Antecedents of opioid dependence and personality disorder: attention-deficit/hyperactivity disorder and conduct disorder

Both attention-deficit/hyperactivity disorder (ADHD) and conduct disorder ( CD) were explored as possible antecedents of opioid dependence and personal ity disorder. One hundred adult opioid-dependent, treatment-seeking male in patients were explored; an extended clinical semistructured interview to co llect sociodemographic, drug use related, and clinical data and the Structu red Clinical Interview for DSM-IV personality disorders SCID-II were carrie d out. Four groups of patients, namely ADHD alone (4 patients), ADHD + CD ( 7 patients), CD alone (47 patients) and no ADHD/no CD (42 patients) were id entified and compared with each other. The results indicate that ADHD alone does not predispose to the development of opioid dependence in male inpati ents. Childhood ADHD may nevertheless be found more frequently in male opio id addicts due to its comorbidity with CD, which was identified in more tha n half of our sample. Patients with ADHD history seemed to go through the d rug abuse career earlier and to develop more frequently histrionic and obse ssive-compulsive personality disorder. Over half of the CD patients develop ed borderline and/or antisocial personality disorder; both ADHD and CD pred ispose significantly to the PD development. Early substance use preventive measures are necessary in children and adolescents suffering from CD and fr om ADHD comorbid with CD.