Slobodin Ortal, Crunelle Cleo L
Department of Education, Ben-Gurion University, Be'er Sheva, Israel.
Department of Psychiatry, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Front Public Health. 2019 Jun 26;7:173. doi: 10.3389/fpubh.2019.00173. eCollection 2019.
Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development and persistence of substance use disorders (SUD). The prevalence of ADHD in patients with SUD varies across countries and cultures. So far, cross-cultural variance in ADHD prevalence rates among SUD patients was mainly ascribed to methodological differences between studies, leaving the role of societal and cultural practices in the ADHD-SUD link hardly acknowledged. The aim of the present mini review is to address this gap in the literature by providing evidence for the effect of socio-cultural practices on the ADHD-SUD link and suggesting directions for future research. To achieve this goal, we map the influence of socio-cultural factors on the ADHD-SUD link along three lines of research. The first line is concerned with the role of socio-cultural factors in the recognition, diagnosis and treatment of childhood ADHD. The second line of research is concerned with socio-cultural influences on substance use (e.g., religion, ethnic identity, acculturation, and socio-economic status). Finally, we describe potential socio-cultural factors which may operate as mechanisms for reducing or increasing access to substance abuse treatment (e.g., ethnic disparities in health care utilization). Identifying socio-cultural influences on the ADHD-SUD link may provide further insight into the bidirectional association between ADHD and SUD in different contexts and encourage future research in the field.
注意力缺陷多动障碍（ADHD）是物质使用障碍（SUD）发生和持续存在的一个风险因素。SUD患者中ADHD的患病率在不同国家和文化中有所不同。到目前为止，SUD患者中ADHD患病率的跨文化差异主要归因于研究之间的方法学差异，社会和文化习俗在ADHD与SUD关联中的作用几乎未得到承认。本小型综述的目的是通过提供社会文化习俗对ADHD与SUD关联影响的证据，并为未来研究提出方向，来填补文献中的这一空白。为实现这一目标，我们沿着三条研究路线梳理社会文化因素对ADHD与SUD关联的影响。第一条路线关注社会文化因素在儿童ADHD的识别、诊断和治疗中的作用。第二条研究路线关注社会文化对物质使用的影响（例如，宗教、族群认同、文化适应和社会经济地位）。最后，我们描述了可能作为减少或增加物质滥用治疗可及性机制的潜在社会文化因素（例如，医疗保健利用方面的种族差异）。识别社会文化对ADHD与SUD关联的影响，可能会进一步深入了解不同背景下ADHD与SUD之间的双向关联，并鼓励该领域的未来研究。
