Dept. of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Heidelberg University, Medical Faculty Mannheim, Germany.
Feuerlein Center of Translational Addiction Medicine.
J Atten Disord. 2020 Dec;24(14):2072-2083. doi: 10.1177/1087054717750272. Epub 2018 Jan 7.
ADHD is common in patients with alcohol dependence, but prevalence results are inconsistent. We investigated ADHD prevalence in a complex design to avoid over- or underdiagnosing. Patients with alcohol dependence starting long-term residential treatment were included. A structured interview (Diagnostic Interview for ADHD in Adults [DIVA]) was conducted on all patients. DIVA results indicating childhood adulthood ADHD were assessed in successive diagnostic interviews by two expert clinicians. 415 of 488 patients had completed the entire diagnostic assessment. ADHD prevalence was 20.5%. DIVA results correlated moderately with experts' diagnoses. In patients with ADHD, a higher comorbid illicit substance use was prevalent and alcohol dependence started earlier and was more severe. This study provides the largest sample on ADHD prevalence in alcohol dependent inpatients. Despite great efforts to avoid overestimation, we found every fifth patient to have ADHD. ADHD diagnosis should not be based solely on a structured interview but should be clinically confirmed.
注意缺陷多动障碍（ADHD）在酒精依赖患者中较为常见，但患病率的结果并不一致。为避免过度或漏诊，我们采用了复杂的设计来调查 ADHD 的患病率。入组了开始长期住院治疗的酒精依赖患者。对所有患者进行了结构化访谈（成人注意缺陷多动障碍诊断访谈表[DIVA]）。通过两位专家临床医生对 DIVA 结果提示儿童期至成年期的 ADHD 进行了连续的诊断访谈。488 名患者中有 415 名完成了整个诊断评估。ADHD 的患病率为 20.5%。DIVA 结果与专家诊断中度相关。在 ADHD 患者中，更常见共病的非法物质使用，且酒精依赖的发病更早，更严重。本研究提供了最大的酒精依赖住院患者中 ADHD 患病率样本。尽管我们努力避免高估，但发现每 5 名患者中就有 1 名患有 ADHD。ADHD 的诊断不应仅基于结构化访谈，而应通过临床确认。
