Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: Results of the IASP study
Addiction. 2013-11-20; 109(2): 262-272
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1. Addiction. 2014 Feb;109(2):262-72. doi: 10.1111/add.12370. Epub 2013 Nov 20.
Psychiatric comorbidity in treatment-seeking substance use disorder patients with
and without attention deficit hyperactivity disorder: results of the IASP study.
van Emmerik-van Oortmerssen K(1), van de Glind G, Koeter MW, Allsop S, Auriacombe
M, Barta C, Bu ET, Burren Y, Carpentier PJ, Carruthers S, Casas M, Demetrovics Z,
Dom G, Faraone SV, Fatseas M, Franck J, Johnson B, Kapitány-Fövény M, Kaye S,
Konstenius M, Levin FR, Moggi F, Møller M, Ramos-Quiroga JA, Schillinger A,
Skutle A, Verspreet S; IASP research group, van den Brink W, Schoevers RA.
Collaborators: Beniwal A, Bosma G, Cassar J, Dahl T, Daigre C, Debrabant R,
Degenhardt L, van der Gaag RJ, Hay D, Lossius K, Løvaas EK, Malivert M, Möller M,
Roncero C, Stevens L, Wallhed S, van Wamel A, Young J.
(1)Arkin Mental Health and Addiction Treatment Center, Amsterdam, the
Netherlands; Amsterdam Institute for Addiction Research, Department of
Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the
Netherlands; Department of Psychiatry, University Medical Center Groningen,
University of Groningen, Groningen, the Netherlands.
AIMS: To determine comorbidity patterns in treatment-seeking substance use
disorder (SUD) patients with and without adult attention deficit hyperactivity
disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking
into account differences related to gender and primary substance of abuse.
DESIGN: Data were obtained from the cross-sectional International ADHD in
Substance use disorder Prevalence (IASP) study.
SETTING: Forty-seven centres of SUD treatment in 10 countries.
PARTICIPANTS: A total of 1205 treatment-seeking SUD patients.
MEASUREMENTS: Structured diagnostic assessments were used for all disorders:
presence of ADHD was assessed with the Conners’ Adult ADHD Diagnostic Interview
for DSM-IV (CAADID), the presence of antisocial personality disorder (ASPD),
major depression (MD) and (hypo)manic episode (HME) was assessed with the Mini
International Neuropsychiatric Interview-Plus (MINI Plus), and the presence of
borderline personality disorder (BPD) was assessed with the Structured Clinical
Interview for DSM-IV Axis II (SCID II).
FINDINGS: The prevalence of DSM-IV adult ADHD in this SUD sample was 13.9%. ASPD
[odds ratio (OR) = 2.8, 95% confidence interval (CI) = 1.8-4.2], BPD (OR = 7.0,
95% CI = 3.1-15.6 for alcohol; OR = 3.4, 95% CI = 1.8-6.4 for drugs), MD in
patients with alcohol as primary substance of abuse (OR = 4.1, 95% CI = 2.1-7.8)
and HME (OR = 4.3, 95% CI = 2.1-8.7) were all more prevalent in ADHD(+) compared
with ADHD(-) patients (P