Adult Attention Deficit Hyperactivity Disorder (ADHD) and its association with substance use and abuse

Transcription

1 SPHC 2014, Olten Adult Attention Deficit Hyperactivity Disorder (ADHD) and its association with substance use and abuse PD Dr. Meichun Mohler-Kuo Natalia Estévez, Gehard Gmel, University of Zurich

2 Attention Deficit Hyperactivity Disorder (ADHD) Inattention and/or hyperactivity-impulsivity symptoms Functional impairment and poor mental health can affect functioning in several life domains Persist into adulthood Seite 2

3 Aims To measure the prevalence of adult ADHD among young Swiss men To investigate the association between ADHD and the use of licit and illicit substances Seite 3

4 Study Design- Sampling Cohort Study of Substance Use Risk Factors (C-SURF) Mandatory conscription: ~98% of all young Swiss men (~ 19 years old) Fieldwork access: prevention (brief interventions) in the recruitment center of Lausanne, covering all francophone men. Swiss Army supports further sampling in Germanspeaking centers Windisch and additionally Mels Seite 4

5 Sample: 21 of 26 cantons, 6000 men Centers coverage: ~ 40% of all CH-conscripts, rural and urban areas, German- and Frenchspeaking -> highly representative Seite 5

6 Study Design- Procedure Recruitment days in the army are used to enroll study participants (consent), and 5 mins «screening» (August 2010-Nov 2011) Collecting detail contact and demographic information. It is NOT a study IN the army! Everything else is independent of the army (baseline, follow-up) Baseline Questionnaire was sent to those who consented to participated in the study Seite 6 6

7 Study Design- Participants Lausanne Windisch Mels TOTAL N N N N Informed Screenings % % % Consent % % % % Baseline completed % % % % % online mail Seite 7

8 Methods-assessment ADHD ADHD Self Report Screener (ASRS) Alcohol Tobacco Cannabis and other illicit drugs Experience of use: Ever used substance Ever used substance excessively Use of substance in the last 12 months Risky substance use Developed by WHO, 6 items, refer to symptoms in the last 12 months Five-point scale from never (0) to very often (4) Substance use disorders Seite 8

9 ADHD- 12-Month Prevalence Score Prevalence 4 96 no ADHD ADHD Seite 9

10 Alcohol use 100 no ADHD ADHD Ever drank alcohol Ever drunk drank alcohol risky alcohol in the past 12 months use abuse dependence Seite 10

11 Tobacco use no ADHD ADHD ever smoked cigarettes ever smoked daily smoked cigarettes in the last 12 months risky tobacco use mild nicotine dependence moderate nicotine dependence severe nicotine dependence Seite 11

12 Cannabis and other illicit drugs no ADHD ADHD ever smoked cannabis ever stoned smoked cannabis in the last 12 months risky cannabis use cannabis dependence ever used other illicit drugs other illicit drugs in the last 12 months Seite 12

13 Adjusted Odds Ratio ADHD and Risky Substance Use Adjusted for socio-demographic variables (age, linguistic region, residence, education, financial autonomy, maternal education and family affluence) and co-morbidity (ASPD, MD) Risk. Alc Use Risk Nic Use Risk Can Use Seite 13

14 Adjusted Odds Ratio ADHD and Substance Use Disorder Adjusted for socio-demographic variables (age, linguistic region, residence, education, financial autonomy, maternal education and family affluence) and co-morbidity (ASPD, MD) Risk. Alc Dis Risk Nic Dis Risk Can Dis Seite 14

15 Conclusion Adult ADHD is common among young Swiss men ADHD was associated with risky use of licit and illicit substances, substance use disorders and the use of tobacco, cannabis and other illicit drugs Prevention among men affected by ADHD may be crucial to reduce substance use Seite 15