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. 2021 May 12;21(1):251.
doi: 10.1186/s12888-021-03263-6.

Naturalistic exploratory study of the associations of substance use on ADHD outcomes and function

Benjamin MacDonald  1 , Joseph Sadek  2
Affiliations

Naturalistic exploratory study of the associations of substance use on ADHD outcomes and function

Benjamin MacDonald et al. BMC Psychiatry. .

Abstract

Background: Although Attention Deficit Hyperactivity Disorder (ADHD) is associated with an increased risk of substance use disorder (SUD), existing literature on how SUD interacts with ADHD outcomes is limited. This study investigates whether SUD among individuals with ADHD is associated with worse ADHD outcomes and prognosis, and the association between overall functioning and SUD. In addition, we seek to understand whether heavy cannabis use is a better predictor of poorer outcomes compared to SUD status alone.

Method: We conducted a retrospective analysis on 50 ADHD patient charts, which were allocated based on SUD status. Subgroup analysis was performed on the total sample population, with allocation based on heavy cannabis use. Mann-Whitney and Chi-Square tests were used for both the primary and subgroup analyses.

Results: SUD status highly correlated with more ADHD-related cognitive impairments and poorer functional outcomes at the time of diagnosis. ADHD patients with comorbid ADHD-SUD scored significantly lower (p = < 0.0001) on objective cognitive testing (Integrated Auditory and Visual Continuous Performance Test (IVA/CPT)) than ADHD patients without SUD. The correlation with poorer ADHD outcomes was more pronounced when groups were allocated based on heavy cannabis use status; in addition to significantly lower IVA/CPT scores (p = 0.0011), heavy cannabis use was associated with more severe fine motor hyperactivity and self-reported hyperactivity/impulsivity scores (p = 0.0088 and 0.0172, respectively).

Conclusion: Future research is needed to determine how substance abuse can be a barrier to improved ADHD outcomes, and the effect cannabis and other substances have on cognitive function and pharmacotherapy of ADHD.

Keywords: Attention-deficit/hyperactivity disorder; Cognition; Psychosocial functioning; Substance abuse.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Objectve Sustained Auditory & Visual Quotients  (SAAQ and SVAQ, respectively) calculated from IVA/CPT, and shows a Box and Whisker plot with min/max range, interquartile ranges, and medians
Fig. 2
Fig. 2
Subjective ADHD Inattention and Hyperactivity/Impulsivity symptom scores, based on participants response to the DSM-5 ADHD Symptom Questionaires. Consists of a Scatter Plot graph, with 95% confidence interval around mean scores
Fig. 3
Fig. 3
Objective Fine Motor Hyperactivity calculated from IVA/CPT, and shows a scatter plot graph with 95% Confidence Interval around mean scores
See this image and copyright information in PMC

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