Everyday life consequences of substance use in adult patients with a substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD): a patient’s perspective

BMC Psychiatry

Theo van Achterberg⁴  Wim van den Brink³  Peter JJ Goossens⁵  Karin Slager-Visscher²  Linda M Kronenberg¹ 

[1] Dual Diagnosis Department, Dimence, Deventer, The Netherlands;Assertive Community Treatment, Dimence, Deventer, The Netherlands;Amsterdam Institute for Addiction Research, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands;Department of Public health and Caring Sciences, Uppsala University, Uppsala, Sweden;Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

关键词: Adults;    Everyday life consequences;    Autism spectrum disorder;    Attention deficit hyperactivity disorder;    Substance use disorders;   

Others  :  1123328
DOI  :  10.1186/s12888-014-0264-1

 received in 2014-03-10, accepted in 2014-09-10,  发布年份 2014

【 摘 要 】

Background

Although the prevalence of substance use disorder (SUD) with co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses. A recent study reported met- and unmet needs for several life domains regarding these patient groups. To improve treatment, it is necessary to identify the everyday life consequences of SUD and co-occurring ADHD or ASD in adult patients.

Methods

Qualitative study using in-depth interviews. 11 SUD + ADHD and 12 SUD + ASD patients participated in the study. The interview transcripts were coded and analysed according to the seven steps for descriptive phenomenology by Colaizzi.

Results

Both patients with ADHD and patients with ASD can get caught in a jumble of thoughts and emotions which can often lead to agitation and impulsivity in the case of ADHD or passivity and melancholia in the case of ASD with co-occurring SUD in both cases. Initially substance use ameliorates the symptoms and related problems, but both patient groups can later experience even greater problems: difficulties with the structuring of daily life due to a lack of planning (SUD + ADHD) or due to a lack of initiative (SUD + ASD). Both groups indicate that structure helps them function better. They also recognize that substance use disorganizes their lives and that an absence of structure contributes to substance use in what becomes a vicious circle which needs to be broken for effective treatment and care.

Conclusions

This study provides insight into the daily life consequences of SUD with a co-occurring ADHD or ASD. Substance use is reported to solve some ADHD- or ASD-related problems in the short run but have negative consequences in the long run (i.e., contribute to already impaired cognitive functioning). Insight is provided into what clinicians can do to break this vicious circle and thus help ADHD patients to refrain from action and ASD patients to take action.

【 授权许可】

   
2014 Kronenberg et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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