Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-18T22:55:52.101Z Has data issue: false hasContentIssue false
  • English
  • Français

Adult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men

Published online by Cambridge University Press:  20 May 2015

N. Estévez ,
M. Dey ,
D. Eich-Höchli ,
S. Foster ,
G. Gmel  and
M. Mohler-Kuo
N. Estévez*
Affiliation:
Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
M. Dey
Affiliation:
Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
D. Eich-Höchli
Affiliation:
Psychiatric University Hospital Zurich, Zurich, Switzerland
S. Foster
Affiliation:
Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
G. Gmel
Affiliation:
Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland
M. Mohler-Kuo
Affiliation:
Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
*
*Address for correspondence: N. Estévez, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland. (Email: natalia.estevezgomez@uzh.ch)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Functional and mental health impairments that adults with attention-deficit/hyperactivity disorder (ADHD) experience may be exacerbated by regular substance use and co-morbidity with substance use disorders (SUD). This may be especially true during young adulthood, which represents a critical stage of life associated with increased substance use and associated problems. However, previous studies investigating the association between ADHD and substance use and SUD have demonstrated inconsistent results, probably due to methodological limitations (e.g., small and non-representative samples). Thus, the relationship of ADHD with substance use and related disorders remains unclear. The aim of the present study was to examine the association between ADHD and both the use of licit and illicit substances and the presence of SUD in a large, representative sample of young men.

Method.

The sample included 5677 Swiss men (mean age 20 ± 1.23 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed using the adult ADHD Self Report Screener (ASRS). The association between ADHD and substance use and SUD was assessed for alcohol, nicotine, cannabis and other illicit drugs, while controlling for socio-demographic variables and co-morbid psychiatric disorders (i.e., major depression (MD) and anti-social personality disorder (ASPD)).

Results.

Men with ADHD were more likely to report having used nicotine, cannabis and other illicit drugs at some time in their life, but not alcohol. ADHD was positively associated with early initiation of alcohol, nicotine and cannabis use, the risky use of these substances, and the presence of alcohol use disorders, and nicotine and cannabis dependence. Additionally, our analyses revealed that these patterns are also highly associated with ASPD. After adjusting for this disorder, the association between ADHD and licit and illicit substance use and the presence of SUDs was reduced, but remained significant.

Conclusions.

Our findings suggest that adult ADHD is significantly associated with a propensity to experiment with licit and illicit substances, especially at earlier ages, to exhibit risky substance use patterns, and to subsequently develop SUDs. Preventive strategies that include early intervention and addressing co-morbidity with ASPD may be crucial to reducing substance use and the development of pathological substance use patterns in young men affected by ADHD and, thus, helping to prevent further illness burden later in life.

Keywords

Adult attention-deficit/hyperactivity disorderalcoholcannabisnicotinesubstance usesubstance use disorder
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 3 , June 2016 , pp. 255 - 266
Copyright
Copyright © Cambridge University Press 2015 

