Role of ADHD in the Co‐Occurrence Between Heavy Alcohol Use and Depression Trajectories in Adulthood

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with greater heavy alcohol use and depressive symptoms in adulthood. Yet, few studies have investigated whether childhood ADHD predicts an increased association between heavy drinking and depression in adulthood when this co-occurrence becomes more common. We examined associations among heavy alcohol use and depression longitudinally from ages 21 to 29 and whether these associations differed for those with or without childhood ADHD, as well as for those with or without persistent ADHD in adulthood. Methods: Data were from the Pittsburgh ADHD Longitudinal Study (PALS), a prospective cohort of children diagnosed with ADHD and demographically similar individuals without ADHD histories. ADHD symptoms in adulthood were self-and parent-reported; depressive symptoms and frequency of drinking five or more drinks in a single drinking occasion were self-reported and measured at five time-points from ages 21-29. Depression and alcohol use were modeled in a multiple-group, parallel process longitudinal growth model. Results: The slopes of heavy alcohol use and depression were significantly and positively associated from ages 25-29 but not at the younger ages. Although the strength of these associations did not differ by group (with or without ADHD, childhood or adulthood), the slopes of depression and heavy drinking at the older ages were highly variable and individuals with ADHD showed significantly faster growth in depression from ages 25-29. Conclusions: Due to the strengthening association between heavy drinking and depression for adults in their late 20s, and increasing depression for adults with ADHD histories, individuals with ADHD may be at greater risk for co-occurring depression and binge drinking. Negative reinforcement-related alcohol use may strengthen as these individuals age toward the fourth decade of life. More rigorous testing of this possibility is warranted.

The relation between ADHD symptoms, perceived stress and binge drinking in college students

“…This hypothesis can be transposed to our own result, with the idea that frequent comorbid psychiatric conditions of inattention symptoms may explain why students with higher levels of inattention were more likely to report binge drinking. Note that a recent longitudinal study (Wang et al, 2019) tends to corroborate this idea, showing a significant association between depression and heavy drinking as well as increasing depression for adults with ADHD histories.…”

Disentangling the Association between ADHD and Alcohol Use Disorder in Individuals Suffering from Bipolar Disorder: A Systematic Review and Meta-Analysis

“…Recent systematic reviews and meta-analyses [ 10 , 11 ] estimated that ADHD might occur in nearly one out of six adults with BD, possibly anticipating its onset by about four years [ 11 ]. It is well known that ADHD itself might be correlated with AUD [ 12 , 13 ]. Previous longitudinal studies have shown that ADHD might have a significant impact on alcohol-related behaviors [ 13 , 14 ].…”

“…It is well known that ADHD itself might be correlated with AUD [ 12 , 13 ]. Previous longitudinal studies have shown that ADHD might have a significant impact on alcohol-related behaviors [ 13 , 14 ]. The high levels of impulsivity and sensation seeking that has been described among individuals with ADHD may significantly increase the risk of AUD [ 15 ].…”

Beers with Peers: Childhood ADHD and Risk for Correlated Change in Perceived Peer and Personal Alcohol Use Across Young Adulthood

“…For instance, adults with versus without ADHD are less likely to be married, report fewer familial connections, have less stable employment, and are less financially independent (Barkley, 2015; Biederman et al, 1993; Hechtman et al, 2016; Klein et al, 2012; Michielsen et al, 2015; Murphy and Barkley, 1996; Pelham III et al, 2020), which may afford relatively more time and opportunity for heavy drinking. These and other factors, such as increasing rates of depression among young adults with ADHD during this time period (Wang et al, 2019) and the manifestation of familial risk for alcoholism (Molina et al, 2016), may contribute to sustained heavy drinking even when their peers begin to decrease their drinking behaviors.…”

“…Factors not examined herein may be important. These include a tightening of the significant association between depression and alcohol use over time for those with ADHD (Wang et al, 2019) and specific facets of impulsivity, including negative and positive urgency (Pedersen et al, 2016). This possibility necessitates longitudinal studies that extend further into adulthood, beyond the 20s, when ADHD‐related risk for alcohol use may more starkly differentiate individuals.…”