Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational studies (by design analogy)
PubMed 22209385 · doi:10.1016/j.drugalcdep.2011.12.007
What was done
A systematic search was performed across MEDLINE, PsycINFO, and EMBASE for English-language studies evaluating DSM-criteria ADHD prevalence in substance use disorder (SUD) patients, excluding studies where nicotine was the primary substance. Following quality assessment, 29 studies were included in a meta-analysis. Meta-regression analyses evaluated the influence of age, primary substance of abuse, setting, and diagnostic assessment instrument on prevalence estimates.
What was found
Across all included SUD subjects, 23.1% (95% CI: 19.4-27.2%) met DSM criteria for comorbid ADHD. Comorbid ADHD prevalence was lower in patients with cocaine dependence than in those with alcohol dependence, opioid dependence, and other addictions. Diagnostic tools influenced results significantly: studies using DICA or SADS-L yielded significantly higher comorbidity rates than those using KSADS, DISC, DIS, or other instruments.
Why it matters
Almost one in four individuals treated for substance use disorders meets criteria for ADHD, demonstrating substantial comorbidity that warrants systematic diagnostic screening in addiction treatment settings.
Limits
The abstract does not state the total participant sample size across the 29 studies. The review was restricted to English-language publications and excluded nicotine dependence as a primary SUD. Prevalence rates varied substantially depending on the diagnostic instrument used.
Cited by
- supports There is a very high prevalence of ADHD among adults who are addicted to alcohol.