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

Adamson, SJ, Sellman, JD (2003). A prototype screening instrument for cannabis use disorder: the cannabis use disorders identification test (CUDIT) in an alcohol-dependent clinical sample. Drug and Alcohol Review 22, 309–315.CrossRefGoogle Scholar
Annaheim, B, Scotto, TJ, Gmel, G (2010). Revising the cannabis use disorders identification test (CUDIT) by means of item response theory. International Journal of Methods in Psychiatric Research 19, 142–155.CrossRefGoogle ScholarPubMed
Baggio, S, Studer, J, Mohler-Kuo, M, Daeppen, JB, Gerhard, G (2013). Profiles of drug users in Switzerland and effects of early-onset intensive use of alcohol, tobacco and cannabis on other illicit drug use. Swiss Medical Weekly 143, w13805.Google ScholarPubMed
Baker, L, Prevatt, F, Proctor, B (2012). Drug and alcohol use in college students with and without ADHD. Journal of Attention Disorders 16, 255–263.CrossRefGoogle ScholarPubMed
Bech, P, Rasmussen, NA, Olsen, LR, Noerholm, V, Abildgaard, W (2001). The sensitivity and specificity of the major depression inventory, using the present state examination as the index of diagnostic validity. Journal of Affective Disorders 66, 159–164.Google Scholar
Bleich, S, Havemann-Reinecke, U, Kornhuber, J (2002). Fagerström-test für nikotinabhängigkeit (ftna). Beltz test: Göttingen.Google Scholar
Brod, M, Schmitt, E, Goodwin, M, Hodgkins, P, Niebler, G (2012). ADHD burden of illness in older adults: a life course perspective. Quality of Life Research 21, 795–799.Google Scholar
Bucholz, KK, Cadoret, R, Cloninger, CR, Dinwiddie, SH, Hesselbrock, VM, Nurnberger, JI Jr., Reich, T, Schmidt, I, Schuckit, MA (1994). A new, semi-structured psychiatric interview for use in genetic linkage studies: a report on the reliability of the SSAGA. Journal of Studies on Alcohol and Drugs 55, 149–158.CrossRefGoogle ScholarPubMed
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 and Adolescent Psychiatry 50, 9–21.Google Scholar
Das, D, Cherbuin, N, Butterworth, P, Anstey, KJ, Easteal, S (2012). A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults. PLoS ONE 7, e31500.Google Scholar
De Alwis, D, Lynskey, MT, Reiersen, AM, Agrawal, A (2014). Attention-deficit/hyperactivity disorder subtypes and substance use and use disorders in NESARC. Addictive Behaviors 39, 1278–1285.Google Scholar
de Zwaan, M, Gruss, B, Muller, A, Graap, H, Martin, A, Glaesmer, H, Hilbert, A, Philipsen, A (2012). The estimated prevalence and correlates of adult ADHD in a German community sample. European Archives of Psychiatry and Clinical Neuroscience 262, 79–86.CrossRefGoogle Scholar
Ebejer, JL, Medland, SE, van der Werf, J, Gondro, C, Henders, AK, Lynskey, M, Martin, NG, Duffy, DL (2012). Attention deficit hyperactivity disorder in Australian adults: prevalence, persistence, conduct problems and disadvantage. PLoS ONE 7, e47404.Google Scholar
Ernst, M, Luckenbaugh, DA, Moolchan, ET, Leff, MK, Allen, R, Eshel, N, London, ED, Kimes, A (2006). Behavioral predictors of substance-use initiation in adolescents with and without attention-deficit/hyperactivity disorder. Pediatrics 117, 2030–2039.CrossRefGoogle ScholarPubMed
Estévez, N, Eich-Hochli, D, Dey, M, Gmel, G, Studer, J, Mohler-Kuo, M (2014). Prevalence of and associated factors for adult attention deficit hyperactivity disorder in young swiss men. PLoS ONE 9, e89298.Google Scholar
Faraone, SV, Biederman, J, Spencer, T, Wilens, T, Seidman, LJ, Mick, E, Doyle, AE (2000). Attention-deficit/hyperactivity disorder in adults: an overview. Biological Psychiatry 48, 9–20.CrossRefGoogle ScholarPubMed
Faul, F, Erdfelder, E, Buchner, A, Lang, AG (2009). Statistical power analyses using g*power 3.1: tests for correlation and regression analyses. Behavior Research Methods 41, 1149–1160.Google Scholar
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
Frei, A, Hornung, R, Eich, D (2010). Tabakkonsum bei erwachsenen mit adhs. Nervenarzt 81, 860–866.Google Scholar
Galera, C, Bouvard, MP, Melchior, M, Chastang, JF, Lagarde, E, Michel, G, Encrenaz, G, Messiah, A, Fombonne, E (2010). Disruptive symptoms in childhood and adolescence and early initiation of tobacco and cannabis use: the Gazel Youth study. European Psychiatry: The Journal of the Association of European Psychiatrists 25, 402–408.Google Scholar
Galera, C, Pingault, JB, Fombonne, E, Michel, G, Lagarde, E, Bouvard, MP, Melchior, M (2013). Attention problems in childhood and adult substance use. The Journal of Pediatrics 163, 1677–1683 e1671.Google Scholar
Gmel, G, Gaume, J, Willi, C, Michaud, PA, Cornuz, J, Daeppen, JB (2010). Challenging the “inoffensiveness” of regular cannabis use by its associations with other current risky substance use--a census of 20-year-old swiss men. International Journal of Environmental Research and Public Health 7, 46–59.CrossRefGoogle ScholarPubMed
