Rates of undiagnosed attention deficit hyperactivity disorder in London drug and alcohol detoxification units

Huntley, Zoe; Maltezos, Stefanos; Williams, Charlotte; Morinan, Alun; Hammon, Amy; Ball, David; Marshall, E. Jane; Keaney, Francis; Young, Susan; Bolton, Patrik; Glaser, Karen; Howe-Forbes, Raoul; Kuntsi, Jonna; Xenitidis, Kiriakos; Murphy, Declan; Asherson, Philip

doi:10.1186/1471-244x-12-223

Cited by 56 publications

(69 citation statements)

References 31 publications

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“…Similar findings were reported by Ohlmeier et al, who observed that habit-forming illnesses can be associated with a high comorbidity with ADHD, expressed in the form of alcohol misuse [10]. In a study conducted by Huntley et al, in 226 alcohol-dependent individuals, 27 (12%) reported with untreated ADHD [21]. In a recent meta-analysis conducted by van de Glind et al, the prevalence rate of ADHD was reported to be approximately 23.3% in patients with SUD seeking treatment [22].…”

Section: Discussionsupporting

confidence: 84%

Prevalence of undiagnosed and untreated attention deficit hyperactivity disorder in men with alcohol dependence – A case-control study

Sushruth¹,

Chate²,

Patil³

et al. 2018

Arch Psych Psych

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SummaryAim: To compare the prevalence of adult attention deficit hyperactivity disorder (ADHD) among male alcohol users and healthy controls. Methods:The current case-control study included 50 male patients with alcohol misuse and 50 age-matched healthy controls. Patients were assessed using the Clinical Institute Withdrawal Assessment of Alcohol ScaleRevised, Severity of Alcohol Dependence Questionnaire, Alcohol Use Disorders Identification Test, Mini-International Neuropsychiatric Interview scale, Adult ADHD Self-Report Scale version 1.1 screener, Diagnostic and Statistical Manual of Mental Disorders criteria for adult ADHD, and ADHD-Rating Scale-IV. The data obtained were analyzed using EPIINFO-7 and compared using paired t-test, student's t-test and Pearson's chisquare test (P≤0.05). Results:The prevalence of undiagnosed ADHD was significantly higher in individuals with alcohol misuse ('cases') when compared with healthy controls (31 vs. 4; P<0.0001). The most common (N=16) subtype of ADHD in alcohol misuse cases was the hyperactive/impulsive type, whereas in controls it was the inattentive type (N=3). Alcohol dependence was of moderate severity in alcohol misuse cases with adult ADHD (N=25), whereas mild dependence was observed in cases without adult ADHD (N=9). The SAD-Q (34.46 ± 7.70 vs. 32.12 ± 10.17) and AUDIT-C (31.34 ± 3.63 vs. 29.23 ± 5.43) scores were higher in cases with adult ADHD as compared with cases without ADHD.Discussion: A significant association between alcohol misuse and the prevalence of ADHD was observed. The majority of patients were young adults, indicating that alcohol misuse with or without ADHD tends to commence early in life. Conclusion:Patients diagnosed with alcohol misuse should be screened frequently and treated for ADHD. adult attention deficit hyperactivity disorder, alcohol use disorder, substance use disorders, prevalence

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Section: Discussionsupporting

confidence: 84%

Prevalence of undiagnosed and untreated attention deficit hyperactivity disorder in men with alcohol dependence – A case-control study

Sushruth¹,

Chate²,

Patil³

et al. 2018

Arch Psych Psych

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“…This observation can be considered as a limitation of the present study. Another limitation may be that retrospective recall of childhood ADHD symptoms is particularly challenging in populations with AUD due to impaired memory and the often complex histories with adverse psychosocial risk factors for the development of behavioral problems (25).…”

Section: Discussionmentioning

confidence: 99%

“…Individuals with SUD and ADHD had significantly higher self-rated impairments across several domains of daily life, as well as higher rates of substance abuse and alcohol consumption, suicide attempts, and depression (25). Patients with AUD and ADHD comorbidity relapse to AUD on average 2.7 months earlier than patients without ADHD (26,27).…”

