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Tijdschrift voor Psychiatrie 54 (2012) 6, 539 - 548

Essay

ADHD and addiction: a complicated liaison

F. Matthys, S. Tremmery, M. Autrique, P. Joostens, D. Möbius, S. Stes, B.G.C. Sabbe

SUMMARY
background The presence of adhd has been linked to a 100% increase in a person’s chance of developing a substance use disorder. The prevalence of childhood and adult adhd in substance-abusing populations has been estimated to be three times higher than in the general population. In addiction centres adhd is often unrecognized and untreated.
aim To describe the obstacles to the diagnosis and treatment of adhd in addicts.
method Using a historical approach, we analysed the evolution of the diagnostic descriptions of the two disorders, giving attention to the influence of social change and scientific research.
results The two disorders have developed in remarkably similar ways; people have been and still are much inclined to make moral judgments about these disorders than about other psychic disorders. Neurobiological research has added a extra dimension to the debate on topics such as impulsivity, personal responsibility and free will.
conclusion It is only recently that adhd has been recognised as having a place in addiction treatment and, as a result, there is a growing need for explanatory models.

keywords ADHD (attention deficit hyperactivity disorder), comorbidity, neurobiology, substance use disorder