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Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men

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Abstract

We investigated whether adult attention-deficit/hyperactivity disorder (ADHD) predicts risky substance use and substance use disorders (SUDs), and its impact on the course of these problematic substance use patterns. Our sample included 4975 Swiss men (mean age 20 ± 1.2 years) who participated in the baseline and 15-month follow-up assessments of the Cohort Study on Substance Use Risk Factors. We examined: (1) the contribution of ADHD, as assessed at baseline, on the risky use of alcohol, nicotine and cannabis, and their corresponding use disorders (AUD, NUD, CUD) at follow-up; and (2) the association between ADHD and the course of outcomes (i.e., absence, initiation, maturing out, persistence) over 15 months. All analyses were adjusted for socio-demographics and co-morbidity. Men with ADHD were more likely to exhibit persistent risky alcohol and nicotine use, and to mature out of risky cannabis use. ADHD at baseline was positively linked to AUD and negatively to CUD at follow-up, but not to NUD. For all SUDs, ADHD had a positive association with use persistence and maturing out. Comparing these two trajectories revealed that early age of alcohol use initiation distinguished between persistence and maturing out of AUD, while the course of NUD and CUD was related to ADHD symptoms and SUD severity at baseline. Already in their early twenties, men with ADHD are especially likely to exhibit persistent problematic substance use patterns. Substance-specific prevention strategies, particularly implemented before early adulthood, may be crucial to reducing the development and persistence of pathological patterns in such individuals.

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Acknowledgements

We thank Joseph Studer, Charlotte Eidenbenz and Laura Werlen for their valuable input. This study has been supported by the Swiss National Science Foundation (grant number: 33CS30_139467) and by the Hartmann Müller-Foundation (grant number: 1708).

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Authors and Affiliations

  1. La Source, School of Nursing Sciences, University of Applied Sciences and Arts, Western Switzerland, Lausanne, Switzerland

    Natalia Estévez-Lamorte & Meichun Mohler-Kuo

  2. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland

    Natalia Estévez-Lamorte, Simon Foster & Meichun Mohler-Kuo

  3. Swiss Research Institute for Public Health and Addiction, Zurich, Switzerland

    Natalia Estévez-Lamorte, Simon Foster & Meichun Mohler-Kuo

  4. Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland

    Natalia Estévez-Lamorte, Simon Foster & Meichun Mohler-Kuo

  5. University Hospital of Psychiatry Zurich, Zurich, Switzerland

    Dominique Eich-Höchli

  6. University Hospital of Psychiatry, University of Bern, Bern, Switzerland

    Franz Moggi

  7. Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland

    Gerhard Gmel

  8. Addiction Switzerland, Lausanne, Switzerland

    Gerhard Gmel

  9. Centre for Addiction and Mental Health, Toronto, Ontario, Canada

    Gerhard Gmel

  10. University of the West of England, Frenchay Campus Coldharbour Lane, Bristol, UK

    Gerhard Gmel

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  1. Natalia Estévez-Lamorte
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  3. Dominique Eich-Höchli
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Correspondence to Natalia Estévez-Lamorte.

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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and have, therefore, been performed in accordance with the Declaration of Helsinki 1964 and its later amendments. All participants gave their informed consent prior to their inclusion in the study.

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Estévez-Lamorte, N., Foster, S., Eich-Höchli, D. et al. Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men. Eur Arch Psychiatry Clin Neurosci 269, 667–679 (2019). https://doi.org/10.1007/s00406-018-0958-3

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