Saad Salman, Muhammad Ismail, Muhammad Anees, Sarir Badshah, Zahid Nazar, Naila Riaz Awan.
Substance abuse in patients with co-morbid ADHD.
J Pak Psych Soc Jan ;9(2):91-6.

Objective: To study the tendency of occurrence of attention-deficit hyperactivity disorder (ADHD) with substance abuse. Design: A cross-sectional, hospital based study. Place and duration of study: The study was carried out at Lady Reading Hospital and Khyber Teaching Hospital, Peshawar from 4th April 2012 to 29th August 2012. Subjects and Methods: A sample of 110 adult patients with 53 heroin dependents, 23 THC, 15 opium, 11 poly drug and 8 alcohol dependents were analyzed that whether they were ADHD and that childhood problem continues to manifest symptoms in adults. For retrospective assessment of childhood ADHD, the Wender Utah Rating Scale (WURS) as well as the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptom checklist for ADHD was used. The Conners’ Adult ADHD Rating Scales (CAARS) was used to assess the persisting symptoms of ADHD in adults.Patient diagnosed with drug and alcohol dependence according to ICD-10 and DSM-IV were included in the study whereas patient co-morbid with any other psychiatric illnesses were excluded. Results: Heroin dependent showed 41.5% (WURS) and 37.7% (DSM-IV diagnostic criteria), whereas THC validated 34.7% (WURS) and 30.4% (DSM-IV), opium demonstrated 46.6% (WURS) and 40% (DSMIV), poly drug dependence established 63.6% (WURS) and 54.5% (DSM-IV) and alcohol dependent showed 50% (WURS) and 37.5% (DSM-IV) indicated evidence of retrospective ADHD affliction in childhood. CAARS was presented in 35.8% heroin dependent, 34.7% THC, 46.6% opioid, 33.3% poly drug dependence and 37.5% alcohol dependent; and exhibited a substantiation of ADHD persistent in adulthood. The difference between the mean score of WURS and CAARS of ADHD patients were significantly greater (P = 0.029), than the normal patients. Conclusions: These results revealed that ADHD is a risk factor associated with substance dependence, expressed in the form of heroine, THC, opioid, alcohol dependence and also in poly drug dependence.

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