Prevalence of undiagnosed and untreated attention deficit hyperactivity disorder in men with alcohol dependence – A case-control study

Sushruth V,Bheemsain Tekalaki,Sandeep Patil,N Patil,Sameeran Chate

doi:10.12740/app/80833

Abstract

Aim of the studyTo compare the prevalence of adult attention deficit hyperactivity disorder (ADHD) among male alcohol users.Subject or material and methodsThe current case-control study included 50 male patients with alcohol abuse and 50 age-matched healthy controls. Clinical Institute Withdrawal Assessment of Alcohol Scale-Revised, severity of alcohol dependence questionnaire, alcohol use disorders identification test, Mini-International Neuropsychiatric Interview Scale, adult ADHD self-report scale version 1.1 screener, diagnostic and statistical manual of mental disorders criteria for adult ADHD, and ADHD-rating scale-IV were used to assess the patients. The data obtained were analyzed using EPIINFO 7 and compared using paired t-test, student’s t-test, and Pearson’s chi-square test (P ≤ 0.05).ResultsThe prevalence of undiagnosed ADHD was significantly higher in alcohol abuse cases when compared to healthy controls (31 vs. 4; P < 0.0001). The most common (16) subtype of ADHD in alcohol abuse cases was the hyperactive/impulsive type, whereas in controls, it was the inattentive type (3). The severity of alcohol dependence was moderate in alcohol abuse cases with adult ADHD (25), whereas mild dependence was observed in cases without adult ADHD (9). The SAD-Q (34.46 ± 7.70 vs. 32.12 ± 10.17) and AUDIT-C (31.34 ± 3.63 vs. 29.23 ± 5.43) scores were higher in cases with adult ADHD as compared to cases without ADHD.DiscussionA significant association between alcohol abuse and the prevalence of ADHD was observed. The majority of the patients were young adults indicating that alcohol abuse with or without ADHD tends to commence early in life.ConclusionsPatients diagnosed with alcohol abuse should be screened frequently and treated for ADHD.

Highlights

Attention deficit hyperactive disorder (ADHD) is a common childhood disorder that persists into adulthood in two-thirds of cases
Patients diagnosed with alcohol misuse should be screened frequently and treated for ADHD
Based on the ASRS-v 1.1 screener, all patients with adult ADHD in the case group (N=31) and in the control group (N=4) were reported to have six of the major ADHD symptoms: difficulty wrapping up final details of a project once the challenging parts have been completed, difficulty in arranging things in order in tasks requiring organization, problems in remembering obligations and appointments, avoiding tasks requiring a lot of thought, fidgeting or squirming when asked to wait, and feeling overactive and almost compelled to do things, as if driven by a motor

Summary

Introduction

Attention deficit hyperactive disorder (ADHD) is a common childhood disorder that persists into adulthood in two-thirds of cases. Prevalence of undiagnosed and untreated attention deficit hyperactivity disorder in men common and impairing comorbidity of an undiagnosed ADHD in adults is substance use disorder (SUD) [1]. There is a high prevalence of alcohol and other drug misuse in adults with undiagnosed ADHD [2]. 11–35% of adults with substance misuse have been found to have ADHD [1,3,4,5]. The prevalence of ADHD in adults with alcohol misuse is as high as 17– 45% [6]. ADHD manifests with the core symptoms of hyperactivity, impulsivity, and inattention [7,8], the presentation of these symptoms in adults may be different and include chaotic lifestyles, poor time management, lack of motivation, stress, reduced concentration, and impulsive behavior [9]

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