TY - JOUR
T1 - Attention Deficit/Hyperactivity Disorder and Global Severity Profiles in Treatment-Seeking Patients with Substance Use Disorders
AU - Icick, Romain
AU - Moggi, Franz
AU - Slobodin, Ortal
AU - Dom, Geert
AU - Mathys, Frieda
AU - Van Den Brink, Wim
AU - Levin, Frances R.
AU - Blankers, Matthijs
AU - Kaye, Sharlene
AU - Demetrovics, Zsolt
AU - Van De Glind, Geurt
AU - Velez-Pastrana, Maria C.
AU - Schellekens, Arnt S.A.
N1 - Funding Information:
The central organization for the IASP studies is located at the Trimbos Institute in the Netherlands. Funding was obtained via participating institutes, such as the University Hospital Vall d’Hebron in Barcelona, the University of Amsterdam, and the Kar-olinska Institute in Stockholm. Four pharmaceutical companies (Janssen-Cilag, Eli Lilly & Company, Shire, and UCB) supported this part of the study with unrestricted grants, meaning that these companies had no influence on the research methods, researchers, or results. In addition, each participating site was responsible for funding its own part of the study. A PhD position at the University of Amsterdam was funded via the Waterloo Foundation (UK), the Noaber Foundation (the Netherlands), and the Augeo Foundation (the Netherlands) to perform and manage data collection. The sponsors had no role in the preparation, the review, nor the decision to submit the current manuscript for publication. The ICASA Foundation received an unrestricted grant from the Waterloo Foundation. This grant focused on the need for data management for the IASP-2 data.
Publisher Copyright:
© 2020
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Comorbid attention deficit/hyperactivity disorder (ADHD) is present in 15-25% of all patients seeking treatment for substance use disorders (SUDs). Some studies suggest that comorbid ADHD increases clinical severity related to SUDs, other psychiatric comorbidities, and social impairment, but could not disentangle their respective influences. To investigate whether comorbid adult ADHD in treatment-seeking SUD patients is associated with more severe clinical profiles in these domains assessed altogether. Methods: Treatment-seeking SUD patients from 8 countries (N = 1,294: 26% females, mean age 40 years [SD = 11 years]) were assessed for their history of DSM-IV ADHD, SUDs, and other psychiatric conditions and sociodemographic data. SUD patients with and without comorbid ADHD were compared on indicators of severity across 3 domains: addiction (number of SUD criteria and diagnoses), psychopathological complexity (mood disorders, borderline personality disorder, lifetime suicidal thoughts, or behavior), and social status (education level, occupational and marital status, and living arrangements). Regression models were built to account for confounders for each severity indicator. Results: Adult ADHD was present in 19% of the SUD patients. It was significantly associated with higher SUD severity, more frequent comorbid mood or borderline personality disorder, and less frequent married or divorced status, as compared with the absence of comorbid ADHD. ADHD comorbidity was independently associated with a higher number of dependence diagnoses (OR = 1.97) and more psychopathology (OR = 1.5), but not marital status. Conclusions: In treatment-seeking SUD patients, comorbid ADHD is associated with polysubstance dependence, psychopathological complexity, and social risks, which substantiates the clinical relevance of screening, diagnosing, and treating ADHD in patients with SUDs.
AB - Comorbid attention deficit/hyperactivity disorder (ADHD) is present in 15-25% of all patients seeking treatment for substance use disorders (SUDs). Some studies suggest that comorbid ADHD increases clinical severity related to SUDs, other psychiatric comorbidities, and social impairment, but could not disentangle their respective influences. To investigate whether comorbid adult ADHD in treatment-seeking SUD patients is associated with more severe clinical profiles in these domains assessed altogether. Methods: Treatment-seeking SUD patients from 8 countries (N = 1,294: 26% females, mean age 40 years [SD = 11 years]) were assessed for their history of DSM-IV ADHD, SUDs, and other psychiatric conditions and sociodemographic data. SUD patients with and without comorbid ADHD were compared on indicators of severity across 3 domains: addiction (number of SUD criteria and diagnoses), psychopathological complexity (mood disorders, borderline personality disorder, lifetime suicidal thoughts, or behavior), and social status (education level, occupational and marital status, and living arrangements). Regression models were built to account for confounders for each severity indicator. Results: Adult ADHD was present in 19% of the SUD patients. It was significantly associated with higher SUD severity, more frequent comorbid mood or borderline personality disorder, and less frequent married or divorced status, as compared with the absence of comorbid ADHD. ADHD comorbidity was independently associated with a higher number of dependence diagnoses (OR = 1.97) and more psychopathology (OR = 1.5), but not marital status. Conclusions: In treatment-seeking SUD patients, comorbid ADHD is associated with polysubstance dependence, psychopathological complexity, and social risks, which substantiates the clinical relevance of screening, diagnosing, and treating ADHD in patients with SUDs.
UR - http://www.scopus.com/inward/record.url?scp=85089204571&partnerID=8YFLogxK
U2 - 10.1159/000508546
DO - 10.1159/000508546
M3 - Article
C2 - 32570249
AN - SCOPUS:85089204571
SN - 1022-6877
VL - 26
SP - 201
EP - 210
JO - European Addiction Research
JF - European Addiction Research
IS - 4-5
ER -
