Adult Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder: A Systematic Review of the Literature

Anja Plemenitaš Ilješ

doi:10.5772/intechopen.93799

Abstract

Attention-deficit and hyperactivity disorder (ADHD) often presents with comorbid substance use disorder (SUD). The extant literature on the comorbidity of adult ADHD and SUD was summarized on the etiology, prevalence, diagnosis, and treatment. ADHD is diagnosed in 15–20% of SUD patients, mostly as ADHD with a combined presentation. ADHD and SUD are believed to have shared pathophysiology. ADHD is associated with the majority of dependence diagnoses. A most used screening questionnaire for screening ADHD patients presenting with SUD is the Adult ADHD Self-report Scale (ARSR). Evidence on pharmacological treatment is limited, but new trials support the use of long-acting stimulants as also recommended with a combination of psychotherapy by expert opinion. Given the prevalence of both ADHD and SUD, more research is needed to understand the theoretical and clinical implications of this comorbidity.

Highlights

Attention-deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent symptoms of inattention and/or hyperactivityimpulsivity
The aim of this study is to summarize extant scientific literature concerning the comorbidity of ADHD and substance use disorder (SUD) on the etiology, prevalence, diagnosis, and treatment
A most used screening questionnaire for screening ADHD patients presenting with SUD is the ADHD Self-Report Scale (ASRS) followed by in-depth diagnostic assessment [10]

Summary

Introduction

Attention-deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent symptoms of inattention and/or hyperactivityimpulsivity. There are three subtypes of ADHD, marked by predominantly inattentive symptoms, or by hyperactivity and impulsiveness, either a combination of inattentiveness and hyperactivity [1]. Studies suggest that the prevalence of ADHD among children may be as high as 15.5%, with approximately 20% of cases persisting into adulthood [2, 3]. A lower prevalence of ADHD in adults compared with children is consistent with the age-dependent decline of the disorder, which has been confirmed in a meta-analysis [4]. ADHD is diagnosed twice as often in boys as in girls. Boys with ADHD tend to present with more impulsivity, while girls with ADHD tend to have more inattentiveness [5]

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