ADHD In Patients Research Articles

Attention Deficit Hyperactivity Disorder and Sexual Functioning - is there a connection?

Understanding how ADHD affects sexual functioning is key to providing comprehensive care. This review looks into the current research on sexual health in people with ADHD, focusing on how common sexual dysfunction is, how ADHD symptoms might impact sexual behavior, and what role medications play. By summarizing the existing studies, this review aims to highlight what we don’t know yet and suggest future research to improve treatment and patient outcomes. The review covers literature related to sexual functioning in ADHD, particularly looking at connections to hypersexuality, paraphilias, and various sexual behaviors. A thorough search of electronic databases, including PubMed, PsycINFO, and Google Scholar, was conducted using relevant keywords such as 'ADHD,' 'hypersexuality,' 'paraphilias,' 'sexuality,' 'sexual behavior,' and 'sexual violence.' The study duration was 6 months. Common features of ADHD, such as impulsivity, poor impulse control, and difficulties with self-regulation, may contribute to risky sexual behaviors, compulsive sexual behavior, or the development of paraphilic interests. It's important for doctors dealing with ADHD in children to discuss sexual health as the patient nears adolescence and offer guidance on safe sex. Treatment should combine medication with therapy. Since impulsivity seems to play a big role in risky sexual behavior, making contraceptives readily available could be important for sexual health. Longitudinal studies are necessary to better understand the temporal relationships and progression of sexual behaviors and ADHD symptoms over time. Given the potential impact of ADHD on sexual behavior and functioning, healthcare providers should consider screening for ADHD in patients presenting with issues related to hypersexuality, paraphilias, or other sexual concerns.

A Post-Hoc Analysis of Emotional Lability With Delayed-Release/Extended-Release Methylphenidate in Children Aged 6 to 12 Years of Age Participating in Two Phase 3 Clinical Trials

Objective: DR/ER-MPH (formerly HLD200) is an evening-dosed delayed-release and extended-release methylphenidate approved for the treatment of ADHD in patients ≥6 years. Post hoc analyses of two pivotal Phase 3 trials: HLD200-107 (NCT02493777) and HLD200-108 (NCT02520388) evaluated emotional lability (EL) with DR/ER-MPH treatment. Methods: Differences in Conners Global Index—Parent (CGI-P) EL subscale scores and age- and gender-adjusted T-scores over an open-label titration phase (HLD200-107) and between treatment and placebo groups at endpoint (HLD200-108) were evaluated. Results: In HLD200-107 (N = 117) mean CGI-P EL subscale scores improved from 5.3 to 1.3 (p < .0001) after 6 weeks; in HLD200-108 significant improvements were observed in the treatment group (n = 81) versus placebo (n = 80; 3.11 vs. 4.08; p = .0053). T-scores showed an improvement with DR/ER-MPH treatment in both trials. Few emotional adverse events (AEs) were reported. Conclusion: DR/ER-MPH treatment resulted in statistically significant improvements in EL to the level of non-ADHD peers as contextualized by T-scores.

ADHD in Adults: Does Age at Diagnosis Matter?

Objective: To provide additional information about clinical features associated with adult ADHD in patients diagnosed in childhood compared to those first diagnosed in adulthood. Method: We stratified a sample of adults with ADHD into patients diagnosed in childhood versus adulthood and compared demographic and clinical characteristics. Results: We found similar clinical features in adults diagnosed in childhood and adults diagnosed in adulthood. Among those diagnosed in adulthood, 95% reported symptom onset in youth. Our results do not support the hypothesis that ADHD diagnosed in adulthood is due to misinterpreting symptoms of other disorders as ADHD. They also suggest incorporating behavioral signs of executive dysfunction into diagnostic criteria for ADHD in adults may increase diagnostic sensitivity. Conclusion: These results support the validity of ADHD diagnoses in adulthood, as these adults show similar clinical profiles to those diagnosed in youth. Our results also suggest that if adult-onset ADHD exists, it is rare.

