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

Geurt van de Glind, Maija Konstenius, Maarten W.J. Koeter, Katelijne van Emmerik-van Oortmerssen, Pieter Jan Carpentier, Sharlene Kaye, Louisa Degenhardt, Arvid Skutle, Johan Franck, Eli Torild Bu, Franz Moggi, Geert Dom, Sofie Verspreet, Zsolt Demetrovics, Máté Kapitány-Fövény, Melina Fatséas, Marc Auriacombe, Arild Schillinger, Merete Møller, Brian JohnsonStephen V. Faraone, J. Antoni Ramos-Quiroga, Miguel Casas, Steve Allsop, Susan Carruthers, Robert A. Schoevers, Sara Wallhed, Csaba Barta, Peter Alleman, Frances R. Levin, Wim van den Brink, Eva Karin Løvaas, Kari Lossius, Anneke van Wamel, Geert Bosma, David Hay, Marion Malivert, Romain Debrabant, Therese Dahl, Laura Stevens, Carlos Roncero, Constanza Daigre, Rutger Jan van der Gaag, Joanne Cassar, Jesse Young

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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. © 2013 The Authors.
Original languageEnglish
Pages (from-to)158-166
JournalDrug and Alcohol Dependence
Volume134
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

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

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