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Is it Attention Deficit Hyperactivity Disorder (ADHD) or Stimulant use disorder ? How is ADHD diagnosed?

Published online by Cambridge University Press:  01 September 2022

N. Sud*
Affiliation:
Bamburgh Clinic, St Nicholas Hospital, Newcastle upon Tyne, United Kingdom

Abstract

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Introduction

From clinical experience, majority of patients in adult forensic services who have childhood diagnosis of ADHD self-report onset of substance misuse around the age of 12.

Objectives

Aim of the study was to explore if routine screening of childhood substance use is considered by ADHD diagnostic services.

Methods

PsycINFO and Embase databases were searched with the keywords: Attention Deficit Hyperactivity Disorder, ADHD, primary care/general practice, family physicians ,paediatrics, and children/adolescents, child and adolescent psychiatry, diagnostic assessments, substance / drug use, prescription drugs and drug screening.

Results

24 articles were retrieved for age groups 12 to 17 years. Studies identified substance misuse as highly comorbid with ADHD but more so in conduct disorder. Studies identified diversion risk in adolescents.

Conclusions

Both ADHD and amphetamine misuse disorders are Axis 1 disorders (Baldwin 2009). Literature links substance misuse in ADHD to conduct disorder. There needs to be research into the diagnostic overlap between conduct disorder and ADHD and how this fits into the trauma model of adult offender treatment pathways. Treatment pathways for ADHD or conduct disorder and childhood onset substance misuse disorder are not clear both in primary or secondary care. Literature appears to put emphasis on early diagnosis and prescription stimulant treatment outside the social and psychological context and cites outcomes of the short term studies as reason for continued prescriptions in adolescence and beyond. There is need for studies exploring perspectives and trajectories of amphetamine use in adults who were diagnosed with ADHD in childhood, adolescence and as adults.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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