Clinical characterization of coexisting ADHD symptoms in a sample of adults with cyclothymia: A preliminary observational study

BackgroundCyclothymia seems to be often associated with coexisting ADHD symptoms, although this comorbidity is understudied. Emotional dysregulation is a core symptom of both conditions. MethodsAdult subjects with cyclothymia were consecutively enrolled at the outpatient service of the Second Psychiatry Unit of the Pisa University Hospital (Italy). Screening for ADHD was performed using the Adult ADHD Self-Report Scale (ASRS). We analyzed differences in sociodemographic and clinical characteristics between subjects with and without ADHD symptomatology. ResultsOf the total sample of 107 subjects, 43 % screened positive for ADHD. ADHD+ subjects were significantly younger than ADHD- subjects, had a lower level of education, a higher prevalence of psychiatric comorbidity, and a more frequent family history for ADHD and alcohol use disorder. In addition, ADHD+ subjects scored higher than ADHD- subjects on the affective instability, negative emotionality, and emotional impulsivity subscales of the RIPoSt-40 questionnaire, as well as on the 40‐item version of Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-40) total score. They also showed a stronger association with the cyclothymic and depressive subscales of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-M) scale. Limitationsthe small sample size, the cross-sectional nature of the study, the use of self-report questionnaires, and the use of a screening test to assess comorbidity with ADHD symptomatology. ConclusionsADHD symptomatology is very common in cyclothymic individuals, and emotional dysregulation blurs the diagnostic boundaries between the two disorders. Several clinical features suggest the need for systematic evaluation of ADHD in patients with cyclothymic disorder.

3.7 Prevalence and Risk Factors for the Development of ADHD in Patients with Childhood Trauma

ADHD is the most common mental health disorder among children. We aim to investigate incidence, characteristics, and risk factors for ADHD in patients diagnosed with childhood trauma (CT) using Cerner Health Facts, a national longitudinal database representing approximately 69 million patients.

Adult attention-deficit hyperactivity disorder among patients with substance use disorders

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a childhood neurodevelopmental disorder that persists into adulthood. ADHD is a well-known risk factor for substance use disorder (SUD). However, the actual contribution of comorbidity is largely unknown. The current study investigated the prevalence of ADHD in a sample of abstinent patients compared to healthy controls.Compared to 51 healthy controls, 51 patients seeking medical treatment for SUD were abstinent from any substance for at least 1 month, interviewed by the use of the ICD-10 symptom checklist, the Social Classification Scale, the Addiction Severity Index, Conners adult ADHD Rating Scales Self-Report (CAARS-S:L), and the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL).ResultsUsing CAARS-S:L, the ADHD index showed that 9 subjects (17.6%) were diagnosed with adult ADHD. Using K-SADS-PL, 8 of the participants (15.7%) were found to have an adult ADHD diagnosis. Lower scores of the ADHD index are related to increased patients’ age, while increased scores of the ADHD index are related to more alcohol-related problems of the patients. The strongest predicting factors of increased ADHD index were drug problems and legal status.ConclusionsThe current study provides evidence of an increased diagnosis of adult ADHD in patients with substance use disorder, regardless of the type of substance abuse.

Diferencias atencionales entre el trastorno por déficit de atención aislado y asociado a neurofibromatosis tipo 1

IntroductionThe incidence of ADHD in patients with NF1 reaches 60%. Beyond the published literature on cognitive aspects in subjects with NF1, some studies suggest that the attentional profile of patients with NF1+ADHD is different from those with isolated ADHD. MethodsA retrospective, analytical case-control study with the objective of comparing the intellectual and attentional profile in children with NF1+ADHD, NF1 and isolated ADHD in order to characterise them, noting similarities and differences. ResultsNeuropsychological evaluations from 2017 to 2021 were reviewed for all subjects with a diagnosis of NF1 (n=46) with IQ>70 and ADHD (n=180). In the ANOVA test, it was observed that patients with NF1+ADHD presented with greater visuospatial impairment (M=84.66; F(2,210)=7.84; P<0.001; η2=0.07) and a lower total intellectual level (M=84.20; F(2,223)=4.35; P=0.01; η2=0.04). In the attentional tests they showed more errors of omission (M=72.66; F(2,223)=18.13; P<.001; η2=0.14) and of commission (M=57.87; F(2,223)=4.68; P=0.01; η2=0.04) and lower reaction speed (M=66.58; F(2,223)=19.24; P<0.001; η2=0.15) compared to patients with NF1 and isolated ADHD. ConclusionsAttention deficit in patients with NF1 is associated with lower performance in intellectual functioning and greater visuospatial impairment. The attentional pattern of patients with NF1+ADHD was different from those with isolated ADHD; the difference being not only quantitative but also qualitative, supporting the hypothesis that attention impairment has its own features of NF1 and independent of ADHD.

