Adolescents with conduct disorder and substance use problems are five times more likely to die prematurely than their peers, with roughly one in 20 dying by their 30s, according to a study.
The research, published in the journal Addiction, suggests that while drug and alcohol use among adolescents draws more attention, antisocial behaviour - including rule-breaking tendencies - may be a more powerful predictor of early mortality.
"This research makes it clear that youth identified with conduct problems are at extreme risk for premature mortality, beyond that which can be explained by substance use problems, and in critical need of greater resources," said Richard Border, a graduate student at the University of Colorado Boulder in the US.
Researchers looked at death rates among 1,463 adolescents who had been arrested or referred to counselling for substance use problems or "conduct disorder."