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Eur Arch Psychiatry Clin Neurosci. 2018 Nov 27. doi: 10.1007/s00406-018-0958-3. [Epub ahead of print]

Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men.

Estévez-Lamorte N1,2,3,4, Foster S5,6,7, Eich-Höchli D8, Moggi F9, Gmel G10,11,12,13, Mohler-Kuo M14,5,6,7.

Author information

1
La Source, School of Nursing Sciences, University of Applied Sciences and Arts, Western Switzerland, Lausanne, Switzerland. natalia.estevezgomez@uzh.ch.
2
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland. natalia.estevezgomez@uzh.ch.
3
Swiss Research Institute for Public Health and Addiction, Zurich, Switzerland. natalia.estevezgomez@uzh.ch.
4
Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland. natalia.estevezgomez@uzh.ch.
5
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.
6
Swiss Research Institute for Public Health and Addiction, Zurich, Switzerland.
7
Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland.
8
University Hospital of Psychiatry Zurich, Zurich, Switzerland.
9
University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
10
Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland.
11
Addiction Switzerland, Lausanne, Switzerland.
12
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
13
University of the West of England, Frenchay Campus Coldharbour Lane, Bristol, UK.
14
La Source, School of Nursing Sciences, University of Applied Sciences and Arts, Western Switzerland, Lausanne, Switzerland.

Abstract

We investigated whether adult attention-deficit/hyperactivity disorder (ADHD) predicts risky substance use and substance use disorders (SUDs), and its impact on the course of these problematic substance use patterns. Our sample included 4975 Swiss men (mean age 20 ± 1.2 years) who participated in the baseline and 15-month follow-up assessments of the Cohort Study on Substance Use Risk Factors. We examined: (1) the contribution of ADHD, as assessed at baseline, on the risky use of alcohol, nicotine and cannabis, and their corresponding use disorders (AUD, NUD, CUD) at follow-up; and (2) the association between ADHD and the course of outcomes (i.e., absence, initiation, maturing out, persistence) over 15 months. All analyses were adjusted for socio-demographics and co-morbidity. Men with ADHD were more likely to exhibit persistent risky alcohol and nicotine use, and to mature out of risky cannabis use. ADHD at baseline was positively linked to AUD and negatively to CUD at follow-up, but not to NUD. For all SUDs, ADHD had a positive association with use persistence and maturing out. Comparing these two trajectories revealed that early age of alcohol use initiation distinguished between persistence and maturing out of AUD, while the course of NUD and CUD was related to ADHD symptoms and SUD severity at baseline. Already in their early twenties, men with ADHD are especially likely to exhibit persistent problematic substance use patterns. Substance-specific prevention strategies, particularly implemented before early adulthood, may be crucial to reducing the development and persistence of pathological patterns in such individuals.

KEYWORDS:

Adult attention-deficit/hyperactivity disorder; Alcohol; Cannabis; Nicotine; Risky substance use; Substance use disorder

PMID:
30483874
DOI:
10.1007/s00406-018-0958-3

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