ADHD prevalence in patients with hypersexuality and paraphilic disorders: a systematic review and meta-analysis.

Hypersexuality and paraphilic disorders have been associated with increased ADHD in several studies. To determine the prevalence of ADHD in hypersexuality and paraphilic disorders. Three databases (Medline, Web of Science and Google Scholar) were explored. Using random effects models, we calculated the pooled estimate of ADHD prevalence. The leave-1-out method and subgroup analyses were carried out to identify sources of heterogeneity. Seven studies from three countries (N = 730 patients with hypersexuality) were included (including five US studies). The overall estimate of the prevalence of ADHD in patients with hypersexuality or paraphilic disorders was 22.6% (95% interval: 17-29.4) with high heterogeneity (I2 = 63%). No publication bias was observed according to Egger's test. We found no significant difference in ADHD prevalence between the following subgroups: hypersexuality vs. paraphilic disorders, studies exploring the history of childhood ADHD vs. adult ADHD, US studies vs. others. The French study was a source of heterogeneity with a much lower rate than others (4.5%) but did not significantly change the prevalence estimate. Removing this study increases the prevalence to 25%. We found no association between the year of publication and ADHD prevalence. ADHD is much more frequent in populations with hypersexuality or paraphilic disorders compared to the general population. It should be systematically screened. The subgroup analyses were not sufficient to identify all sources of heterogeneity, other sources should be explored in further studies.

ATTENTION DEFICIT HYPERACTIVITY DISORDER SYMPTOMS IN ADULTS WITH ESSENTIAL TREMOR

Background: Essential tremor is the most common movement disorder. İn this disease, which is characterized by tremor that increases with action and passes at rest, different accompanying symptoms can also be seen. Objective: The purpose of this study was to investigate attention deficit hyperactivity symptoms in adults with ET. Methods: Fifty six essential tremor patients and 56 controls were included in the study. Patients were recruited from outpatient clinic at Kirikkale University Medicine Faculty. An informed consent form was signed by each patient after detailed information. Institutional ethics committee approval was obtained. Patients’ characteristics such as education level, gender, age and disease duration were recorded. Symptoms of ADHD in patients and controls were determined by using the Adult Report Deficit / Hyperactivity Disorder Self Report Scale. Short Form-36 and Hospital Anxiety and Depression Scale were also performed. Essential tremor severity was determined by using the Whiget essential tremor scale. Results: Essential tremor patients had significantly higher rate of Adult Attention Disorder Self-Report Scale Deficit/Hyperactivity scores compared to controls. Scores of Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale were associated with depression and anxiety scores and physical and mental component scores of Short Form-36 in bivariate analyses. There was a positive correlation between tremor severity and ASRS scores( ASRS A scores= 17,3±5,5, p=0,032, ASRS B scores= 27,7±6,7,p=0,043, ASRS T scores= 45±12,2, p=0,017) however there was no significant statistical relationship between the duration of disease and ASRS scores. Conclusion: This study showed that ADHD symptoms can be observed in adult essential tremor patients and this may be associated with increased psychosocial morbidity and lowered quality of life in ET patients.

Risk factors and diagnostic significance of the N-terminal pro-brain natriuretic peptide as a marker in patients with acute decompensated heart failure and diabetic kidney disease

