Adult Attention Deficit Hyperactivity Disorder in Patients with Substance Use Disorders: A Study from Southern India

Abstract

Context:Externalizing disorders of childhood characterized by attention deficit hyperactivity disorder (ADHD), conduct disorder and oppositional defiant disorder are well known to predispose an individual to experiment with substances at an early age and the later lead to the development of substance use disorders (SUD). ADHD, a developmental disorder, persists into adulthood in about two-thirds of the cases.Aims:In the present study, we aimed to explore the prevalence of ADHD and its subtypes in treatment-seeking patients with SUD in an outpatient setting. Secondarily, we also aimed to compare the ADHD scores in the early onset and late onset subtypes of SUD.Subjects and Methods:Adult ADHD self-report scale symptom checklist was administered in 240 patients with SUD. The prevalence of ADHD and the difference in scores in early onset and late onset dependent groups of SUD patients were calculated.Statistical Analysis:Independent sample t-test was used to calculate the mean differences, and Chi-square test was used to calculate the difference in the proportion of cases screening positive across subgroups.Results:Among the 240 patients with SUD, 135 (56.25%) screened positive for “likely ADHD” and 52 (21.7%) for “highly likely ADHD.” The scores on the inattention domain and the prevalence of “likely ADHD” were significantly higher among the early onset group.Conclusions:The results are in agreement with similar studies of larger samples performed worldwide. Routine screening for ADHD in the treatment-seeking patients with SUD will enable the early detection and management of this highly comorbid condition.

Prevalence of Adult ADHD Co-morbidity in Alcohol Use Disorders in a General Hospital Setup

“…The findings from the current study are similar to earlier studies in India and from other countries. [1,2,4] Subjects with ADHD had a relatively faster progression of the disease process. This is reflected in the significantly earlier age of onset of craving, higher amount of alcohol use, tolerance, withdrawal symptoms, salience, and early morning use among these patients in the current sample.…”

“…ADHD persists into adulthood among the majority of the affected children. [12] However, with the increasing age, the symptom manifestation changes considerably: the hyperactivity decreases, while the inattention and impulsivity persist. [3] Studies around the world have shown that the prevalence of childhood ADHD in the general population ranges 5%-12% while the prevalence of adult ADHD ranges 2%-6%.…”

“…[6,7] Kumar et al reported 40% prevalence for adult ADHD among fishermen with alcohol-dependence, while in another outpatient-based screening study, Ganesh et al reported that 21.7% of the SUD subjects screened positive for "highly likely ADHD." [1,10] Both the studies were done in South India and had used screening tools to check for ADHD in patients with AUD.…”

Family Loading and Morbidity Risk of Attention-deficit Hyperactivity Disorder in Patients with Alcohol-dependence Syndrome

“…This replicates similar findings from our previous studies on ADHD and SUD. [ 2 3 ] The MR for ADHD and other externalizing spectrum disorders in children of all alcohol dependents was high, especially with the patients of EO of dependence. Furthermore, the probability of developing alcohol dependence in children of EO patients was much more.…”

“…[ 1 ] Our previous study in a treatment cohort from India suggested that the rates of comorbidity of ADHD and SUD are around 21.7%. [ 2 ] Another study from our center found that there were higher odds of ADHD in individuals with early onset (EO) of alcohol-dependence syndrome (ADS) defined as ADS established by the age of 25 years or earlier. [ 3 ] Furthermore, the SUD and related problems are severe, and outcomes are poorer in individuals with ADHD than those without ADHD.…”