Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: A meta-analysis and meta-regression analysis

• Published in: Drug and alcohol dependence Vol. 122; no. 1-2; pp. 11 - 19
• Main Authors: van Emmerik-van Oortmerssen, Katelijne, van de Glind, Geurt, van den Brink, Wim, Smit, Filip, Crunelle, Cleo L., Swets, Marije, Schoevers, Robert A.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.04.2012; Elsevier
• Subjects: Addictive behaviors; ADHD; Adult and adolescent clinical studies; Alcohol; Alcoholism; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit disorders. Hyperactivity; Attention deficit hyperactivity disorder; Biological and medical sciences; Child clinical studies; Cocaine; Comorbidity; Diagnosis, Dual (Psychiatry); Drug abuse; Drug dependency; Drugs; Humans; Medical sciences; Meta-analysis; Miscellaneous; Morbidity; Nicotine; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Substance abuse disorders; Substance use; Substance use disorders; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance use disorders; ADHD; Prevalence; Meta-analysis; Human; Drug addiction; Evidence-based practice; Patient; Substance abuse; Regression analysis; Review; Epidemiology; Evidence-based medicine; Metaanalysis; Addiction; Drug of abuse; Attention disorder with hyperactivity; Public health
• ISSN: 0376-8716; 1879-0046; 1879-0046
• DOI: 10.1016/j.drugalcdep.2011.12.007

Substance use disorders (SUD) are a major public health problem. Attention deficit hyperactivity disorder (ADHD) is a comorbid condition associated with both onset and prognosis of SUD. Prevalence estimates of ADHD in SUD vary significantly. To obtain a best estimate of the prevalence of ADHD in SUD populations. A literature search was conducted using MEDLINE, PsycINFO and EMBASE. Search terms were ADHD, substance-related disorders, addiction, drug abuse, drug dependence, alcohol abuse, alcoholism, comorbidity, and prevalence. Results were limited to the English language. After assessing the quality of the retrieved studies, 29 studies were selected. Studies in which nicotine was the primary drug of abuse were not included. All relevant data were extracted and analysed in a meta-analysis. A series of meta-regression analyses was performed to evaluate the effect of age, primary substance of abuse, setting and assessment procedure on the prevalence of ADHD in a variety of SUD populations. Overall, 23.1% (CI: 19.4–27.2%) of all SUD subjects met DSM-criteria for comorbid ADHD. Cocaine dependence was associated with lower ADHD prevalence than alcohol dependence, opioid dependence and other addictions. Studies using the DICA or the SADS-L for the diagnosis of ADHD showed significantly higher comorbidity rates than studies using the KSADS, DISC, DIS or other assessment instruments. ADHD is present in almost one out of every four patients with SUD. The prevalence estimate is dependent on substance of abuse and assessment instrument.