Childhood Disruptive Disorders May Not Lead to Antisocial Personality Disorders in Adults

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Children and adolescents who were diagnosed with disruptive disorders had more than a 3-fold higher rate of MDD and bipolar disorder, and a 5-fold increase in substance use disorders.
Children and adolescents who were diagnosed with disruptive disorders had more than a 3-fold higher rate of MDD and bipolar disorder, and a 5-fold increase in substance use disorders.

Researchers studied 267 children from parents with and without major depression who also had no ASPD or bipolar disorder (BD). These children were followed for more than 33 years, and outcomes were tested through interviews conducted at 1, 2, 10, 20, 25, and 30 years. 

Of the 267 participants interviewed during the first year, 89 were diagnosed with DDs: 70 from depressed parents and 19 from nondepressed parents. Participants with DDs, when compared with those who did not have DDs, were more likely to be male (59.6% vs 39.3%). However, researchers noted no differences in age during the first and final interview, the years between interviews, or the number of interviews. Of the 89 offspring, 65 had conduct disorder (CD) only, 11 had ADHD only, and 13 had both. In adulthood, participants with DDs reported higher rates of attempted suicide and suicidal ideations than those who did not have DDs (27.3% vs 11.2%, P =.07). Global functioning was lower in those with DDs than those who did not have DDs (76 vs 84, P=.001). DDs also did not predict adulthood ASPD.

Researchers concluded that “if there is no familial risk for ASPD, bipolar disorder, or substance use, childhood DDs do not lead to ASPD in adulthood.” However, the prognosis is poor into midlife. Researchers suggest early therapies for children with DDs, especially conduct disorder.

Reference

Diaz AP, Svob C, Zhao R, et al. Adult outcomes of childhood disruptive disorders in offspring of depressed and healthy parentsJ Affect Disorders. 2018;244:107-112.

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