Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-10T09:19:51.267Z Has data issue: false hasContentIssue false
  • English
  • Français

Attention-deficit hyperactivity disorder (ADHD) in adults attending addiction treatment in Ireland: preliminary international ADHD in substance-use disorders prevalence study (IASP) results

Published online by Cambridge University Press:  29 May 2013

M. C. Van Hout  and
M. Foley
M. C. Van Hout*
Affiliation:
Lecturer, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
M. Foley
Affiliation:
Researcher, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
*
*Address for correspondence: M. C. Van Hout, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland. (Email mcvanhout@wit.ie)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Attention-deficit hyperactivity disorder (ADHD) is a neuro-behavioural disorder characterised by early onset of persistent inattention–disorganisation and hyperactivity–impulsivity. Symptoms causing significant impairment in psychosocial function commence in childhood and heighten the risk for early substance experimentation and potential development of substance-use disorders (SUD). The research aimed to estimate the occurrence of adult attention-deficit hyperactivity disorder (ADHD) in new treatment cases of adults attending addiction treatment services.

Methods

The Adult ADHD Symptoms Rating Scale (ASRS) self-administered questionnaire was administered on entry and 2 weeks later for first admissions to inpatient and outpatient addiction treatment settings The ASRS is a validated and reliable 18-item self-report scale derived from the DSM-IV-TR diagnostic criteria for ADHD, comprising nine items on inattention and nine items on hyperactivity/impulsivity.

Results

A total of 47 new treatment cases took part in the study. The occurrence of ADHD among SUDs in this sample was 13% (n = 6). Four of the participants were being treated for Problem Poly Substance use, whereas two participants were being treated for Problem Drug use. None of the participants screening positive for ADHD were being treated for Problem Alcohol use. Of the positively screened cases, all were male, predominantly single and unemployed.

Conclusions

The ASRS screening instrument may be a useful tool to detect ADHD co-morbidity in SUD treatment-seeking cases. More research is needed to appropriately develop the SUD treatment pathways for adolescent and adult ADHD sufferers in Ireland.

