Attention-Deficit/Hyperactivity Disorder, Medication Treatment, and Substance Use Patterns Among Adolescents and Young Adults

2005 ◽  
Vol 15 (5) ◽  
pp. 799-809 ◽  
Author(s):  
Himanshu P. Upadhyaya ◽  
Kelly Rose ◽  
Wei Wang ◽  
Kathleen O'Rourke ◽  
Brian Sullivan ◽  
...  
2018 ◽  
Vol 212 (4) ◽  
pp. 234-238 ◽  
Author(s):  
Kai-Lin Huang ◽  
Han-Ting Wei ◽  
Ju-Wei Hsu ◽  
Ya-Mei Bai ◽  
Tung-Ping Su ◽  
...  

BackgroundAttention-deficit hyperactivity disorder (ADHD) increases the risk of suicidal behaviours through psychiatric comorbidities; however, a significant direct association has not been observed between ADHD and suicide attempts.AimsTo evaluate the risk of suicide attempt in adolescents and young adults with ADHD.MethodUsing a nationwide, population-based insurance claims database, this longitudinal cohort study enrolled 20 574 adolescents and young adults with ADHD and 61 722 age- and gender-matched controls between 2001 and 2009. Any suicide attempt was identified from enrolment to 31 December 2011. The association between ADHD medications and the likelihood of suicide attempt was assessed.ResultsADHD was an independent risk factor for any suicide attempt (hazard ratio = 3.84, 95% CI = 3.19–4.62) and repeated suicide attempts (hazard ratio = 6.52, 95% CI = 4.46–9.53). Subgroup analyses of men, women, adolescents and young adults demonstrated the same trend. Methylphenidate or atomoxetine treatment did not increase the risk of suicide attempt or repeated suicide attempts. Long-term methylphenidate treatment was associated with a significantly decreased risk of repeated suicide attempts in men (hazard ratio = 0.46, 95% CI = 0.22–0.97).ConclusionADHD was a risk factor for suicide attempt and a stronger predictor of repeated suicide attempts, independent of comorbidities. Further investigation is warranted to explore the mechanism underlying the association between ADHD and suicidal behaviours.Declaration of interestNone.


2009 ◽  
Vol 194 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Suzanne McCarthy ◽  
Philip Asherson ◽  
David Coghill ◽  
Chris Hollis ◽  
Macey Murray ◽  
...  

BackgroundSymptoms of attention-deficit hyperactivity disorder (ADHD) are known to persist into adulthood in the majority of cases.AimsTo determine the prevalence of methylphenidate, dexamfetamine and atomoxetine prescribing and treatment discontinuation in adolescents and young adults.MethodA descriptive cohort study using the UK General Practice Research Database included patients aged 15–21 years from 1999 to 2006 with a prescription for a study drug.ResultsPrevalence of prescribing averaged across all ages increased 6.23-fold over the study period. Overall, prevalence decreased with age: in 2006, prevalence in males dropped 95% from 12.77 per 1000 in 15-year-olds to 0.64 per 1000 in 21-year-olds. A longitudinal analysis of a cohort of 44 patients aged 15 years in 1999 demonstrated that no patient received treatment after the age of 21 years.ConclusionsThe prevalence of prescribing by general practitioners to patients with ADHD drops significantly from age 15 to age 21 years. The fall in prescribing is greater than the reported age-related decrease in symptoms, raising the possibility that treatment is prematurely discontinued in some young adults in whom symptoms persist.


2015 ◽  
Vol 25 (3) ◽  
pp. 255-266 ◽  
Author(s):  
N. Estévez ◽  
M. Dey ◽  
D. Eich-Höchli ◽  
S. Foster ◽  
G. Gmel ◽  
...  

Background.Functional and mental health impairments that adults with attention-deficit/hyperactivity disorder (ADHD) experience may be exacerbated by regular substance use and co-morbidity with substance use disorders (SUD). This may be especially true during young adulthood, which represents a critical stage of life associated with increased substance use and associated problems. However, previous studies investigating the association between ADHD and substance use and SUD have demonstrated inconsistent results, probably due to methodological limitations (e.g., small and non-representative samples). Thus, the relationship of ADHD with substance use and related disorders remains unclear. The aim of the present study was to examine the association between ADHD and both the use of licit and illicit substances and the presence of SUD in a large, representative sample of young men.Method.The sample included 5677 Swiss men (mean age 20 ± 1.23 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed using the adult ADHD Self Report Screener (ASRS). The association between ADHD and substance use and SUD was assessed for alcohol, nicotine, cannabis and other illicit drugs, while controlling for socio-demographic variables and co-morbid psychiatric disorders (i.e., major depression (MD) and anti-social personality disorder (ASPD)).Results.Men with ADHD were more likely to report having used nicotine, cannabis and other illicit drugs at some time in their life, but not alcohol. ADHD was positively associated with early initiation of alcohol, nicotine and cannabis use, the risky use of these substances, and the presence of alcohol use disorders, and nicotine and cannabis dependence. Additionally, our analyses revealed that these patterns are also highly associated with ASPD. After adjusting for this disorder, the association between ADHD and licit and illicit substance use and the presence of SUDs was reduced, but remained significant.Conclusions.Our findings suggest that adult ADHD is significantly associated with a propensity to experiment with licit and illicit substances, especially at earlier ages, to exhibit risky substance use patterns, and to subsequently develop SUDs. Preventive strategies that include early intervention and addressing co-morbidity with ASPD may be crucial to reducing substance use and the development of pathological substance use patterns in young men affected by ADHD and, thus, helping to prevent further illness burden later in life.


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