The relevance of ADHD in substance use disorders(SUD).

At a recent seminar hosted by INCADDS key speaker Dr Pieter-Jan Carpentier (ICASA). Presented the most recent research on the subject. The research shows that many young people and adults with undiagnosed ADHD are at risk of substance misuse, but there is hope if consultants gain expertise in this field both in diagnosing and treatment. Dr Carpentier explained that in his country a group of interested consultants came together to increase their expertise through training in this complex area. Through this there are now many consultants with this expertise available in Holland to provide early expert diagnoses and multi modal long team seamless treatment

Validity of the ADHD module of the Mini International Neuropsychiatric Interview PLUS for screening of adult ADHD in treatment seeking substance use disorder patients: ADHD screening with MINI-Plus

Az ADHD szűrési lehetőségei a Mini-plus mérőeszköz segítségéve

Persistence and Subtype Stability of ADHD Among Substance Use Disorder Treatment Seekers

OBJECTIVE: To examine ADHD symptom persistence and subtype stability among substance use disorder (SUD) treatment seekers. METHOD: In all, 1,276 adult SUD treatment seekers were assessed for childhood and adult ADHD using Conners' Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; CAADID). A total of 290 (22.7%) participants met CAADID criteria for childhood ADHD and comprise the current study sample. RESULTS: Childhood ADHD persisted into adulthood in 72.8% (n = 211) of cases. ADHD persistence was significantly associated with a family history of ADHD, and the presence of conduct disorder and antisocial personality disorder. The combined subtype was the most stable into adulthood (78.6%) and this stability was significantly associated with conduct disorder and past treatment of ADHD. CONCLUSION: ADHD is highly prevalent and persistent among SUD treatment seekers and is associated with the more severe phenotype that is also less likely to remit. Routine screening and follow-up assessment for ADHD is indicated to enhance treatment management and outcomes

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Validity of the ADHD module of the Mini International Neuropsychiatric Interview PLUS for screening of adult ADHD in treatment seeking substance use disorder patients: ADHD screening with MINI-Plus

Comorbidity; Psychometrics; Substance use disorderComorbilitat; Psicometria; Trastorn per consum de substànciesComorbilidad; Psicometría; Trastorno por consumo de sustanciasObjective This study aims to assess the validity of the ADHD module of the Mini-International Neuropsychiatric Interview (MINI-Plus) in patients with substance use disorders (SUD), using the Conners’ Adult ADHD Diagnostic Interview for DSM-IV (CAADID) as the external criterion. Method A cross sectional international multi-center study in 10 countries was conducted in treatment seeking SUD patients. A sample of 1263 patients with both MINI-Plus and CAADID was analyzed to determine the psychometric properties of the MINI-Plus. Results According to the CAADID, 179 patients (14.2%) met criteria for adult ADHD, whereas according to the MINI-Plus 227 patients (18.0%) were identified as having adult ADHD. Sensitivity of the MINI-Plus ADHD module was 74%, specificity was 91%, positive predictive value was 60% and negative predictive value was 96%. Kappa was 0.60. Conclusion The MINI-Plus has acceptable criterion validity for the screening of adult ADHD in treatment seeking SUD patients. Scientific significance On the basis of the results, The MINI-Plus may be used for the screening of ADHD in SUD patients.The IASP study was funded by several institutions in each country. The ICASA Foundation developed the study and coordinated with each institution the regional funding process. The funding sources did not have any influence on the study (research protocol, sampling, issues, analyses, publication). Australia: a strategic grant from Curtin University of Technology (Perth, Western Australia) funded the IAS screening phase. Belgium: the IASP project in this country received private funding. Hungary: No direct funding was received, it was supported by a grant from The European Union and European Social Fund (under agreement to finance the project) no. TÁMOP 4.2.1./B-09/1/KMR-2010-0003. The Netherlands, Amsterdam: no external funding was obtained. The participating institute, Arkin, paid for the costs involved. Norway, Bergen Clinics Foundation: 50% of funding was provided by the Regional Research Council For Addiction in West Norway (Regionalt kompetansesenter for rusmiddelforskning I Helse Vest (KORFOR); the remaining 50% was supported by Bergen Clinics Foundation (Staff and infrastructure). Norway, Fredrikstad: The IASP was funded by the hospital (Sykehuset Østfold HF) not with money, but with 50% of the salary of the participants, then by two sources outside the hospital: The Regional center of Dual Diagnosis and the social – and Health directory. Spain, Barcelona: Financial support was received from Plan Nacional sobre Drogas, Ministerio de Sanidad y Política Social (PND 0080/2011), the Agència de Salut Pública de Barcelona and the Departament de Salut, Government of Catalonia, Spain. Sweden, Stockholm: The study was funded by the Stockholm Center for Dependency Disorders. Switzerland, Berne/Zurich: The IASP in Switzerland was funded by the Swiss Foundation of Alcohol Research (Grant # 209). USA, Syracuse: no funding was obtained. The funding sources did not have influence on: who participated as an author in this study; the research protocol; the sampling of data; the topics chosen for publications; the analyses of the data; the content of the publication

An intervention program for ADHD in patients with substance use disorders: preliminary results of a field trial

The comorbidity of attention deficit hyperactivity disorder (ADHD) is frequently not well recognized in substance abuse treatment institutions in The Netherlands. As a consequence, patients with substance use disorder (SUD) and ADHD often receive suboptimal treatment. To prevent every treatment center from having to invent its own diagnostic procedure and intervention for ADHD, a national working group was established. This group developed an intervention program for the screening, diagnosis, and treatment of ADHD in patients with SUD. This article describes the development and content of this intervention program. An important part of this development was testing the intervention program in two addiction treatment centers in The Netherlands. Systematic screening of ADHD was part of the test. A self-report questionnaire was used. Subjects with positive screening results were referred for the diagnostic procedure. Nine hundred twenty-eight screenings were performed: 207 screened positive, 115 came for further diagnostics, and 65 were ultimately diagnosed with ADH

The International ADHD in Substance Use Disorders Prevalence (IASP) study:background, methods and study population

<p>Attention deficit/hyperactivity disorder (ADHD) is an increasingly recognized comorbid condition in subjects with substance use disorders (SUDs).</p><p>This paper describes the methods and study population of the International ADHD in Substance Use Disorders Prevalence (IASP) study. Objectives of the IASP are to determine the prevalence of ADHD in adult treatment seeking patients with SUD in different countries and SUD populations, determine the reliability and validity of the Adult ADHD Self-report Scale V 1.1 (ASRS) as ADHD screening instrument in SUD populations, investigate the comorbidity profile of SUD patients with and without ADHD, compare risk factors and protective factors in SUD patients with and without a comorbid diagnosis of ADHD, and increase our knowledge about the relationship between ADHD and the onset and course of SUD.</p><p>In this cross-sectional, multi-centre two stage study, subjects were screened for ADHD with the ASRS, diagnosed with the Conner's Adult ADHD Diagnostic Interview for DSM-IV (CAADID), and evaluated for SUD, major depression, bipolar disorder, anti social personality disorder and borderline personality disorder.</p><p>Three thousand five hundred and fifty-eight subjects from 10 countries were included. Of these 40.9% screened positive for ADHD.</p><p>This is the largest international study on this population evaluating ADHD and comorbid disorders. Copyright (c) 2013 John Wiley & Sons, Ltd.</p>