Young Susan, Abbasian Cyrus, Al-Attar Zainab, Branney Polly, Colley Bill, Cortese Samuele, Cubbin Sally, Deeley Quinton, Gudjonsson Gisli Hannes, Hill Peter, Hollingdale Jack, Jenden Steve, Johnson Joe, Judge Deborah, Lewis Alexandra, Mason Peter, Mukherjee Raja, Nutt David, Roberts Jane, Robinson Fiona, Woodhouse Emma, Cocallis Kelly
Department of Psychology, Psychology Services Limited, Croydon CR9 7AE, United Kingdom.
Department of Psychology, Reykjavik University, Reykjavik, Iceland.
World J Psychiatry. 2023 Mar 19;13(3):84-112. doi: 10.5498/wjp.v13.i3.84.
Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with substance use (SU) and/or substance use disorder (SUD). Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment. This can be further complicated by the context in which services are delivered. Also, when working with young people and adults with co-existing ADHD and SU/SUD, there is uncertainty among healthcare practitioners on how best to meet their needs. In February 2022, the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues. Following presentations providing attendees with an overview of the literature, group discussions were held synthesizing research evidence and clinical experience. Topics included: (1) A review of substances and reasons for use/misuse; (2) identification, assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services; and (3) identification, assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services. Dis-cussions highlighted inter-service barriers and fragmentation of care. It was concluded that a multimodal and multi-agency approach is needed. The consensus group generated a table of practice recommendations providing guidance on: identification and assessment; pharmacological and psychological treatment; and multi-agency interventions.
注意力缺陷多动障碍（ADHD）常与物质使用（SU）和/或物质使用障碍（SUD）同时出现。患有ADHD与SU/SUD并发的个体可能有复杂的症状表现，这可能会使诊断和治疗变得复杂。服务提供的背景会使情况进一步复杂化。此外，在为同时患有ADHD和SU/SUD的年轻人及成年人提供服务时，医疗从业者对于如何最好地满足他们的需求存在不确定性。2022年2月，英国ADHD合作组织主办了一次会议，多学科专家出席会议以解决这些问题。在向与会者介绍了文献综述之后，进行了小组讨论，综合了研究证据和临床经验。讨论的主题包括：（1）对使用/滥用物质及原因的回顾；（2）在社区服务中出现的患有ADHD的年轻人及成年人中非法SU/SUD的识别、评估和治疗；（3）在SU/SUD社区和住院服务中出现的成年人ADHD的识别、评估和治疗。讨论突出了服务间的障碍和护理的碎片化。得出的结论是需要一种多模式、多机构的方法。共识小组生成了一份实践建议表，为以下方面提供指导：识别与评估；药物和心理治疗；以及多机构干预。
