Substance abuse in patients with co-morbid adhd

ABSTRACT

To study the tendency of occurrence of attention-deficit hyperactivity disorder [ADHD] with substance abuse. A cross-sectional, hospital based study. The study was carried out at Lady Reading Hospital and Khyber Teaching Hospital, Peshawar, Pakistan from 4th April 2012 to 29th August 2012. A sample of 110 adult patients with 53 heroin dependents, 23 THC, 15 opium, 11 poly drug and 8 alcohol dependents were analyzed that whether they were ADHD and that childhood problem continues to manifest symptoms in adults. For retrospective assessment of childhood ADHD, the Wender Utah Rating Scale [WURS] as well as the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] symptom checklist for ADHD was used. The Conners' Adult ADHD Rating Scales [CAARS] was used to assess the persisting symptoms of ADHD in adults.Patient diagnosed with drug and alcohol dependence according to DSM-IV were included in the study whereas patient co-morbid with any other psychiatric illnesses were excluded. Heroin dependent showed 41.5% [WURS] and 37.7% [DSM-IV diagnostic criteria], whereas THC validated 34.7% [WURS] and 30.4% [DSM-IV], opium demonstrated 46.6% [WURS] and 40%[DSM-IV], poly drug dependence established 63.6% [WURS] and 54.5% [DSM-IV] and alcohol dependent showed 50% [WURS] and 37.5% [DSM-IV] indicated evidence of retrospective ADHD affliction in childhood. CAARS was presented in 35.8% heroin dependent, 34.7% THC, 46.6% opioid, 33.3% poly drug dependence and 37.5% alcohol dependent; and exhibited a substantiation of ADHD persistent in adulthood. The difference between the mean score of WURS and CAARS of ADHD patients were significantly greater [P = 0.029], than the normal patients. Pese results revealed that ADHD is a risk factor associated with substance dependence, expressed in the form of heroine, THC, opioid, alcohol dependence and also in poly drug dependence