Attention Deficit Hyperactivity Disorder among Clients Diagnosed with a Substance Use Disorder in the Therapeutic Communities: Prevalence and Psychiatric Comorbidity

Exploring dual diagnosis in opioid agonist treatment patients: a registry-linkage study in Czechia and Norway

BACKGROUND

Knowledge of co-occurring mental disorders (termed 'dual diagnosis') among patients receiving opioid agonist treatment (OAT) is scarce. This study aimed (1) to estimate the prevalence and structure of dual diagnoses in two national cohorts of OAT patients and (2) to compare mental disorders between OAT patients and the general populations stratified on sex and standardized by age.

METHODS

A registry-linkage study of OAT patients from Czechia (N = 4,280) and Norway (N = 11,389) during 2010-2019 was conducted. Data on mental disorders (F00-F99; ICD-10) recorded in nationwide health registers were linked to the individuals registered in OAT. Dual diagnoses were defined as any mental disorder excluding substance use disorders (SUDs, F10-F19; ICD-10). Sex-specific age-standardized morbidity ratios (SMR) were calculated for 2019 to compare OAT patients and the general populations.

RESULTS

The prevalence of dual diagnosis was 57.3% for Czechia and 78.3% for Norway. In Czechia, anxiety (31.1%) and personality disorders (25.7%) were the most prevalent, whereas anxiety (33.8%) and depression (20.8%) were the most prevalent in Norway. Large country-specific variations were observed, e.g., in ADHD (0.5% in Czechia, 15.8% in Norway), implying differences in screening and diagnostic practices. The SMR estimates for any mental disorders were 3.1 (females) and 5.1 (males) in Czechia and 5.6 (females) and 8.2 (males) in Norway. OAT females had a significantly higher prevalence of co-occurring mental disorders, whereas SMRs were higher in OAT males. In addition to opioid use disorder (OUD), other substance use disorders (SUDs) were frequently recorded in both countries.

CONCLUSIONS

Results indicate an excess of mental health problems in OAT patients compared to the general population of the same sex and age in both countries, requiring appropriate clinical attention. Country-specific differences may stem from variations in diagnostics and care, reporting to registers, OAT provision, or substance use patterns.

Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among Substance Use Disorder (SUD) Populations: Meta-Analysis

(1) Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of age-inappropriate levels of inattention and/or hyperactivity/impulsivity that results in functional impairment at work, education, or hobbies and affects family life, social contacts, and self-confidence. ADHD is a comorbid condition associated with a prognosis of severe substance use disorder (SUD) and the early onset of such. The aim of this meta-analysis was to obtain the best estimate of the prevalence of ADHD in SUD populations. (2) Methods: A literature research was conducted using PUBMED® and Web of Science®. The following search terms were used: [ADHD], [prevalence], and [substance use disorder]. RStudio® was used for meta-analysis methods. (3) Results: In total, 31 studies were included. We estimate the prevalence of ADHD among SUD patients at 21%.

The motivation against change in male methamphetamine users in the compulsory detoxification setting

AIMS

The study was designed to develop a measurement for the motivation for and against change in methamphetamine users in the compulsory detoxification setting.

DESIGN

This is a cross-sectional study.

SETTING

The study was carried out in a compulsory detoxification center for male drug users in China.

PARTICIPANTS

A total of 228 male methamphetamine users who had undergone the program for at least 30 days.

MEASUREMENTS

The motivation for/against change relating to compulsory detoxification was carried out using the Likert scale. A series of questionnaires were filled out by the participants, including the Egna Minnen Beträffande Uppfostran for rearing style, the Barratt Impulsiveness Scale-11, the adult ADHD self-report scale, and the Pittsburgh sleep quality index. Participants were also asked to recall the withdrawal symptoms before the program and to rate their current craving levels.

FINDINGS

Motivations were grouped into three factors, namely, the expectation to use drugs upon the completion of the program (factor 1), the disagreement with the compulsory setting (factor 2), and the motivation to quit drug use (factor 3). Cronbach's alpha values were 0.8037, 0.8049, and 0.6292, respectively. The structural equation model showed that the overall motivation was characterized by motivation against change rather than that for change. The overall motivation was also directly affected by the current craving level and indirectly affected by the severity of addiction, paternal authoritarian upbringing style, and ADHD traits.

CONCLUSION

This study provided a measurement of motivation for and against change in subjects with drug misconduct and suggested that the motivation against change may disclose more psychological barriers than the motivation for change.

Effects of a Residential Multimodal Psychological Treatment in an Addicted Population, at 6 and 12 Months: Differences Between Men and Women

The aim of this study is to explore the effects of a residential multimodal treatment intervention for an addict population. We gathered participants from the "Programa Base" (n = 166) of the Solidarity and Reinsertion Foundation of Murcia, and assessed the various problematic areas with the EuropASI at baseline level, 6 months and 12 months of treatment. We found improved outcomes in every area except for Legal Status. In addition, we found differences between male and female participants in their baseline evaluation, as well as between completers and non-completers. In conclusion, this data shows us some changes which occurred in individuals with problematic drug use during treatment, going further into the complex social reality which causes great suffering and damage to people and their families.