Gotham, HJ, Sher, KJ, Wood, PK (2003). Alcohol involvement and developmental task completion during young adulthood. Journal of Studies on Alcohol and Drugs 64, 32–42.Google Scholar
Heatherton, TF, Kozlowski, LT, Frecker, RC, Fagerstrom, KO (1991). The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. British Journal of Addiction 86, 1119–1127.Google Scholar
Hesselbrock, M, Easton, C, Bucholz, KK, Schuckit, M, Hesselbrock, V (1999). A validity study of the SSAGA–a comparison with the scan. Addiction 94, 1361–1370.CrossRefGoogle ScholarPubMed
Iacus, SA, Porro, G (2007). Missing data imputation, matching and other applications of random recursive partitioning. Computational Statistics & Data Analysis 52, 773–789.Google Scholar
Kessler, RC, Adler, L, Ames, M, Demler, O, Faraone, S, Hiripi, E, Howes, MJ, Jin, R, Secnik, K, Spencer, T, Ustun, TB, Walters, EE (2005). The world health organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population. Psychological Medicine 35, 245–256.Google Scholar
Kessler, RC, Adler, LA, Gruber, MJ, Sarawate, CA, Spencer, T, Van Brunt, DL (2007). Validity of the world health organization adult ADHD self-report scale (ASRS) screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research 16, 52–65.Google Scholar
Klein, RG, Mannuzza, S, Olazagasti, MA, Roizen, E, Hutchison, JA, Lashua, EC, Castellanos, FX (2012). Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Archives of General Psychiatry 69, 1295–1303.Google Scholar
Knight, JR, Wechsler, H, Kuo, M, Seibring, M, Weitzman, ER, Schuckit, MA (2002). Alcohol abuse and dependence among U.S. College students. Journal of Studies on Alcohol and Drugs 63, 263–270.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.Google Scholar
Madsen, AG, Dalsgaard, S (2014). Prevalence of smoking, alcohol and substance use among adolescents with attention-deficit/hyperactivity disorder in Denmark compared with the general population. Nordic Journal of Psychiatry 68, 53–59.Google Scholar
Odgers, CL, Caspi, A, Nagin, DS, Piquero, AR, Slutske, WS, Milne, BJ, Dickson, N, Poulton, R, Moffitt, TE (2008). Is it important to prevent early exposure to drugs and alcohol among adolescents? Psychological Science 19, 1037–1044.CrossRefGoogle ScholarPubMed
Olsen, LR, Jensen, DV, Noerholm, V, Martiny, K, Bech, P (2003). The internal and external validity of the major depression inventory in measuring severity of depressive states. Psychological Medicine 33, 351–356.Google Scholar
Regier, DA, Farmer, ME, Rae, DS, Locke, BZ, Keith, SJ, Judd, LL, Goodwin, FK (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the epidemiologic catchment area (ECA) study. JAMA: The Journal of the American Medical Association 264, 2511–2518.Google Scholar
Rehm, J, Taylor, B, Room, R (2006). Global burden of disease from alcohol, illicit drugs and tobacco. Drug and Alcohol Review 25, 503–513.Google Scholar
Rosenthal, JA (1996). Qualitative descriptors of strength of association and effect size. Journal of Social Service Research 21, 37–59.Google Scholar
Serra-Pinheiro, MA, Coutinho, ES, Souza, IS, Pinna, C, Fortes, D, Araujo, C, Szobot, CM, Rohde, LA, Mattos, P (2013). Is ADHD a risk factor independent of conduct disorder for illicit substance use? A meta-analysis and metaregression investigation. Journal of Attention Disorders 17, 459–469.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry 59, Suppl 20: 22–33;quiz 34–57.Google Scholar
Silva, N Jr., Szobot, CM, Shih, MC, Hoexter, MQ, Anselmi, CE, Pechansky, F, Bressan, RA, Rohde, LA (2014). Searching for a neurobiological basis for self-medication theory in ADHD comorbid with substance use disorders: an in vivo study of dopamine transporters using (99 m)tc-trodat-1 spect. Clinical Nuclear Medicine 39, e129–134.Google Scholar
Steinhausen, HC, Winkler, C, Meier, MM, Kannenberg, R (1998). Prevalence of child and adolescent psychiatric disorders: the Zurich epidemiological study. Acta Psychiatrica Scandinavica 98, 262–271.CrossRefGoogle ScholarPubMed
Studer, J, Baggio, S, Mohler-Kuo, M, Dermota, P, Gaume, J, Bertholet, N, Daeppen, JB, Gmel, G (2013). Examining non-response bias in substance use research--are late respondents proxies for non-respondents? Drug and Alcohol Dependence 132, 316–323.Google Scholar
Toumbourou, JW, Stockwell, T, Neighbors, C, Marlatt, GA, Sturge, J, Rehm, J (2007). Adolescent health 4-interventions to reduce harm associated with adolescent substance use. Lancet 369, 1391–1401.Google Scholar
Wilens, TE (2007). The nature of the relationship between attention-deficit/hyperactivity disorder and substance use. The Journal of Clinical Psychiatry 68(Suppl. 11), 4–8.Google Scholar
Wilens, TE, Adamson, J, Sgambati, S, Whitley, J, Santry, A, Monuteaux, MC, Biederman, J (2007). Do individuals with ADHD self-medicate with cigarettes and substances of abuse? Results from a controlled family study of ADHD. The American Journal on Addictions 16, 14–23.CrossRefGoogle ScholarPubMed