Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study

Katelijne Van Emmerik-van Oortmerssen; Geurt van de Glind; Maarten W.J. Koeter; Steve Allsop; Marc Auriacombe; Csaba Barta; Eli Torild H. Bu; Yuliya Burren; Pieter-Jan Carpentier; Susan Carruthers; Miguel Casas; Zsolt Demetrovics; Stephen V. Faraone; Melina Fatseas; Johan Franck; Brian Johnson; Máté Kapitány-Fövény; Sharlene Kaye; Maija Konstenius; Frances R. Levin; Franz Moggi; Merete Möller; J. Antoni Ramos-Quiroga; Arild Schillinger; Arvid Skutle; Sofie Verspreet; IASP Research Group; Wim van den Brink; Robert A. Schoevers

doi:10.1111/add.12370

Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study

Katelijne Van Emmerik-van Oortmerssen
, Geurt van de Glind
, Maarten W.J. Koeter
, Steve Allsop
, Marc Auriacombe
, Csaba Barta
, Eli Torild H. Bu
, Yuliya Burren
, Pieter-Jan Carpentier
, Susan Carruthers
, Miguel Casas
, Zsolt Demetrovics
, Stephen V. Faraone
, Melina Fatseas
, Johan Franck
, Brian Johnson
, Máté Kapitány-Fövény
, Sharlene Kaye
, Maija Konstenius
, Frances R. Levin

Franz Moggi, Merete Möller, J. Antoni Ramos-Quiroga, Arild Schillinger, Arvid Skutle, Sofie Verspreet, IASP Research Group, Wim van den Brink, Robert A. Schoevers

Research output: Contribution to journal › Article › peer-review

149 Citations (Scopus)

Abstract

Aims: To determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of abuse.

Design: Data were obtained from the cross-sectional International ADHD in Substance use disorder Prevalence (IASP) study.

Setting: Forty-seven centres of SUD treatment in 10 countries.

Participants: A total of 1205 treatment-seeking SUD patients.

Measurements: Structured diagnostic assessments were used for all disorders: presence of ADHD was assessed with the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID), the presence of antisocial personality disorder (ASPD), major depression (MD) and (hypo)manic episode (HME) was assessed with the Mini International Neuropsychiatric Interview-Plus (MINI Plus), and the presence of borderline personality disorder (BPD) was assessed with the Structured Clinical Interview for DSM-IV Axis II (SCID II).

Findings: The prevalence of DSM-IV adult ADHD in this SUD sample was 13.9%. ASPD [odds ratio (OR)=2.8, 95% confidence interval (CI)=1.8-4.2], BPD (OR=7.0, 95% CI=3.1-15.6 for alcohol; OR=3.4, 95% CI=1.8-6.4 for drugs), MD in patients with alcohol as primary substance of abuse (OR=4.1, 95% CI=2.1-7.8) and HME (OR=4.3, 95% CI=2.1-8.7) were all more prevalent in ADHD⁺ compared with ADHD^- patients (P<0.001). These results also indicate increased levels of BPD and MD for alcohol compared with drugs as primary substance of abuse. Comorbidity patterns differed between ADHD subtypes with increased MD in the inattentive and combined subtype (P<0.01), increased HME and ASPD in the hyperactive/impulsive (P<0.01) and combined subtypes (P<0.001) and increased BPD in all subtypes (P<0.001) compared with SUD patients without ADHD. Seventy-five per cent of ADHD patients had at least one additional comorbid disorder compared with 37% of SUD patients without ADHD.

Conclusions: Treatment-seeking substance use disorder patients with attention deficit hyperactivity disorder are at a very high risk for additional externalizing disorders.

