New research published in the journal Addiction revealed that American youth with conduct and substance use disorders — and their siblings — have a significantly higher risk for premature death than the general population.
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Conduct disorder, a precursor to antisocial personality disorder in adults, refers to behavioral and emotional problems in youth that often results in repetitive aggressive behavior or age-inappropriate violations.
CD can also be associated with conditions like substance use disorder and attention deficit hyperactivity disorder.
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Through the juvenile correctional system, court-mandated substance abuse treatment programs or correctional schools, University of Colorado-Boulder scientists recruited 1,463 youth with conduct or substance use problems, plus 1,399 of their siblings for the Addiction study. The control group included more than 900 youths similar in age and demographic background.
Using mortality data from the National Death Index, the researchers assessed causes of death. More than 4 percent of the study subjects (compared to less than 1 percent of the control subjects) had died after an average follow-up age of 32.7 years. Juveniles with conduct or substance use problems, including their siblings, had fives times higher mortality rates compared to the control group. Boys were nearly three times as likely to die young.
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"American youth who engage in risk behaviors, such as substance abuse and criminal activities, are two to nine times more likely to die prematurely than their general population counterparts," lead author Richard Border said in a statement.
While substance use accounted for the most deaths (32 percent), followed by traffic-related deaths, suicides and assault-related deaths, conduct disorder was deemed a more powerful independent risk factor than substance use, according to the study.
“Although it remains unclear which domains comprise the most pressing target for intervention and prevention efforts...it is clear that youth identified with conduct problems are at extreme risk for premature mortality and in critical need of greater resources,” researchers concluded, urging future studies to examine the independent contributions of substance abuse disorders and conduct disorders to premature mortality through measures of socioeconomic status.
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Some limitations of the study include:
- The ambiguity of determining whether some causes of death are substance-related versus suicides
- Lack of a comprehensive measure of socioeconomic status
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