Attention deficit/hyperactivity disorders with co-existing substance use disorder is characterized by early antisocial behaviour and poor cognitive skills

BMC Psychiatry

Research Article

Jussi Jokinen¹  Sven Bölte²  Tatja Hirvikoski²  Berit Bihlar Muld³ 

[1] Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;Department of Women’s and Children’s Health, Karolinska Institute, Pediatric Neuropsychiatry Unit, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), 22B, SE-113 30, Stockholm, Gävlegatan, Sweden;SiS LVM Institution Hornö, Enköping, Sweden;Department of Women’s and Children’s Health, Karolinska Institute, Pediatric Neuropsychiatry Unit, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), 22B, SE-113 30, Stockholm, Gävlegatan, Sweden;

关键词: ADHD;    SUD;    Co-morbidity;    Compulsory care;    Adults;    Cognition;   

DOI  :  10.1186/1471-244X-13-336

 received in 2013-02-22, accepted in 2013-12-06,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAttention Deficit/Hyperactivity Disorder (ADHD) is associated with an increased risk of co-existing substance abuse. The Swedish legislation on compulsory healthcare can be applied to persons with severe substance abuse who can be treated involuntarily during a period of six months. This context enables a reliable clinical assessment of ADHD in individuals with severe substance use disorder (SUD).MethodsIn the context of compulsory care for individuals with severe SUD, male patients were assessed for ADHD, co-morbid psychiatric symptoms, psychosocial background, treatment history, and cognition. The data from the ADHD/SUD group (n = 60) was compared with data from (1) a group of individuals with severe substance abuse without known ADHD (SUD group, n = 120), as well as (2) a group with ADHD from an outpatient psychiatric clinic (ADHD/Psych group, n = 107).ResultsCompared to the general SUD group in compulsory care, the ADHD/SUD group had already been significantly more often in compulsory care during childhood or adolescence, as well as imprisoned more often as adults. The most common preferred abused substance in the ADHD/SUD group was stimulant drugs, while alcohol and benzodiazepine abuse was more usual in the general SUD group. Compared to the ADHD/Psych group, the ADHD/SUD group reported more ADHD symptoms during childhood and performed poorer on all tests of general intellectual ability and executive functions.ConclusionsThe clinical characteristics of the ADHD/SUD group differed from those of both the SUD group and the ADHD/Psych group in several respects, indicating that ADHD in combination with SUD is a particularly disabling condition. The combination of severe substance abuse, poor general cognitive ability, severe psychosocial problems, including indications of antisocial behaviour, and other co-existing psychiatric conditions should be considered in treatment planning for adults with ADHD and SUD.

【 授权许可】

Unknown   
© Bihlar Muld et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.