Keywords

AddictionADHDalcoholattention deficit hyperactivity disorderdrug
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 30 , Issue 3 , September 2013 , pp. 171 - 177
Copyright
Copyright © College of Psychiatrists of Ireland 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Arias, AJ, Gelernter, J, Chan, G, Weiss, RD, Brady, KT, Farrer, L, Farrer, L, Kranzler, HR (2008). Correlates of co-occurring ADHD in drug-dependent subjects: prevalence and features of substance dependence and psychiatric disorders. Addictive Behaviours 33, 1199–1207.CrossRefGoogle ScholarPubMed
Barkley, R, Fischer, M, Smallish, L, Fletcher, K (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology 111, 279–289.CrossRefGoogle ScholarPubMed
Bellerose, D, Carew, AM, Lyons, S (2011). Trends in treated problem drug use in Ireland 2005–2010. HRB Trends Series 12. Health Research Board: Dublin.Google Scholar
Biederman, J (2005). Attention-deficit/hyperactivity disorder: a selective overview. Biological Psychiatry 57, 1215–1220.CrossRefGoogle ScholarPubMed
Biederman, J, Farone, S, Milberger, S, Curtis, S, Chen, L, Marrs, A, Oeullette, , Moore, P, Spencer, T (1996). Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry 35, 343–351.CrossRefGoogle ScholarPubMed
Biederman, J, Monuteaux, MC, Mick, E, Spencer, T, Wilens, TE, Silva, JM, Snyder, LE, Faroane, SV (2000). Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychological Medicine 36, 167–179.CrossRefGoogle Scholar
Biederman, J, Petty, CR, Monuteaux, MC, Fried, R, Byrne, D, Mirto, T, Spencer, T, Wilens, T, Faroane, SV (2010). Adult psychiatric outcomes of girls with attention deficit hyperactivity disorder: 11-year follow-up in a longitudinal case-control study. American Journal of Psychiatry 167, 409–417.CrossRefGoogle Scholar
Carew, AM, Bellerose, D, Lyons, S (2011). Trends in treated problem alcohol use in Ireland 2005 to 2010. HRB Trends Series 11. Health Research Board: Dublin.Google Scholar
Carpentier, PJ, de Jong, CA, Dijkstra, BA, Verbrugge, CA, Krabbe, PF (2005). A controlled trial of methylphenidate in adults with attention deficit/hyperactivity disorder and substance use disorders. Addiction 100, 1868–1874.CrossRefGoogle ScholarPubMed
Castells, X, Ramos-Quiroga, JA, Bosch, R, Nogueira, M, Casas, M (2011a). Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Systematic Review 6 doi:10.1002/14651858.CD007813.Google Scholar
Castells, X, Ramos-Quiroga, JA, Rigau, D, Bosch, R, Nogueira, M, Vidal, X, Casas, M (2011b). Efficacy of methylphenidate for adults with attention-deficit hyperactivity disorder: a meta-regression analysis. CNS Drugs 2, 157–169.CrossRefGoogle Scholar
Charach, A, Yeung, E, Climans, T, Lillie, E (2011). Childhood attention deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. Journal of the American Academy of Child & Adolescent Psychiatry 50, 9–21.CrossRefGoogle ScholarPubMed
Chronis, AM, Lahey, BB, Pelham, WE, Kipp, HL, Baumann, BL, Lee, SS (2003). Psychopathology and substance abuse in parents of young children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry 42, 1424–1432.CrossRefGoogle ScholarPubMed
Clarke, C, Fitzpatrick, C (2005). Psychiatric problems in children exposed to opiates in utero. Irish Journal of Psychological Medicine 22, 121–123.CrossRefGoogle ScholarPubMed
Daly, A, Walsh, D (2010). Activities of Irish psychiatric units and hospitals 2009: main findings. HRB Statistics Series 9. Health Research Board: Dublin.Google Scholar
Davids, E, Gastpar, M (2003). Attention-deficit/hyperactivity disorder and substance abuse. Psychiatrische Praxis 30, 182–186.Google ScholarPubMed
Edokpolo, O, Nkire, N, Smyth, BP (2010). Irish Adolescents with ADHD and comorbid substance use disorder. Irish Journal of Psychological Medicine 27, 148–151.CrossRefGoogle ScholarPubMed
Faraone, SV, Sergeant, J, Gillberg, C, Biederman, J (2003). The worldwide prevalence of ADHD: is it an American condition? World Psychiatry 2, 104–113.Google ScholarPubMed
