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
Drug and Alcohol Dependence. 2014-01-01; 134: 158-166
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1. 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.
van de Glind G(1), Konstenius M(2), Koeter MWJ(3), van Emmerik-van Oortmerssen
K(4), Carpentier PJ(5), Kaye S(6), Degenhardt L(7), Skutle A(8), Franck J(2), Bu
ET(8), Moggi F(9), Dom G(10), Verspreet S(10), Demetrovics Z(11), Kapitány-Fövény
M(12), Fatséas M(13), Auriacombe M(13), Schillinger A(14), Møller M(14), Johnson
B(15), Faraone SV(15), Ramos-Quiroga JA(16), Casas M(16), Allsop S(17),
Carruthers S(17), Schoevers RA(18), Wallhed S(19), Barta C(20), Alleman P(21);
IASP Research Group, Levin FR(22), van den Brink W(3).
(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:
(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,
(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,
(17)National Drug Research Institute/Curtin University of Technology, Perth,
(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,
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
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.
Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights
PMID: 24156882 [Indexed for MEDLINE]