Abstract
Introduction: The estimated prevalence for attention-deficit hyperactivity disorder (ADHD) in adulthood is 2-6%. Patients with a substance use disorder met the criteria for ADHD between 30 and 50%. ADHD and conduct disorders are discussed to increase risk of developing substance abuse and increase severity of disorder. Method: We compared epidemiological and clinical characteristics and ...
Abstract
Introduction: The estimated prevalence for attention-deficit hyperactivity disorder (ADHD) in adulthood is 2-6%. Patients with a substance use disorder met the criteria for ADHD between 30 and 50%. ADHD and conduct disorders are discussed to increase risk of developing substance abuse and increase severity of disorder. Method: We compared epidemiological and clinical characteristics and comorbidity in subgroups of 314 adult alcoholics of German descent with or without persistent symptoms of attention-deficit hyperactivity disorder (ADHD). Aim of the study was to identify specific pathophysiological mechanisms that could contribute to vulnerability, severity or complication of alcohol dependence. Results: 21.3% of the alcoholics fulfilled DSM-IV-criteria of ADHD with ongoing symptoms in adulthood and had a Wender-Utah-Rating-Scale score > 90. Subgroup of alcoholics with ADHD were significantly younger at age of onset of alcoholism (24 years versus 30 years), had a significantly higher daily alcohol intake (253 g versus 196 g EtOH), had significantly more social stress, lifetime experiences in court proceedings against them (11 versus 2%) and suicidal ideation (25 versus 11%). In the subgroup of alcoholics with ADHD 51% fulfilled criteria of antisocial personality disorder. The early onset of alcoholism was most pronounced in this subgroup. Conclusion: In our sample, persistence of ADHD symptoms from childhood into adulthood and antisocial personality disorder contributes to vulnerability and morbidity of alcohol dependence with early onset and greater severity of disorder.
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