Aim. To assess the risk factors and diagnostic significance of the N-terminal probrain natriuretic peptide (NT-proBNP) in patients with acute decompensated heart failure (ADHF) and diabetic kidney disease (DKD).Material and methods. A total of 125 patients with ADHF and type 2 diabetes (T2D) were examined. They were divided into 2 groups depending on the presence/ absence of chronic kidney disease (CKD). The first group consisted of 43 (34,4%) patients with DKD, the second — 82 (65,6%) without CKD. The inclusion criterion was the presence of ADHF and T2D. There were following exclusion criteria: cardiogenic shock, pulmonary edema, acute thromboembolic events, type 1 diabetes, prediabetes, acute coronary syndrome, stroke, prior transient ischemic attack (&lt;1 month old), dissecting aneurysm or aortic dissection, acute valvular disorders, major surgery (&lt;1 month old), cardiac trauma, infective endocarditis, acute hepatitis and cirrhosis, terminal CKD, alcohol abuse, non-cardiac edema, cancer, dementia and mental disorders.Results. With the development of a hypertensive crisis and an increase in diastolic blood pressure &gt;100 mm Hg, the odds ratio (OR) and the relative risk (RR) of ADHF in patients with DKD increases by 5,1 and 4,5 times, 2,5 and 1,8 times, respectively. In the presence of grade III-V premature ventricular contractions, OR and RR of ADHF in patients with DKD were 2,6 and 1,9, respectively. OR and RR of ADHD in patients with DKD and prior stroke or transient ischemic attack were 3,8 and 3,2, respectively. Verification of anemia at a hemoglobin level of 5 mmol/l, the OR of ADHF in patients with DKD increases by 3,7 times, the OR — by 2,3 times. The NT-proBNP &gt;1289 pg/ml is diagnostic for verifying ADHF in DKD patients with the sensitivity of 64,3% and specificity of 93,3%.Conclusion. Every third patient with ADHF and T2D is diagnosed with DKD. A certain range of risk factors for the development of ADHF in patients with DKD has been identified. As the glomerular filtration rate (GFR) decreases, the NT-proBNP level increases. With a decrease in GFR of 60 ml/min/1,73 m2 in patients with T2D, the diagnostic value of NT-proBNP &gt;1289 pg/ml should be considered to verify ADF.

Adulthood and childhood ADHD in patients consulting for obesity is associated with food addiction and binge eating, but not sleep apnea syndrome

IntroductionThe exact mechanisms underlying the established association between ADHD and obesity remain unclear. Food addiction and binge eating may contribute to this link. We examined for the first time the association between childhood/adult ADHD and food addiction/binge eating in patients with obesity, as well as the association between ADHD and sleep apnea syndrome. MethodsWe included 105 obese patients from the Nutrition Department of the University Hospital of Tours (France) between January and December 2014. We assessed categorical diagnoses of childhood/adulthood ADHD (semi-structured interview DIVA 2.0), food addiction (Yale Food Addiction Scale 2.0), binge eating (Binge Eating Scale), obstructive sleep apnea (clinical assessment), and BMI (clinical assessment). ResultsPatients with adult ADHD were at significantly higher risk of food addiction than patients without adult ADHD (28.6% vs. 9.1%; p = .016). Adult and childhood ADHD were significantly associated with self-reported food addiction, food addiction scores and binge eating scores, with a larger effect size for adult (ORs: 4.00 [1.29–12.40], 1.37 [1.14–1.65] and 1.08 [1.03–1.14], respectively) than childhood (ORs: 3.32 [1.08–10.23], 1.29 [1.08–1.55] and 1.06 [1.01–1.11], respectively) ADHD. ADHD diagnosis was not significantly correlated to obstructive sleep apnea. Mean age of onset of ADHD preceded mean age of onset of obesity. ConclusionADHD diagnosis is associated with food addiction and binge eating, with a larger effect size for adult than childhood ADHD. Our results provide a strong rationale for further longitudinal research on the link between ADHD, food addiction, binge eating and obesity, paving the way for evidence-based therapeutic interventions for these patients.

Pharmacotherapy of ADHD in patients with substance use disorders: Challenges and solutions

Pharmacotherapy of ADHD in patients with substance use disorders: Challenges and solutions

Diagnosing ADHD during active substance use: Feasible or flawed?

