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J Atten Disord. 2016 Feb 27. pii: 1087054716629217. [Epub ahead of print]

Persistence and Subtype Stability of ADHD Among Substance Use Disorder Treatment Seekers.

Author information

University of New South Wales, Sydney, Australia
Universitat Autònoma de Barcelona, Spain.
ICASA Foundation, Amsterdam, The Netherlands University of Amsterdam, Amsterdam, The Netherlands.
Columbia University, New York, NY, USA.
Upstate Medical University, Syracuse, NY, USA.
Curtin University, Perth, Australia.
University of New South Wales, Sydney, Australia University of Melbourne, Australia.
University of Bern, Switzerland University of Fribourg, Switzerland.
Semmelweis University, Budapest, Hungary.
Karolinska Institutet, Stockholm, Sweden.
Bergen Clinics Foundation, Norway.
University of Amsterdam, Amsterdam, The Netherlands.
Eötvös Loránd University, Budapest, Hungary.
Eötvös Loránd University, Budapest, Hungary Nyírő Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary.
University of Groningen, The Netherlands.
University of Amsterdam, Amsterdam, The Netherlands Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands.
Reinier van Arkel groep,'s-Hertogenbosch, The Netherlands.
University of Antwerp, Belgium Psychiatric Center Alexian Brothers, Boechout, Belgium.
Curtin University, Perth, Australia University of Melbourne, Australia The University of Western Australia, Perth, Australia.
University of New South Wales, Sydney, Australia.
Université de Bordeaux, France.
Deakin University, Geelong, Australia.
University of Haifa, Israel.



To examine ADHD symptom persistence and subtype stability among substance use disorder (SUD) treatment seekers.


In all, 1,276 adult SUD treatment seekers were assessed for childhood and adult ADHD using Conners' Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; CAADID). A total of 290 (22.7%) participants met CAADID criteria for childhood ADHD and comprise the current study sample.


Childhood ADHD persisted into adulthood in 72.8% (n = 211) of cases. ADHD persistence was significantly associated with a family history of ADHD, and the presence of conduct disorder and antisocial personality disorder. The combined subtype was the most stable into adulthood (78.6%) and this stability was significantly associated with conduct disorder and past treatment of ADHD.


ADHD is highly prevalent and persistent among SUD treatment seekers and is associated with the more severe phenotype that is also less likely to remit. Routine screening and follow-up assessment for ADHD is indicated to enhance treatment management and outcomes.


ADHD; persistence; substance related disorders; subtypes

Conflict of interest statement

Declaration of Conflicting Interests The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: G. van de Glind was, on one occasion, a consultant for Shire, for which he refused payment. In 2013, he received an unrestricted travel grant from Neurotech and he is a member (unpaid) of the advisory board of Neurotech. P. J. Carpentier received a fee for speaking at a conference organized by Eli Lilly in 2011. F. R. Levin reports Study Medication provided by US WorldMeds and being a consultant to GW Pharmaceuticals. She served as a consultant to Shire and Eli Lilly from 2005 to 2007. The ICASA Foundation has reimbursed her for airfare to attend the Annual Meeting as a speaker. S. Kaye reports receiving unrestricted travel grants for participation in the World ADHD Federation conference in Berlin (2011) from Shire, Janssen, and Eli Lilly. In the past year, S. V. Faraone received consulting income and/or research support from Shire, Akili Interactive Labs, VAYA Pharma, SynapDx, and Alcobra and research support from the National Institutes of Health (NIH). His institution is seeking a patent for the use of sodium–hydrogen exchange inhibitors in the treatment of ADHD. In previous years, he received consulting fees or was on advisory boards or participated in continuing medical education programs sponsored by Shire, Alcobra, Otsuka, McNeil, Janssen, Novartis, Pfizer, and Eli Lilly. He receives royalties from books published by Guilford Press: Straight Talk About Your Child’s Mental Health and Oxford University Press: Schizophrenia: The Facts. In the last 3 years, J. A. Ramos-Quiroga has been on the speakers’ bureau and/or acted as consultant for Eli Lilly, Janssen-Cilag, Novartis, Shire, and Rubió. He also received travel awards (air tickets + hotel) for taking part in psychiatric meetings from Janssen-Cilag, Shire, and Eli Lilly. The ADHD Program chaired by him has received unrestricted educational and research support from Eli Lilly, Janssen-Cilag, Shire, and Rubió in the past 3 years. Z. Demetrovics received reimbursement for participating at symposia organized by Lundbeck (2011). G. Dom acted as a paid consultant for Lundbeck and received a speaker’s fee and reimbursement for symposium attendance from GSK, Janssen Ph., Astra-Zeneca, and Eli Lilly. F. Moggi received a speaker’s fee from Novartis and from Eli Lilly. M. Auriacombe and his institution report unrestricted grants and advisory board activities from RBK Pharmaceutical, Mundipharma, and D&A Pharma. J. Franck declares his research group received an unrestricted research grant from Janssen-Cilag in 2007. The grant was received and administered by his university (Karolinska Institutet). W. van den Brink has received a fee from Eli Lilly for organizing a symposium on the role of impulsivity in psychiatric disorders and a speaker’s fee from Eli Lilly for a presentation on the relationship between ADHD and addiction. Apart from the funding resources described above, the authors declare no other conflicts of interest.

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