Attention deficit hyperactivity disorder and obsessive-compulsive disorder among former heroin addicts currently in methadone maintenance treatment.

BACKGROUND

The aim of this study was to evaluate the prevalence of childhood and adulthood attention deficit hyperactivity disorder (ADHD) and clinical obsessive-compulsive disorder (OCD) among adult patients in methadone maintenance treatment (MMT) and to characterize possible risk factors.

SAMPLING AND METHODS

A random sample of 154 current MMT patients was studied for childhood ADHD (Wender Utah Rating Scale), current clinical OCD (Yale-Brown Obsessive Compulsive Scale), lifetime trauma history and modified Addiction Severity Index for demographics, as well as any lifetime DSM-IV-TR psychiatric diagnosis.

RESULTS

Fifty-one patients (33.1%) had childhood ADHD, and more of this group currently had clinical OCD compared to patients who did not have childhood ADHD (55.3 vs. 30.1%). The two groups did not differ with regard to gender and age of admission to MMT. Logistic regression found that the childhood ADHD group had a higher risk of having OCD [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.6-8.8], more severe nicotine smoking (OR 1.4, 95% CI 1.1-1.7) and fewer years of education (OR 0.8, 95% CI 0.6-1) and were more likely to have a DSM-IV-TR axis II disorder (OR 4.3, 95% CI 1.4-13.4) and a history of falls (OR 4.3, 95% CI 1.4-12.9).

CONCLUSIONS

Although ADHD is more prevalent among males in the general population, the rates in our MMT population were similar in each gender. One third of our sample had suffered from ADHD during childhood, which may have led them to self-medicate with drugs and thus to addiction. Childhood ADHD was associated with current OCD, and both conditions were highly prevalent among our MMT patients. The reason for a history of repeated falls warrants further study.