الفهرس 
EPIDEMIOLOGY OF ADULT ATTENTION DEFICIT HYPERACTIVITY DISorder IN SUBSTANCE USE DISORDEROnly 14 pages are availabe for public view
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Abstract
A
ttention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that causes functional impairment in many different domains of life. The core symptoms of ADHD are age-inappropriate problems with inattention and hyperactive/impulsive behavior, in combination or separately. ADHD typically first appears in early childhood and by early adolescence. About 60 to 85 percent of those diagnosed as children continuing to meet criteria for the disorder in adolescence, and up to 60 percent continuing to be symptomatic into adulthood.
A significant proportion of patients with the disorder presents with one or more comorbid conditions. Substance Use Disorder (SUD) remains among the most problematic co-occurring disorders with ADHD.
As regards the pattern of use in Egypt, it was concluded in a study conducted in 2016 that 13.3% used substance once in their lives, 6.0% were experimental users, and 6.7% are regular on substance use, while, 6.4% were fulfilling the criteria of dependence. There was a highly significant difference between both genders as regards the use of substance, 15.8% of the sample were male substance users while 2.2% were female substance users.
Little number of studies had discussed the comorbidity of both disorders in a sample of only female patients. So our study was concerned with that topic providing clear descriptive data about comorbidity of adult ADHD in female patients with SUD.
This study aimed at finding the rate of co-occurrence of adult ADHD, finding the socio demographic and clinical data of Adult ADHD comorbid with SUD, assessing the severities of SUD and ADHD and identifying specific substance use in female patients with Adult ADHD.
One hundred and ten female patients were included in the study fulfilling the criteria for SUD. They were screened for adult ADHD and severity of both disorders was measured.
We used Designed questionnaire (Ain Shams University, institute of psychiatry questionnaire) to assess the socio demographic data of the patients. We used clinical interview for DSM -IV Axis Disorders (SCID I) to diagnose substance abuse and to exclude other psychiatric comorbidities. Addiction Severity Index (ASI) was used to assess the severity of addiction in those patients. For diagnosing Adult ADHD Diagnostic Interview for Adult ADHD (DIVA 2.0) was used. Conner’s Adult ADHD Rating Scale (CAARS) was used for analyzing the severity of symptoms of Adult ADHD.
Our study estimated the rate of co-occurrence adult ADHD in female patients with SUD as 13.6%.
We found a significant difference between both groups of patients regarding age of onset of abuse. Female patients with ADHD start abuse of nicotine and other substances earlier than patients without ADHD.
Female patients with ADHD reported higher rate of suicidal attempts than other patients without ADHD, 93.3% of them had previously attempted suicide.
It is found that female patients with ADHD had longer duration of abuse than others which reflect the severity of SUD course in those patients.
In our study, the patients with ADHD are poly-substance abusers. A significant difference between both groups of patients regarding abuse of alcohol, cannabis, synthetic cannabinoid, pregabalin and anticholinergic drugs was found. Patients with ADHD used these substances more than patients without ADHD. Higher doses of substances especially cannabis were found in patients with ADHD.
There is a significant difference between both groups of patients regarding the severity of ADHD and SUD. We estimated the severity of ADHD symptoms (inattention, hyperactivity and impulsivity). The total symptoms severity is found to be very much above average in 80% of the patients. On the other hand, we found that there is a significant severity of SUD in patients with ADHD regarding problematic alcohol use and psychiatric symptoms.