Adult attention-deficit/hyperactivity disorder: Associations between subtype and lifetime substance use - a clinical study.

Michael Liebrenz,Alex Gamma,Dominique Eich,Anna Buadze,Iliyan Ivanov

doi:10.12688/f1000research.6780.1

Michael Liebrenz, Alex Gamma + Show 3 more

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https://doi.org/10.12688/f1000research.6780.1

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Abstract

ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD). Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples.The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

Highlights

Attention-deficit/hyperactivity disorder (ADHD) is a complex neuropsychiatric syndrome that is common in childhood and adolescence, but in adulthood1–4
In order to make a diagnosis of attention-deficit/hyperactivity disorder (ADHD), the two diagnostic manuals, the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders Third Edition Revision (DSM-III-R) and the World Health Organisation’s (WHO) International Statistical Classification of Diseases and Related Health Conditions (ICD-10), require the presence of both inattentive and hyperactive-impulsive symptoms8,9
Total substance use excluding abuse and dependence was clearly lower in drop-outs (23.4% vs. 63.6%, p=.000)

Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a complex neuropsychiatric syndrome that is common in childhood and adolescence, but in adulthood. Attention-deficit/hyperactivity disorder (ADHD) is a complex neuropsychiatric syndrome that is common in childhood and adolescence, but in adulthood1–4 It is characterized by symptoms of inattention (distractibility), hyperactivity, and impulsivity, which all contribute to significant psychosocial impairment in affected individuals of all age groups. In order to make a diagnosis of ADHD, the two diagnostic manuals, the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders Third Edition Revision (DSM-III-R) and the World Health Organisation’s (WHO) International Statistical Classification of Diseases and Related Health Conditions (ICD-10), require the presence of both inattentive and hyperactive-impulsive symptoms. The clinical response to pharmacologic treatment by subtype or symptom clusters was investigated, as were subtype differences in psychosocial functioning, and the rate of comorbidity in different age groups

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