[Clinical Psychiatry News 26(2):5, 1998. © 1998 International Medical News Group.]
|
TORONTO -- Adult attention-deficit hyperactivity disorder increases the risk of substance use disorders and worsens their course, Eric Mick said at the annual meeting of the American Academy of Child and Adolescent Psychiatry. Adults with attention-deficit hyperactivity disorder (ADHD) are more likely to move from alcohol to drug abuse and less likely to experience remissions, said Mr. Mick, a doctoral candidate at Harvard School of Public Health in Boston. He reported data from a study that compared 239 consecutive adults who were diagnosed with ADHD and 268 adult relatives who did not have the disorder. Neither ADHD nor comorbid psychiatric conditions appeared to affect the transition from drugs to alcohol, but the ADHD patients were nearly four times more likely than controls to have progressed from alcohol to drug use, Mr. Mick said. Also, ADHD patients were five times more likely to move from substance dependence to abuse. In contrast, individuals with a concurrent psychiatric diagnosis--conduct disorder, antisocial personality disorder, mood disorder, or anxiety disorder--were six times more likely to move from abuse to dependence, he said. ADHD was associated with a more chronic course of substance use disorder. Controls had a higher rate of remission, and it took a median of 4 years longer--7 years vs. 3 years--for substance use disorder to remit in ADHD patients. "They had a more difficult time stopping," Mr. Mick said. Comorbidity, age, and low socioeconomic status had no effect on remission rates. "ADHD was the only factor, affecting remission rates," he said. Although women were more likely to remit in the control group, no sex difference was seen in the patient group. "The deleterious effect of ADHD could be stronger than the protective effect of gender," he said. Contrary to widespread belief, individuals with ADHD were no more prone than others to abuse stimulants. In fact, there was no difference in the drugs of choice between the two groups: Marijuana was the most popular by a wide margin, and stimulants including cocaine followed far behind, Mr. Mick said. |