Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Research Report Eur Addict Res 2012;18:253–264 DOI: 10.1159/000337328 Risk of Mental Disorders in Children of Parents with Alcohol or Heroin Dependence: A Controlled High-Risk Study Sonia I. Vidal a, b Caroline Vandeleur a, b Stéphane Rothen a, b Mehdi Gholam-Rezaee b Enrique Castelao b Olivier Halfon b Jean-Michel Aubry a François Ferrero a Martin Preisig b a Department of Mental Health and Psychiatry, University Hospital of Geneva, Geneva, and b Department of Psychiatry, University Hospital Center and University of Lausanne, Prilly, Switzerland Introduction Excessive alcohol and illicit drug use are major public health issues. Indeed, they are associated with severe medical complications, disruption of life course, loss of productivity, and delinquency [1–8]. The familial aggre- gation of alcohol use disorders has been demonstrated by a large number of studies using alcoholic probands from both treatment and community settings [9–18]. Although there are fewer studies on the familiality of drug use dis- orders, the existing family studies also support familial aggregation of these disorders [19–21]. Therefore, the children of alcohol- and drug-dependent parents repre- sent a population at risk for mental health problems and social malfunctioning. The study of offspring of parents with psychoactive substance dependence (‘high-risk de- sign’) is a potent strategy to assess the impact of these parental psychopathologies on early psychiatric manifes- tations of their children [22]. The better understanding of the problems these youth experience is essential in order to promote primary and secondary prevention. During the last two decades, twelve controlled studies of the minor offspring (in the age range between 6 and 18 years) of parents with DSM-IV alcohol or illicit drug dependence have been conducted using standardized Key Words Psychopathology  High-risk offspring  Co-parent  Substance use disorders Abstract Aim: To assess the specific effect of alcohol dependence (AD) or heroin dependence (HD) in patients and their spous- es on the risk of psychopathology in their 276 6.0- to 17.9- year-old children (mean 11.3 years). Methods: The sample included 101 offspring of patients with AD, 23 of patients with HD, and 152 of medical controls, as well as their 2 par- ents. Participants were assessed using semistructured diag- nostic interviews and family history reports by psychologists blind to patient diagnoses. Results: Children of HD and AD patients had largely elevated rates of recurrent major de- pressive disorder. Children of HD patients were also at an increased risk for attention deficit hyperactivity disorder and substance use disorders (SUD). There were interactions be- tween SUD in the 2 parents to increase the risk of SUD in off- spring. Conclusions: These results emphasize the need for prompt identification and treatment of these children and highlight the need to pay clinical attention not only to the patient, but also to the co-parent in order to optimize pre- vention in offspring. Copyright © 2012 S. Karger AG, Basel Received: October 31, 2011 Accepted: February 16, 2012 Published online: June 9, 2012 E u r o pea n Addi cti o n c R e e s ar h Sonia Vidal Department of Psychiatry University Hospital of Lausanne, Site de Cery CH–1008 Prilly (Switzerland) Tel. +41 21 643 6608, E-Mail sonia.vidal  @  chuv.ch © 2012 S. Karger AG, Basel 1022–6877/12/0185–0253$38.00/0 Accessible online at: www.karger.com/ear