Original language	English
Pages (from-to)	262-272
Number of pages	11
Journal	Addiction
Volume	109
Issue number	2
DOIs	https://doi.org/10.1111/add.12370
Publication status	Published - Feb 2014
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

ADHD
Antisocial personality disorder
Bipolar disorder
Borderline personality disorder
Comorbidity
Depression
Substance use disorder

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10.1111/add.12370Licence: In Copyright

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Van Emmerik-van Oortmerssen, K., van de Glind, G., Koeter, M. W. J., Allsop, S., Auriacombe, M., Barta, C., Bu, E. T. H., Burren, Y., Carpentier, P.-J., Carruthers, S., Casas, M., Demetrovics, Z., Faraone, S. V., Fatseas, M., Franck, J., Johnson, B., Kapitány-Fövény, M., Kaye, S., Konstenius, M., ... Schoevers, R. A. (2014). Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study. Addiction, 109(2), 262-272. https://doi.org/10.1111/add.12370

@article{2d6e227c130f48dd91471e0a5692c24b,

title = "Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study",

abstract = "Aims: To determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of abuse. Design: Data were obtained from the cross-sectional International ADHD in Substance use disorder Prevalence (IASP) study. Setting: Forty-seven centres of SUD treatment in 10 countries. Participants: A total of 1205 treatment-seeking SUD patients. Measurements: Structured diagnostic assessments were used for all disorders: presence of ADHD was assessed with the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID), the presence of antisocial personality disorder (ASPD), major depression (MD) and (hypo)manic episode (HME) was assessed with the Mini International Neuropsychiatric Interview-Plus (MINI Plus), and the presence of borderline personality disorder (BPD) was assessed with the Structured Clinical Interview for DSM-IV Axis II (SCID II). Findings: The prevalence of DSM-IV adult ADHD in this SUD sample was 13.9\%. ASPD [odds ratio (OR)=2.8, 95\% confidence interval (CI)=1.8-4.2], BPD (OR=7.0, 95\% CI=3.1-15.6 for alcohol; OR=3.4, 95\% CI=1.8-6.4 for drugs), MD in patients with alcohol as primary substance of abuse (OR=4.1, 95\% CI=2.1-7.8) and HME (OR=4.3, 95\% CI=2.1-8.7) were all more prevalent in ADHD+ compared with ADHD- patients (P<0.001). These results also indicate increased levels of BPD and MD for alcohol compared with drugs as primary substance of abuse. Comorbidity patterns differed between ADHD subtypes with increased MD in the inattentive and combined subtype (P<0.01), increased HME and ASPD in the hyperactive/impulsive (P<0.01) and combined subtypes (P<0.001) and increased BPD in all subtypes (P<0.001) compared with SUD patients without ADHD. Seventy-five per cent of ADHD patients had at least one additional comorbid disorder compared with 37\% of SUD patients without ADHD. Conclusions: Treatment-seeking substance use disorder patients with attention deficit hyperactivity disorder are at a very high risk for additional externalizing disorders.",

keywords = "ADHD, Antisocial personality disorder, Bipolar disorder, Borderline personality disorder, Comorbidity, Depression, Substance use disorder",

author = "\{Van Emmerik-van Oortmerssen\}, Katelijne and \{van de Glind\}, Geurt and Koeter, \{Maarten W.J.\} and Steve Allsop and Marc Auriacombe and Csaba Barta and Bu, \{Eli Torild H.\} and Yuliya Burren and Pieter-Jan Carpentier and Susan Carruthers and Miguel Casas and Zsolt Demetrovics and Geert Dom and Faraone, \{Stephen V.\} and Melina Fatseas and Johan Franck and Brian Johnson and M{\'a}t{\'e} Kapit{\'a}ny-F{\"o}v{\'e}ny and Sharlene Kaye and Maija Konstenius and Levin, \{Frances R.\} and Franz Moggi and Merete M{\"o}ller and Ramos-Quiroga, \{J. Antoni\} and Arild Schillinger and Arvid Skutle and Sofie Verspreet and \{IASP Research Group\} and Atul Beniwal and Geert Bosma and Joanne Cassar and Therese Dahl and Constanza Daigre and Romain Debrabant and Louisa Degenhardt and \{van der Gaag\}, \{Rutger Jan\} and David Hay and Kari Lossius and L{\o}vaas, \{Eva Karin\} and Marion Malivert and Merete M{\"o}ller and Carlos Roncero and Laura Stevens and Sara Wallhed and \{van Wamel\}, Anneke and Jesse Young and \{van den Brink\}, Wim and Schoevers, \{Robert A.\}",

