The diagnostic accuracy of attention-deficit/hyperactivity disorder in adults with substance use disorders

Curr Opin Psychiatry. 2012 May;25(3):219-25. doi: 10.1097/YCO.0b013e3283523d7c.


Purpose of review: Adult attention deficit/hyperactivity disorder (ADHD) is a common comorbid condition to substance use disorder (SUD) and is associated with worse prognosis and quality of life. This review summarizes recent work assessing ADHD diagnosis reliability in SUD patients and provides arguments to enhance the accuracy of detecting this disorder.

Recent findings: Adequate diagnosis of ADHD in SUD patients is challenged by phenomenological aspects of addiction and frequently associated other psychiatric disorders that overlap with key symptoms of ADHD. A detailed comprehensive search for child and adult symptoms including the temporal relationship of ADHD, substance use and other psychiatric disorders should maximize the validity and the reliability of adult ADHD diagnosis in this population. Further, a follow-up evaluation of ADHD symptoms during treatment of SUD may reduce the likelihood of misdiagnosis.

Summary: Considering the high rate of ADHD comorbidity among SUD patients, it is crucial to promote a systematic diagnostic approach to this disorder in specialized addiction treatment settings. However, overlapping symptoms between disorders frequently challenge the accuracy of adult ADHD diagnosis. Areas in need of further investigations include the development of valid screening procedures, associated neuropsychological factors and effective treatment strategies for these populations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Comorbidity
  • Humans
  • Mass Screening / instrumentation
  • Reproducibility of Results
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology*