Psychosis in adulthood is associated with high rates of ADHD and CD problems during childhood
Sammanfattning
Background: Patients diagnosed with schizophrenia display poor premorbid adjustment (PPA) in
half of the cases. Attention defi cit/hyperactivity disorder (ADHD) and conduct disorder (CD)
are common child psychiatric disorders. These two facts have not previously been linked in the
literature. Aims: To determine the prevalence of ADHD/CD problems retrospectively among
patients with psychoses, and whether and to what extent the high frequency of substance abuse
problems among such patients may be linked to ADHD/CD problems. Method: ADHD and CD
problems/diagnoses were retrospectively recorded in one forensic ( n 149) and two non-forensic
samples ( n 98 and n 231) of patients with a psychotic illness: schizophrenia, bipolar or
other, excluding drug-induced psychoses. Results: ADHD and CD were much more common
among the patients than in the general population - the odds ratio was estimated to be greater
than 5. There was no signifi cant difference in this respect between forensic and non-forensic
patients. Substance abuse was common, but substantially more common among patients with
premorbid ADHD/CD problems. Conclusions: Previous views regarding PPA among patients
with a psychotic illness may refl ect an association between childhood ADHD/CD and later
psychosis. The nature of this association remains uncertain: two disorders sharing some
generative mechanisms or one disorder with two main clinical manifestations. Childhood ADHD
and particularly CD problems contribute to the high frequency of substance abuse in such
groups.