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

Abstract

BackgroundAvailable 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.MethodsA 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.ResultsPrevalence 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.ConclusionsGiven 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.

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

“…The main reason for this inconsistency may be that we used the Adult ADHD Scale as the gold standard, whereas Roncero et al (8) used Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID). In a multicenter international study, the 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 (50). Thus, like the cutoff score of ASRS, prevalence rates of ADHD may also differ according to the population that is studied and the language of the scale.…”

Attention Deficit Hyperactivity Disorder Symptoms are Common in Patients in Opioid Maintenance Treatment

“…A recent meta-analysis of 29 predominantly US studies estimated a pooled ADHD prevalence rate of 23% in mixed SUD populations [1]. A rate of 14% (5–31% between countries) was reported by the International ADHD in Substance use disorder Prevalence (IASP) study [6]. This is the largest clinical study so far to evaluate ADHD and comorbid disorders in treatment-seeking adults with SUD [7].…”

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

“…The majority of patients were young adults, indicating that alcohol misuse with or without ADHD tends to commence early in life. In a similar study, the mean age of patients with ADHD varied between 37 and 43 years [18]. Similarly, a study conducted by Ganesh et al [19] on 240 patients observed for early onset of SUD the majority of cases (N=209) had a mean age of 32.75 (SD ±11.14) years.…”