Early developmental, temperamental and educational problems in ‘substance use disorder’ patients with and without ADHD: Does ADHD make a difference?
Addictive Behaviors Reports. 2015-12-01; 2: 13-18
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1. Addict Behav Rep. 2015 Mar 28;2:13-18. doi: 10.1016/j.abrep.2015.03.001.
eCollection 2015 Dec.
Early developmental, temperamental and educational problems in ‘substance use
disorder’ patients with and without ADHD. Does ADHD make a difference?
Skutle A(1), Bu ETH(1), Jellestad FK(2), van Emmerik-van Oortmerssen K(3)(4), Dom
G(5), Verspreet S(5), Carpentier PJ(6), Ramos-Quiroga JA(7), Franck J(8),
Konstenius M(8), Kaye S(9), Demetrovics Z(10), Barta C(11), Fatséas M(12),
Auriacombe M(12), Johnson B(13)(14), Faraone SV(13)(14), Levin FR(15), Allsop
S(16), Carruthers S(16), Schoevers RA(17), Koeter MWJ(3), van den Brink W(3),
Moggi F(18)(19), Møller M(20), van de Glind G(21).
(1)Bergen Clinics Foundation, Bergen, Norway.
(2)Department of Biological and Medical Psychology, University of Bergen, Norway.
(3)Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic
Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
(4)The Netherlands Arkin, Amsterdam, The Netherlands.
(5)Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian
Brothers, Boechout, Belgium.
(6)Reinier van Arkel groep, ‘s-Hertogenbosch, The Netherlands.
(7)Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, CIBERSAM,
Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain.
(8)Department of Clinical Neuroscience, Division of Psychiatry, Karolinska
Institutet, Stockholm, Sweden.
(9)National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia.
(10)Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
(11)Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry,
Semmelweis University, Budapest, Hungary.
(12)Laboratoire de psychiatrie Département d’addictologie, Université de
Bordeaux, Bordeaux, France.
(13)Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.
(14)Department of Neuroscience and Physiology, SUNY Upstate Medical University,
Syracuse, NY, USA.
(15)Columbia University/the New York State Psychiatric Institute, New York, USA.
(16)National Drug Research Institute/Curtin University of Technology, Perth,
(17)Dept of Psychiatry, University Medical Center Groningen, University of
Groningen, Groningen, The Netherlands.
(18)Department of Psychology, University of Fribourg, Fribourg, Switzerland.
(19)University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
(20)Sykehuset Østfold, Norway.
(21)Trimbos Instituut, ICASA Foundation, The Netherlands.
Introduction: The prevalence of ADHD among patients with substance use disorder
(SUD) is substantial. This study addressed the following research questions: Are
early developmental, temperamental and educational problems overrepresented among
SUD patients with ADHD compared to SUD patients without ADHD? Do this comorbid
group receive early help for their ADHD, and are there signs of self-medicating
with illicit central stimulants?
Method: An international, multi-centre cross-sectional study was carried out
involving seven European countries, with 1205 patients in treatment for SUD. The
mean age was 40 years and 27% of the sample was female. All participants were
interviewed with the Mini International Neuropsychiatric Interview Plus and the
Conners’ Adult ADHD Diagnostic Interview for DSM-IV.
Results: SUD patients with ADHD (n = 196; 16.3% of the total sample) had a
significantly slower infant development than SUD patients without ADHD
(n = 1,009; 83.4%), had greater problems controlling their temperament, and had
lower educational attainment. Only 24 (12%) of the current ADHD positive patients
had been diagnosed and treated during childhood and/or adolescence. Finally, SUD
patients with ADHD were more likely to have central stimulants or cannabis as
their primary substance of abuse, whereas alcohol use was more likely to be the
primary substance of abuse in SUD patients without ADHD.
Conclusion: The results emphasize the importance of early identification of ADHD
and targeted interventions in the health and school system, as well as in the