disorder in early adolescence and substance use in late
adolescence. METHOD: Adolescents included in the study were identified by
means of a household sampling frame and participated in the Ontario Child
Health Study in 1983 and the follow-up in 1987. There were 726
12-16-year-olds (369 boys and 357 girls) in 1983 who had complete
information in 1987. Data on substance use were collected from adolescents
by using a structured, self-administered questionnaire. Data on psychiatric
disorder were collected in 1983 from both adolescents and their parents by
using problem checklists to assess conduct disorder, attention deficit
disorder, and emotional disorder. RESULTS: Prior substance use in 1983 was
associated strongly with subsequent use in 1987. Among the psychiatric
disorders assessed in 1983, only conduct disorder made an independent
contribution to predicting use of marijuana (relative odds = 3.46) and
other hard drugs (relative odds = 6.82) in 1987, after prior use of these
substances and coexisting attention deficit and emotional disorders were
controlled. Corresponding estimates of attributable risk (the expected
contribution of exposure to conduct disorder to the development of
substance use) were 5.7% and 11.1%, respectively. CONCLUSIONS: Although a
statistically significant relationship existed between conduct disorder in
early adolescence and use of marijuana and hard drugs in late adolescence,
the potential is limited for preventing substance use in the general
population by treating conduct disorder early on.
