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Guideline for Screening, Diagnosis and Treatment of ADHD in Adults with Substance Use Disorders

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Abstract

Currently there is no guideline for the screening, diagnosis and treatment of adult attention deficit/hyperactivity disorder (ADHD) in patients with a substance use disorder (SUD). The aim was to develop such a guideline, starting out from a systematic review and based on the methodology of the Scottish Intercollegiate Guideline Network (SIGN). Due to the lack of scientific evidence on some of the topics, the guideline is a combination of evidence based and practice based recommendations. Given the high prevalence of ADHD in treatment seeking SUD patients and the availability of valid screening instruments, all treatment seeking SUD patients should be screened for ADHD. Diagnosis of ADHD should be based on clinical observation and history taking, including informant data. Integrated treatment of ADHD and SUD is recommended, including pharmacotherapy, psycho-education, coaching, and cognitive behavioral therapy (CBT). The lack of scientific data and the overall lack of expertise in the field are significant obstacles to the implementation of the guideline. Intensive training programs in the substance abuse sector need to be organized to implement these guidelines.

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Acknowledgments

We are grateful to the Forum of Addiction Medicine, the Guideline Development Group and all the participants of the focus groups. The study was funded by the Belgian Federal Public Service (FPS) Food Chain Safety and Environment (Health.belgium.be 2014).

Role of Funding Sources

The study was funded by the Belgian Federal Public Service (Health, Food Chain Safety and Environment). The Federal Public Service had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Conflict of Interest

All authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. University Hospital Brussels and Free University Brussels (VUB), MSOC Free Clinic, Antwerp, Belgium

    Frieda Matthys

  2. University Psychiatric Centre at Katholieke Universiteit Leuven, Leuven, Belgium

    Steven Stes

  3. Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Wim van den Brink

  4. Psychiatric Centre Broeders Alexianen, Tienen, Belgium

    Peter Joostens

  5. Vereniging voor Alcohol- en andere Drugproblemen, Brussels, Belgium

    David Möbius

  6. Department Child & Adolescent Psychiatry, University Hospitals Leuven, Leuven, Belgium

    Sabine Tremmery

  7. Department of Neurosciences, KU Leuven, Leuven, Belgium

    Sabine Tremmery

  8. Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Free University Brussels (VUB) and Psychiatric Hospital Sint-Norbertus, Duffel, Belgium

    Bernard Sabbe

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  1. Frieda Matthys
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  2. Steven Stes
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  3. Wim van den Brink
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  4. Peter Joostens
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  5. David Möbius
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  6. Sabine Tremmery
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  7. Bernard Sabbe
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Correspondence to Frieda Matthys.

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Matthys, F., Stes, S., van den Brink, W. et al. Guideline for Screening, Diagnosis and Treatment of ADHD in Adults with Substance Use Disorders. Int J Ment Health Addiction 12, 629–647 (2014). https://doi.org/10.1007/s11469-014-9496-z

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