Estimating the causal effect of conduct disorder on the time from first substance use to substance use disorders using g-estimation.

Journal Article (Journal Article)

BACKGROUND: The effect of conduct disorder (CD) as a major risk factor of substance use disorder (SUD), controlling for other psychiatric problems, has been well established in the literature. However, other psychiatric problems are associated as confounders with an increased risk of SUD. When confounding exists, the use of the standard survival analysis approach would lead to a biased estimate of the effect of a time-varying exposure on the time to event. METHODS: The authors used a G-estimation approach to estimate the causal effect of CD while controlling for time-varying confounders. RESULTS: The present study (N = 1420) found a substantial difference in the estimated hazard ratio of CD (4.49 vs. 1.93) when the results from G-estimation and Cox regression were compared. CONCLUSIONS: G-estimation fixed the problem of underestimating the hazard ratio of conduct disorder (CD) while controlling for all measured covariates.

Full Text

Duke Authors

Cited Authors

  • Sung, M; Erkanli, A; Costello, EJ

Published Date

  • 2014

Published In

Volume / Issue

  • 35 / 2

Start / End Page

  • 141 - 146

PubMed ID

  • 24821350

Pubmed Central ID

  • PMC4284820

Electronic International Standard Serial Number (EISSN)

  • 1547-0164

Digital Object Identifier (DOI)

  • 10.1080/08897077.2013.816651


  • eng

Conference Location

  • United States