Conduct disorder symptoms were associated with increased hazards for all subsequent alcohol transitions (HR = 1.19–1.39, p ⩽ 1.30×10−3, pFDR ⩽ 4.12×10−3; online Supplementary Table S1). ADHD hyperactive symptoms were also prospectively associated with increased hazards for all alcohol transitions (HR = 1.16–1.92, p ⩽ 0.014, pFDR ⩽ 0.027; online Supplementary Table S1) except time from initiation to first intoxication (HR = 1.02–1.15, p ⩾ 0.19). ADHD inattentive symptoms were not significantly associated with hazards for any alcohol transition (0.89⩽HR⩽1.05, p ⩾ 0.13). Oppositional defiant disorder symptoms were associated with increased hazards for subsequent alcohol initiation transition to first AUD diagnosis (HR⩾1.24, p ⩽3.80 × 10−3, pFDR = 9.03 × 10−3) but not other transitions (HR = 0.96–1.05, p ⩾ 0.18; Figure 1a; online Supplementary Table S1). Post hoc analyses of AUD severity showed that conduct disorder symptoms were linked with increased hazards of transitioning to moderate and severe AUD, hyperactive ADHD symptoms with transition to mild AUD, and oppositional defiant symptoms with transition to severe AUD (online Supplementary Fig. S1; Supplementary Table S2).