Section: Introductionmentioning

confidence: 97%

“…In addition, the prevalence of undiagnosed ADHD in AUD inpatients is estimated to be high, and it is related with the severity of AUD and other negative variables such as psychiatric comorbidity (25). Unfortunately, this implies greater therapeutic needs and negatively affects the quality of life and interpersonal relationships of these patients (8).…”

Section: Introductionmentioning

confidence: 99%

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Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in a sample of Inpatients with alcohol use disorder

Evren¹,

Umut²,

Bozkurt³

et al. 2016

Dusunen Adam

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Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in a sample of inpatients with alcohol use disorder Objective: The Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) allows dimensional self-rating assessment of ADHD according to DSM-IV. The Turkish version of the scale was validated in university students. The aim of the present study was to evaluate psychometric properties of the Turkish version of the ASRS in a sample of inpatients with alcohol use disorder (AUD).Method: Participants included 190 inpatients with AUD. Participants were evaluated with the ASRS and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (Adult ADHD Scale).Results: The ASRS-18 (18 item version) was found to be a psychometrically sound adult ADHD screening measure with high convergent validity when compared with Adult ADHD Scale (r=0.738; 0.694 for inattentive-IN subscale and 0.690 for hyperactive/impulsive-HI subscale) and to have a Cronbach's α of 0.863 (0.822 for IN subscale and 0.775 for HI subscale). Two components accounted for 31.13% and 9.27% of total variance, respectively, for the ASRS-18. Subscales were highly correlated with total ASRS-18 score (n=190, r=0.887, r=0.886, respectively) and moderately correlated with each other (r=0.571). Test-retest correlation was moderate (n=120, r=0.677) for IN subscale whereas test-retest correlation was high for HI subscale (r=0.774) and for ASRS-18 (r=0.765). The ASRS-18 had sensitivity and specificity scores of 0.81 and 0.75, respectively, when using the optimal cut-off score of 30. Additionally, the ASRS-18 showed good discriminant validity as it significantly differentiated alcohol-dependent inpatients with a risk of ADHD from those without. The ASRS-6 (6 item version) showed psychometric properties similar to those of ASRS-18, although the sensitivity score (0.75) was lower than in ASRS-18, whereas the specificity score (0.79) was similar to ASRS-18, when using the optimal cut-off score of 10 for ASRS-6.Conclusion: These findings confirm the Turkish version of the ASRS (both 18-item and 6-item versions) as a reliable and valid adult ADHD screening instrument that measures a two-dimension construct among inpatients with AUD. Keywords: ADHD, alcohol use disorder, ASRS, factor analysis, reliability, validity ÖZET Yatarak tedavi gören alkol kullanım bozukluğu hastalarında Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu Kendi Bildirim Ölçeği (ASRS-v1.1) Türkçe formunun psikometrik özellikleriAmaç: Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHA) Kendi Bildirim Ölçeği (ASRS-v1.1) DEHA'nın DSM-IV'e göre boyutsal özbildirim değerlendirmesine olanak sağlamaktadır. Bu çalışmanın amacı ASRS'nin Türkçe formunun psikometrik özelliklerinin alkol kullanım bozukluğu (AKB) olan ve yatarak tedavi gören hasta örnekleminde değerlendirilmesidir.Yöntem: Çalışmaya AKB olan ve yatarak tedavi gören 190 hasta katıldı. Katılımcılar ASRS ve Erişkin BEB/DEHA DSM-IV Tabanlı Tanı Tarama ve Değerlendirme Öl...

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“…Additionally, untreated hyperactive boys with ADHD are at increased risk of substance use disorders and impairment. 11 The burden of ADHD must be analyzed not only in an individual context, but also from a collective standpoint. The economic consequences of the lack of ADHD treatment for society can result in very high losses.…”

Section: Introductionmentioning

confidence: 99%

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

Maia

Stella²,

Wagner

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. Trial registration number: NCT01705613.

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Rates of undiagnosed attention deficit hyperactivity disorder in London drug and alcohol detoxification units

Cited by 56 publications

References 31 publications

Prevalence of undiagnosed and untreated attention deficit hyperactivity disorder in men with alcohol dependence – A case-control study

Prevalence of undiagnosed and untreated attention deficit hyperactivity disorder in men with alcohol dependence – A case-control study

Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in a sample of Inpatients with alcohol use disorder

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

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