Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) are associated with Risk Behaviors (RB) such as substance-related problems, suicidal behaviors and sex risk behaviors. However, some issues remain controversials: is ADHD an independent risk factor for RB? Is CD a confounding factor of the relationship between ADHD and RB?

To assess the link between childhood hyperactivity-inattention symptoms and subsequent RB, controlling for other risk factors among which conduct disorder symptoms.

We have conducted multivariate analyses from a French community-based sample (N = 1107) belonging to the youth GAZEL cohort. The sample was first assessed at ages 4 to 18, and then assessed 8 years later. Child psychopathology and RB patterns were evaluated through parent and adolescent self-reports.

In males, results show an effect of hyperactivity-inattention symptoms on more severe RB such as regular cannabis use, illicit drug experimentation and suicidal behaviors (adjusted OR = 2 to 5, all Ps significants). In females, they show an effect of hyperactivity-inattention symptoms on regular tobacco use (adjusted OR = 2, P < .05). The risk of RB initiation was increased in youths with high levels of conduct disorder symptoms, particularly in combination with simultaneously high levels of hyperactivity-inattention symptoms (adjusted OR = 2, P < .05).

This work enhances the knowledge of a link between disruptive behaviors in childhood and subsequent risk behaviors. It underscores the importance of a better acknowledgement of these disorders, in order to better identify and treat them to prevent negative long-term outcomes.