Crunelle C L, van den Brink W, Schellekens A, van de Glind G, Icasa Consortium Belgisch/Nederlands, Matthys F
Tijdschr Psychiatr. 2019;61(7):477-487.
Substance use disorders (SUD) and attention-deficit/hyperactivity disorder (ADHD) often co-occur in adults. Together, they complicate diagnosis and can negatively influence treatment outcome.
AIM: To develop a practical guide to assist professionals with the screening, diagnosis and treatment of adult patients with SUD and ADHD.
METHOD: A literature search and a consensus procedure between several international scientific and clinical experts. This manuscript is an adapted and summarized Dutch version of the International consensus statement on screening, diagnosis and treatment of patients with SUD and comorbid ADHD.
RESULTS: The routine use of adequate screening tools enables ADHD to be detected earlier in adults with SUD. The diagnostic process for ADHD should be initiated as soon as possible in patients with SUD. Integrated treatment, involving a combination of pharmacotherapy and psychotherapy, is preferred. Long-acting stimulants with up-titration to higher dosages may be considered.
CONCLUSION: Early detection of ADHD in patients with SUD is essential for adequate diagnosis and more effective treatment and follow-up for these patients.
物质使用障碍(SUD)与注意力缺陷多动障碍(ADHD)在成年人中常常同时出现。二者共同作用会使诊断变得复杂,并可能对治疗结果产生负面影响。
制定一份实用指南,以协助专业人员对患有SUD和ADHD的成年患者进行筛查、诊断和治疗。
进行文献检索,并在多位国际科学和临床专家之间开展共识程序。本手稿是关于SUD合并ADHD患者筛查、诊断和治疗的国际共识声明的改编和总结版荷兰语版本。
常规使用适当的筛查工具能够在患有SUD的成年人中更早地检测出ADHD。对于患有SUD的患者,应尽早启动ADHD的诊断流程。首选综合治疗,包括药物治疗和心理治疗相结合。可以考虑使用长效兴奋剂并逐渐增加剂量至更高水平。
在患有SUD的患者中早期发现ADHD对于这些患者进行充分诊断以及更有效的治疗和随访至关重要。