Fayyad, J, De Graaf, R, Kessler, R, Alonso, J, Angermeyer, M, Demyttenaere, K, De Girolamo, G, Haro, JM, Karam, EG, Lara, C, Lepine, JP, Ormel, J, Posada-Villa, J, Zaslavsky, AM, Jin, R (2007). Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. British Journal of Psychiatry 190, 402–409.CrossRefGoogle ScholarPubMed
Fitzgerald, M (1998). Adult attention deficit hyperactivity disorder. Irish Journal of Psychological Medicine 15, 82–83.CrossRefGoogle Scholar
Fitzgerald, M (2001). Psychopharmacological treatment of adolescent and adult attention deficit hyperactivity disorder. Irish Journal of Psychological Medicine 18, 93–98.CrossRefGoogle ScholarPubMed
Fitzgerald, M (2005). Attention Deficit Hyper Activity Disorder in adulthood. Irish Journal of Psychological Medicine 22, 1–34.Google Scholar
Goossensen, MA, van de Glind, G, Carpentier, PJ, Wijsen, RMA, van Duin, D, Kooij, S (2006). An intervention program for ADHD in patients with substance use disorders: preliminary results of a field trial. Journal of Substance Abuse Treatment 30, 253–259.CrossRefGoogle ScholarPubMed
Hinshaw, SP, Owens, EB, Sami, N, Fargeon, S (2006). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into adolescence: evidence for continuing cross-domain impairment. Journal of Consulting and Clinical Psychology 74, 489–499.CrossRefGoogle ScholarPubMed
James, PD, Smyth, BP, Apantaku-Olajide, T (2013). Substance use and psychiatric disorders in Irish adolescents: a cross sectional study of patients attending substance abuse treatment service. Mental Health and Substance Use 6 (2), 124–132.CrossRefGoogle Scholar
Kalbag, AS, Levin, FR (2005). Adult ADHD and substance abuse: diagnostic and treatment issues. Substance Use and Misuse 40, 1955–1981, 2043–2048.CrossRefGoogle ScholarPubMed
Kessler, RC, Adler, L, Barkley, R, Biederman, J, Conners, CK, Demler, O, etal. (2006). The prevalence and correlates of adult ADHD in the United States: results from the national comorbidity survey replication. American Journal of Psychiatry 163, 716–723.CrossRefGoogle ScholarPubMed
Kessler, RC, Adler, LA, Barkley, R, Biederman, J, Conners, CK, Faraone, SV, Greenhill, LL, Howes, MJ, Secnik, K, Spencer, T, Ustun, TB, Walters, EE, Zaslavsky, AM (2005). Patterns and predictors of attention deficit/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biological Psychiatry 57, 1442–1451.CrossRefGoogle ScholarPubMed
Kirley, A, Fitzgerald, M (2002). Adult attention deficit hyperactivity disorder: a controversial diagnosis. Irish Journal of Psychological Medicine 19, 86–91.CrossRefGoogle ScholarPubMed
Konstenius, M, Jayaram-Lindström, N, Beck, O, Franck, J (2010). Sustained release methylphenidate for the treatment of ADHD in amphetamine abusers: a pilot study. Drug and Alcohol Dependence 108, 130–133.CrossRefGoogle ScholarPubMed
Lee, SS, Humphreys, KL, Flory, K, Liu, R, Glass, K (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clinical Psychology Review 31, 328–341.CrossRefGoogle ScholarPubMed
Lee, SS, Lahey, BB, Owens, EB, Hinshaw, SP (2008). Few preschool boys and girls with ADHD are well-adjusted during adolescence. Journal of Abnormal Child Psychology 36, 373–383.CrossRefGoogle ScholarPubMed
Levin, FR, Evans, SM, Brooks, DJ, Garawi, F (2007). Treatment of cocaine dependent treatment seekers with adult ADHD: double-blind comparison of methylphenidate and placebo. Drug and Alcohol Dependence 87, 20–29.CrossRefGoogle ScholarPubMed
Levin, FR, Evans, SM, Brooks, DJ, Kalbag, AS, Garawi, F, Nunes, EV (2006). Treatment of methadone-maintained patients with adult ADHD: double-blind comparison of methylphenidate, bupropion and placebo. Drug and Alcohol Dependence 81, 137–148.CrossRefGoogle ScholarPubMed
Lynch, F, Mills, C, Daly, I, Fitzpatrick, C (2006). Challenging times: prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents. Journal of Adolescence 29, 555–573.CrossRefGoogle ScholarPubMed
Lynskey, MT, Hall, W (2001). Attention deficit hyperactivity disorder and substance use disorders: is there a causal link? Addiction 96, 815–822.CrossRefGoogle ScholarPubMed
Matsumoto, T, Kamijo, A, Yamaguchi, A, Iseki, E, Hirayasu, Y (2005). Childhood histories of attention-deficit hyperactivity disorders in Japanese methamphetamine and inhalant abusers: preliminary report. Psychiatry and Clinical Neurosciences 59, 102–105.CrossRefGoogle ScholarPubMed
Matthies, S, Philipsen, A, Svaldi, J (2012). Risky decision making in adults with ADHD. Journal of Behavior Therapy and Experimental Psychiatry 43, 938–946.CrossRefGoogle ScholarPubMed
Meltzer, H, Gatward, R, Goodman, R, Ford, T (2000). Mental health of children and adolescents in Great Britain: office for national statistics. Stationery Office: London.CrossRefGoogle Scholar
Molina, BSG, Marshal, MP, Pelham, WE Jr, Wirth, RJ (2005). Coping skills and parent support mediate the association between childhood attention-deficit/hyperactivity disorder and adolescent cigarette use. Journal of Pediatric Psychology 30, 345–357.CrossRefGoogle ScholarPubMed
Owens, EB, Hinshaw, SP, Lee, SS, Lahey, BB (2009). Few girls with childhood attention-deficit/hyperactivity disorder show positive adjustment during adolescence. Journal of Clinical Child & Adolescent Psychology 38, 132–143.CrossRefGoogle ScholarPubMed
Polanczyk, G, Rohde, LA (2007). Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Current Opinions in Psychiatry 20, 386–392.CrossRefGoogle ScholarPubMed
Riggs, PD, Levin, F, Green, AI, Vocci, F (2008). Comorbid psychiatric and substance abuse disorders: recent treatment research. Substance Abuse 29, 51–63.CrossRefGoogle ScholarPubMed
Scahill, L, Schwab-Stone, M (2000). Epidemiology of ADHD in school-age children. Child and Adolescent Psychiatric Clinics of North America 9, 541–555.CrossRefGoogle ScholarPubMed
Sullivan, MA, Rudnik-Levin, F (2001). Attention deficit/hyperactivity disorder and substance abuse. Diagnostic and therapeutic considerations. Annals of the New York Academy of Sciences 931, 251–270.CrossRefGoogle ScholarPubMed
Syed, H, Masaud, TM, Nkire, N, Iro, C, Garland, MR (2010). Estimating the prevalence of adult ADHD in the psychiatric clinic: a cross-sectional study using the adult ADHD self-report scale (ASRS). Irish Journal of Psychological Medicine 27, 195–197.CrossRefGoogle Scholar
Thurstone, C, Riggs, PD, Salomonsen-Sautel, S, Mikulich-Gilbertson, CK (2010). Randomized, controlled trial of atomoxetine for attention-deficit/hyperactivity disorder in adolescents with substance use disorder. Journal of the American Academy of Child & Adolescent Psychiatry 49, 573–582.Google ScholarPubMed
Van den Brink, W (2012). Screening for Adult ADHD in SUD Patients Reliability and Validity of the ASRS-v1 (Preliminary Results). ICASA Satellite Symposium Bordeaux, September 2012.Google Scholar
van Emmerik-van Oortmerssen, K, van de Glind, G, van den Brink, W, Smit, F (2012). Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug and Alcohol Dependence 122, 11–19.CrossRefGoogle ScholarPubMed
Wender, PH, Wolf, LE, Wasserstein, J (2001). Adults with ADHD. An overview. Annals of the New York Academy of Sciences 931, 1–16.CrossRefGoogle ScholarPubMed
Wilens, TE (2004). Attention-deficit/hyperactivity disorder and the substance use disorders: the nature of the relationship, subtypes at risk, and treatment issues. Psychiatric Clinics of North America 27, 283–301.CrossRefGoogle ScholarPubMed
Wilens, TE, Fusillo, S (2007). When ADHD and substance use disorders intersect: relationship and treatment implications. Current Psychiatry Reports 9, 408–414.CrossRefGoogle ScholarPubMed
Wilens, TE, Upadhyaya, HP (2007). Impact of substance use disorder on ADHD and its treatment. Journal of Clinical Psychiatry 68, e20.CrossRefGoogle ScholarPubMed
Wilens, T, Martelon, MK, Joshi, G, Bateman, C, Fried, R, Petty, C, Biederman, J (2011). Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. Journal of the American Academy of Child & Adolescent Psychiatry 50, 543–553.CrossRefGoogle ScholarPubMed