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is highly prevalent in patients with a substance use disorder (SUD). Because of possible problems with validity, diagnostic assessment of ADHD is usually postponed until after a period of abstinence, which may jeopardize adequate and timely treatment. The aim of this study is to investigate how a diagnostic assessment of ADHD in patients who are actively using substances compares to the results of a second assessment after a period of full or partial abstinence. MethodsProspective test-retest study in a SUD treatment center among 127 treatment seeking adult SUD patients with a comorbid diagnosis of adult ADHD. Conners’ Adult ADHD Diagnostic Interview for DSM-IV was administered at intake and after four SUD treatment sessions. ResultsThe mean time interval between intake and retest assessment was 78days (SD=32; range 31–248). At the second ADHD assessment, substance use had decreased to about 50% of baseline consumption. Of the 127 patients with an initial diagnosis of ADHD, 121 patients (95.3%) still fulfilled DSM-IV adult ADHD criteria at re-diagnosis. Subtyping of ADHD was less stable (Cohen’s Kappa=0.53). Agreement on the number of childhood and adult ADHD symptoms between both assessments was good (intraclass correlation coefficient of 0.69 and 0.65, respectively). Sensitivity analyses in subgroups of patients who were fully abstinent during the second assessment yielded very similar results. ConclusionsThese findings strongly suggest that a pragmatic approach, in which patients are evaluated for ADHD even when they are not (yet) abstinent, is feasible and justifiable.

Guidelines for managing ADHD and substance use disorders

Guideline for managing ADHD and substance use disorders (SUD)Frieda Matthys, MD, PhD.BackgroundDespite the high prevalence of ADHD in adults with SUD and the availability of an approved guideline, under diagnosis and inadequate treatment still persist. This comorbidity associates with reduced treatment effectiveness, making successful treatment in adults with ADHD and SUD a challenge.MethodsThe guideline of 2010 for recognizing and treating adult ADHD in patients with SUD is updated in 2016, in cooperation with caregivers, of the addiction centers in Belgium and based on research literature and clinical experience. The english translation is discussed by an international group of clinicians and experts to result in a consensus statement via ICASA (International Collaboration on ADHD and Substance Abuse).ResultsThis consensus presents a useful guide for the diagnosis and treatment of ADHD and SUD. Due to the lack of scientific evidence on some of the topics, the guide is a combination of evidence based and practice based recommendations.ConclusionThe management of ADHD in patients with SUD remains a challenge. Diagnosis is complicated by SUD symptoms and by the skepticism associated with the recognition of ADHD in adults. The treatment is hampered by high relapse rates and reduced effectiveness of the currently available pharmacotherapies. Combining psycho-and pharmacotherapy in an integrated treatment that covers both ADHD and SUD, may help to keep these patients in treatment.A Dutch manual for the integrated treatment of ADHD and SUD is being developed.Disclosure of interestHonorarium Lilly.Advisory board Johnson&amp;Johnson.

Neuroimage studies: The effect of methylphenidate in cocaine users with ADHD

BackgroundAttention deficit/hyperactivity disorder (ADHD) is an important contributing factor in the pathophysiology of substance use disorders (SUD), and ADHD occurs more often in populations with SUD compared to the general population. This high prevalence rate and comorbidity may relate to a shared neurobiological vulnerability, including a deregulation of the brain's dopamine system. This comorbidity directly impacts the treatment of ADHD: treatment with methylphenidate is less effective in patients with ADHD and SUD compared to ADHD patients without SUD.MethodsWe investigate the underlying neurobiological background of reduced treatment effectiveness for adult ADHD patients with comorbid SUD.ResultsWe observed lower available dopamine transporters, as well as a reduced binding of methylphenidate to these transporters, and more neurocognitive dysfunction in adults ADHD patients with SUD compared to ADHD patients without SUD.ConclusionComorbid ADHD and SUD has a high prevalence rate and reduces ADHD treatment effectiveness, which makes it necessary to screen for the presence of ADHD in patients seeking SUD treatment. Neurobiological and neurocognitive differences are present between ADHD patients with and without SUD, which together may partially explain the reduced effectiveness of methylphenidate in adult ADHD patients with SUD.Disclosure of interestThe author has not supplied his declaration of competing interest.

The Features of Comorbidity of Childhood ADHD in Patients With Obsessive Compulsive Disorder

Objective: Our aim is to investigate the impact of childhood ADHD comorbidity on the clinical features of obsessive compulsive disorder (OCD). Method: Ninety-five adult outpatients with a diagnosis of OCD were assessed by using the Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version, ADHD module, and the Yale–Brown Obsessive Compulsive Scale. Patients with or without childhood ADHD were compared in terms of the sociodemographic and clinical features, psychiatric comorbidities, and rating scales. Results: The rate of episodic course of OCD (p < .001), religious and sexual obsessions (p = .009, p = .020, respectively), lifetime comorbidity of bipolar disorder (BD), social anxiety disorder (SAD; p = .001, p = .009, respectively), and tic disorder (TD) comorbidity (p < .001) were higher in the OCD + ADHD group than in the OCD without ADHD group. Conclusion: Childhood ADHD may be associated with higher rates of BD, SAD, and TD comorbidity and episodic course of OCD as well as higher frequency of certain types of obsessions.

