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Drug Alcohol Depend. 2014 Jan 1;134:158-166. doi: 10.1016/j.drugalcdep.2013.09.026. Epub 2013 Oct 5.

Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: results from an international multi-center study exploring DSM-IV and DSM-5 criteria.

Author information

1
Trimbos-instituut and ICASA Foundation, Utrecht, The Netherlands; Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: gglind@trimbos.nl.
2
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
3
Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
4
Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
5
Reinier van Arkel groep, 's-Hertogenbosch, The Netherlands.
6
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
7
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia.
8
Bergen Clinics Foundation, Bergen, Norway.
9
University Hospital of Psychiatry Bern and Department of Psychology, University of Fribourg, Fribourg, Switzerland.
10
Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout, Belgium.
11
Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
12
Institute of Psychology, Eötvös Loránd University, Budapest, Hungary; Nyírő Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary.
13
Laboratoire de psychiatrie, Sanpsy CNRS USR 3413, Université de Bordeaux, and Département d'addictologie, CH Ch. Perrens/CHU de Bordeaux, Bordeaux, France.
14
Østfold Hospital Trust, Department for Substance Abuse Treatment, Norway.
15
Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA.
16
Servei de Psiquiatria, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.
17
National Drug Research Institute/Curtin University of Technology, Perth, Australia.
18
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
19
Stockholm Centre for Dependency Disorders, Sweden.
20
Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary.
21
Alcohol Treatment Research, Kirchlindach and Ellikon, Switzerland.
22
Columbia University/New York State Psychiatric Institute, New York City, NY, USA.

Abstract

BACKGROUND:

Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed.

METHODS:

A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview.

RESULTS:

Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4-8.3) for Hungary to 31.3% (CI 95%:25.2-37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1-11.1) for Hungary to 32.6% (CI 95%: 26.4-38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2-83%→5.4-31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV.

CONCLUSIONS:

Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD.

KEYWORDS:

Adults; Attention deficit hyperactivity disorder; DSM-5; Prevalence; Substance use disorder

PMID:
24156882
PMCID:
PMC4133781
DOI:
10.1016/j.drugalcdep.2013.09.026
[Indexed for MEDLINE]
Free PMC Article

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