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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board Member: Birch, Diana ML / Blum, Robert W. / Furniss, Tilman / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie

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Attention deficit hyperactivity disorder and dual disorders. Educational needs for an underdiagnosed condition

1 / Nestor Szerman2 / Carlos Knecht3 / Raquel de Alvaro4

1Teaching Unit of Psychiatry and Psychological Medicine, Hospital Universitario Doctor Peset and University of Valencia, Valencia, Spain

2Hospital General Universitario Gregorio Marañón, Madrid, Spain

3Unidad de Salud Mental de Vila-Real, Departamento de Salud de La Plana, AgenciaValenciana de Salut, Castellón, Spain

4RPMD Carlet, Departamento de Salud de Alzira, Conselleria de Justicia y Bienestar Social, Valencia, Spain

Corresponding author: Jose Martinez-Raga, MD, PhD, Servicio de Psiquiatría, Hospital Universitario Dr Peset, Avda Gaspar Aguilar 90, 46017 Valencia, Spain

Citation Information: International Journal of Adolescent Medicine and Health. Volume 25, Issue 3, Pages 231–243, ISSN (Online) 2191-0278, ISSN (Print) 0334-0139, DOI: 10.1515/ijamh-2013-0057, July 2013

Publication History

Received:
2012-08-05
Accepted:
2012-09-19
Published Online:
2013-07-12

Abstract

A wide range of comorbid psychiatric disorders overlap with attention-deficit hyperactivity disorder (ADHD) across the life span. There is a robust and complex link between ADHD and substance use disorders (SUD). The aim of this report was to review the neurobiological and other vulnerability factors explaining the comorbidity of ADHD and an addictive disorder, as well as the key aspects of the assessment and diagnosis of dually diagnosed ADHD patients. A comprehensive and systematic search of relevant databases (PubMed, Embase, and PsychINFO) was conducted to identify studies published in peer-reviewed journals until July 31, 2012, with the aim of exploring the association of ADHD and SUD with postgraduate training and residency education. Across the life span, ADHD is associated with significant impairment and comorbidity. Data from epidemiological, clinical and epidemiological studies show a very solid link between ADHD and SUD. Therefore, it is very important to carefully and systematically assess for any substance use in patients with suspected ADHD coming to initial assessment, and vice versa. While there are various valid and reliable rating and screening scales, diagnosis cannot solely rely on any of the instruments available for both SUD and ADHD in adult patients with dual pathology. The most important and effective tool in the assessment of dually diagnosed patients with ADHD and SUD is a full and comprehensive clinical and psychosocial assessment. Hence, it is essential to actively incorporate training opportunities on the assessment, diagnosis, and management of adult ADHD and dually diagnosed ADHD patients during postgraduate education residency or specialist training.

Keywords: addiction; ADHD; dual disorders/pathology; postgraduate training; psychiatric training

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