Psychiatric Comorbidity in Treatment-Seeking Alcohol Dependence Patients With and Without ADHD

Objective: To estimate the prevalence of ADHD in adult patients treated for alcohol dependence and to analyze the characteristics of consumption and psychiatric comorbidity, in function of a possible ADHD in adulthood. Method: We administered the Adult ADHD Self-Report Scale (ASRS) to 726 alcohol-dependent patients. Clinical diagnosis, following Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria was made in the first four weeks of treatment. A subsample of 297 patients was evaluated using Conners’ Adult ADHD Diagnostic Interview for DSM-IV (CAADID-II) to test the psychometric properties of ASRS. Results: After analyzing the properties of the ASRS (sensitivity: 83.3%; specificity: 66.1%), the prevalence of ADHD, in the whole sample, was estimated to be 16.2%. Being younger, lifetime history of cocaine dependence and the presence of an affective, anxiety or personality disorder were associated with a possible ADHD. Conclusion: The estimated prevalence of ADHD in patients being treated for alcohol dependence is high, and the presence of a possible ADHD in adulthood is associated with an increase in psychiatric comorbidity.

Adult Adhd Screening in Alcohol-dependent Patients

Introduction The association of ADHD and Substance Abuse has been a focus of research. Studies point to elevated rates of ADHD in patients with history of alcohol abuse or dependence. Objectives The main objective of this study was to assess the presence of ADHD in patients with history of alcohol abuse or dependence and investigate a possible relationship with consumption patterns and other mental comorbidities, including personality disorders. Methods We interviewed patients that were hospitalized, were attending the Day Hospital or were being followed in therapeutic groups in a Treatment and Alcohol Rehabilitation Unit of the Centro Hospitalar Psiquiatrico de Lisboa. It was collected social and demographic data and applied the following scales: Adult ADHD Self-Report Scale (ASRS); Diagnostic Interview for ADHD in adults (DIVA 2.0); Personality Diagnostic Questionnaire for the DSM IV (PDQ4). Patients were also submitted to a psychiatric interview in order to assess the presence of other comorbidities and suicide attempts. Results 57 patients were evaluated, 80% were male; 63.2% obtained scores PDQ4 suggestive of personality disorder. A high percentage of patients had an history of consumption of other abuse substances and had comorbidity with depression and anxiety disorders. In ASRS scale, 33.3% had scores suggestive of ADHD. Conclusions Diagnosis of ADHD in patients with substance abuse is complex since there are similar symptoms that are present in other mental disorders. However, the presence of ADHD is associated with a more severe expression of addictive behaviors and a worse prognosis, hence the importance of its early diagnosis.

Implementing hospital pharmacy practice changes

Accountability, bedside discharge counseling, and the Pharmacy Practice Model Initiative (PPMI) were just a few topics spotlighted at the 2012 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting & Exposition.

Rates of undiagnosed attention deficit hyperactivity disorder in London drug and alcohol detoxification units

BackgroundADHD is a common childhood onset mental health disorder that persists into adulthood in two-thirds of cases. One of the most prevalent and impairing comorbidities of ADHD in adults are substance use disorders. We estimate rates of ADHD in patients with substance abuse disorders and delineate impairment in the co-morbid group.MethodScreening for ADHD followed by a research diagnostic interview in people attending in-patient drug and alcohol detoxification units.ResultsWe estimated prevalence of undiagnosed ADHD within substance use disorder in-patients in South London around 12%. Those individuals with substance use disorders and ADHD had significantly higher self-rated impairments across several domains of daily life; and higher rates of substance abuse and alcohol consumption, suicide attempts, and depression recorded in their case records.ConclusionsThis study demonstrates the high rates of untreated ADHD within substance use disorder populations and the association of ADHD in such patients with greater levels of impairment. These are likely to be a source of additional impairment to patients and represent an increased burden on clinical services.