year = "2014",

month = feb,

doi = "10.1111/add.12370",

language = "English",

volume = "109",

pages = "262--272",

journal = "Addiction",

issn = "0965-2140",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "2",

}

Van Emmerik-van Oortmerssen, K, van de Glind, G, Koeter, MWJ, Allsop, S, Auriacombe, M, Barta, C, Bu, ETH, Burren, Y, Carpentier, P-J, Carruthers, S, Casas, M, Demetrovics, Z, Faraone, SV, Fatseas, M, Franck, J, Johnson, B, Kapitány-Fövény, M, Kaye, S, Konstenius, M, Levin, FR, Moggi, F, Möller, M, Ramos-Quiroga, JA, Schillinger, A, Skutle, A, Verspreet, S, IASP Research Group, van den Brink, W & Schoevers, RA 2014, 'Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study', Addiction, vol. 109, no. 2, pp. 262-272. https://doi.org/10.1111/add.12370

Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study. / Van Emmerik-van Oortmerssen, Katelijne; van de Glind, Geurt; Koeter, Maarten W.J. et al.
In: Addiction, Vol. 109, No. 2, 02.2014, p. 262-272.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder

T2 - results of the IASP study

AU - Van Emmerik-van Oortmerssen, Katelijne

AU - van de Glind, Geurt

AU - Koeter, Maarten W.J.

AU - Allsop, Steve

AU - Auriacombe, Marc

AU - Barta, Csaba

AU - Bu, Eli Torild H.

AU - Burren, Yuliya

AU - Carpentier, Pieter-Jan

AU - Carruthers, Susan

AU - Casas, Miguel

AU - Demetrovics, Zsolt

AU - Dom, Geert

AU - Faraone, Stephen V.

AU - Fatseas, Melina

AU - Franck, Johan

AU - Johnson, Brian

AU - Kapitány-Fövény, Máté

AU - Kaye, Sharlene

AU - Konstenius, Maija

AU - Levin, Frances R.

AU - Moggi, Franz

AU - Möller, Merete

AU - Ramos-Quiroga, J. Antoni

AU - Schillinger, Arild

AU - Skutle, Arvid

AU - Verspreet, Sofie

AU - IASP Research Group

AU - Beniwal, Atul

AU - Bosma, Geert

AU - Cassar, Joanne

AU - Dahl, Therese

AU - Daigre, Constanza

AU - Debrabant, Romain

AU - Degenhardt, Louisa

AU - van der Gaag, Rutger Jan

AU - Hay, David

AU - Lossius, Kari

AU - Løvaas, Eva Karin

AU - Malivert, Marion

AU - Möller, Merete

AU - Roncero, Carlos

AU - Stevens, Laura

AU - Wallhed, Sara

AU - van Wamel, Anneke

AU - Young, Jesse

AU - van den Brink, Wim

AU - Schoevers, Robert A.

