Detecting the comorbidity of attention deficit hyperactivity disorder (ADHD) in a population of outpatients with alcohol use disorder (AUD): the role of personality traits, age at first alcohol use and level of craving

Alcohol. 2024 Nov 4:S0741-8329(24)00174-5. doi: 10.1016/j.alcohol.2024.11.001. Online ahead of print.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) commonly affects individuals with alcohol use disorder (AUD). However, despite the negative outcomes associated with this comorbidity, ADHD is underdiagnosed in this population. We aim to identify clinical parameters and propose cutoff scores enabling the detection of ADHD among patients with AUD. We retrospectively analyzed data from 199 patients, out of a global sample of 412 who were consecutively admitted to a day hospital for alcohol-related problems between 2009 and 2022. We found that lower level of self-directedness, higher levels of novelty seeking, self-transcendence, harm avoidance and craving, and earlier first alcohol consumption could accurately predict the presence of ADHD in AUD (AUC=0.926). Self-directedness and novelty seeking had the best predictive abilities: a self-directedness score below 52 was associated with an accuracy of 82% and, combined with a novelty seeking score over 53, the accuracy reached 85%. Such findings could be useful to help clinicians detect ADHD in patients with AUD so that they can receive the adequate care.

Keywords: alcohol use disorder; attention-deficit/hyperactive disorder; comorbidity; diagnosis; novelty seeking; self-directedness.