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Tijdschrift voor Psychiatrie 61 (2019) 7, 477 - 487


International consensus for the screening, diagnosis and treatment of adult patients with substance use disorder and ADHD

C.L. Crunelle, W. van den Brink, A. Schellekens, G. van de Glind, Belgisch/Nederlands Icasa consortium, F. Matthys

background 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.

keywords adhd, dependence, diagnosis, guideline, substance use disorders, treatment