PY - 2014/2

Y1 - 2014/2

N2 - Aims: To determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of abuse. Design: Data were obtained from the cross-sectional International ADHD in Substance use disorder Prevalence (IASP) study. Setting: Forty-seven centres of SUD treatment in 10 countries. Participants: A total of 1205 treatment-seeking SUD patients. Measurements: Structured diagnostic assessments were used for all disorders: presence of ADHD was assessed with the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID), the presence of antisocial personality disorder (ASPD), major depression (MD) and (hypo)manic episode (HME) was assessed with the Mini International Neuropsychiatric Interview-Plus (MINI Plus), and the presence of borderline personality disorder (BPD) was assessed with the Structured Clinical Interview for DSM-IV Axis II (SCID II). Findings: The prevalence of DSM-IV adult ADHD in this SUD sample was 13.9%. ASPD [odds ratio (OR)=2.8, 95% confidence interval (CI)=1.8-4.2], BPD (OR=7.0, 95% CI=3.1-15.6 for alcohol; OR=3.4, 95% CI=1.8-6.4 for drugs), MD in patients with alcohol as primary substance of abuse (OR=4.1, 95% CI=2.1-7.8) and HME (OR=4.3, 95% CI=2.1-8.7) were all more prevalent in ADHD+ compared with ADHD- patients (P<0.001). These results also indicate increased levels of BPD and MD for alcohol compared with drugs as primary substance of abuse. Comorbidity patterns differed between ADHD subtypes with increased MD in the inattentive and combined subtype (P<0.01), increased HME and ASPD in the hyperactive/impulsive (P<0.01) and combined subtypes (P<0.001) and increased BPD in all subtypes (P<0.001) compared with SUD patients without ADHD. Seventy-five per cent of ADHD patients had at least one additional comorbid disorder compared with 37% of SUD patients without ADHD. Conclusions: Treatment-seeking substance use disorder patients with attention deficit hyperactivity disorder are at a very high risk for additional externalizing disorders.

AB - Aims: To determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of abuse. Design: Data were obtained from the cross-sectional International ADHD in Substance use disorder Prevalence (IASP) study. Setting: Forty-seven centres of SUD treatment in 10 countries. Participants: A total of 1205 treatment-seeking SUD patients. Measurements: Structured diagnostic assessments were used for all disorders: presence of ADHD was assessed with the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID), the presence of antisocial personality disorder (ASPD), major depression (MD) and (hypo)manic episode (HME) was assessed with the Mini International Neuropsychiatric Interview-Plus (MINI Plus), and the presence of borderline personality disorder (BPD) was assessed with the Structured Clinical Interview for DSM-IV Axis II (SCID II). Findings: The prevalence of DSM-IV adult ADHD in this SUD sample was 13.9%. ASPD [odds ratio (OR)=2.8, 95% confidence interval (CI)=1.8-4.2], BPD (OR=7.0, 95% CI=3.1-15.6 for alcohol; OR=3.4, 95% CI=1.8-6.4 for drugs), MD in patients with alcohol as primary substance of abuse (OR=4.1, 95% CI=2.1-7.8) and HME (OR=4.3, 95% CI=2.1-8.7) were all more prevalent in ADHD+ compared with ADHD- patients (P<0.001). These results also indicate increased levels of BPD and MD for alcohol compared with drugs as primary substance of abuse. Comorbidity patterns differed between ADHD subtypes with increased MD in the inattentive and combined subtype (P<0.01), increased HME and ASPD in the hyperactive/impulsive (P<0.01) and combined subtypes (P<0.001) and increased BPD in all subtypes (P<0.001) compared with SUD patients without ADHD. Seventy-five per cent of ADHD patients had at least one additional comorbid disorder compared with 37% of SUD patients without ADHD. Conclusions: Treatment-seeking substance use disorder patients with attention deficit hyperactivity disorder are at a very high risk for additional externalizing disorders.

KW - ADHD

KW - Antisocial personality disorder

KW - Bipolar disorder

KW - Borderline personality disorder

KW - Comorbidity

KW - Depression

KW - Substance use disorder

UR - https://www.scopus.com/pages/publications/84892431375

U2 - 10.1111/add.12370

DO - 10.1111/add.12370

M3 - Article

C2 - 24118292

AN - SCOPUS:84892431375

SN - 0965-2140

VL - 109

SP - 262

EP - 272

JO - Addiction

JF - Addiction

IS - 2

ER -

Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study

Abstract

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Keywords

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