International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder

被引：33

作者：

Ozgen, Heval ^{[1
]}

Spijkerman, Renske ^{[1
]}

Noack, Moritz ^{[2
]}

Holtmann, Martin ^{[2
]}

Schellekens, Arnt S. A. ^{[3
,4
]}

van de Glind, Geurt ^{[4
,5
]}

Banaschewski, Tobias ^{[6
]}

Barta, Csaba ^{[7
,8
]}

Begeman, Alex ^{[9
]}

Casas, Miguel ^{[10
]}

Crunelle, Cleo L. ^{[11
]}

Blanco, Constanza Daigre ^{[12
,13
,14
]}

Dalsgaard, Soren ^{[15
]}

Demetrovics, Zsolt ^{[16
]}

den Boer, Jacomine ^{[9
]}

Dom, Geert ^{[17
]}

Eapen, Valsamma ^{[18
]}

Faraone, Stephen, V ^{[19
]}

Franck, Johan ^{[20
]}

Gonzalez, Rafael A. ^{[21
,22
]}

Grau-Lopez, Lara ^{[12
,13
,14
,47
]}

Groenman, Annabeth P. ^{[23
,24
]}

Hemphala, Malin ^{[20
]}

Icick, Romain ^{[25
,26
,27
]}

Johnson, Brian ^{[19
]}

Kaess, Michael ^{[28
,29
]}

Kapitany-Foveny, Mate ^{[30
,31
]}

Kasinathan, John G. ^{[32
]}

Kaye, Sharlene S. ^{[33
]}

Kiefer, Falk ^{[34
]}

Konstenius, Maija ^{[20
]}

Levin, Frances R. ^{[35
]}

Luderer, Mathias ^{[36
]}

Martinotti, Giovanni ^{[37
]}

Matthys, Frieda I. A. ^{[38
]}

Meszaros, Gergely ^{[39
]}

Moggi, Franz ^{[40
]}

Munasur-Naidoo, Ashmita P. ^{[41
,42
]}

Post, Marianne ^{[43
]}

Rabinovitz, Sharon ^{[44
,45
]}

Antoni Ramos-Quiroga, J. ^{[13
,14
,46
,47
]}

Sala, Regina ^{[48
]}

Shafi, Abu ^{[49
]}

Slobodin, Ortal ^{[50
]}

Staal, Wouter G. ^{[51
,52
]}

Thomasius, Rainer ^{[53
]}

Truter, Ilse ^{[54
]}

van Kernebeek, Michiel W. ^{[55
]}

Velez-Pastrana, Maria C. ^{[56
]}

Vollstadt-Klein, Sabine ^{[34
]}

机构：

[1] Parnassia Psychiat Inst, Parnassia Addict Res Ctr PARC, Zoutkeetsingel 40, NL-2512 HN The Hague, Netherlands

[2] Ruhr Univ Bochum, LWL Univ Hosp, Dept Child & Adolescent Psychiat, Hamm, Germany

[3] RadboudUMC, Dept Psychiat, Donders Inst, Nijmegen, Netherlands

[4] RadboudUMC, Nijmegen Inst Scientist Practitioners Addict NISP, Nijmegen, Netherlands

[5] Int Collaborat ADHD & Subst Abuse ICASA Fdn, Nijmegen, Netherlands

[6] Heidelberg Univ, Cent Inst Mental Hlth Mannheim CIMH, Dept Child & Adolescent Psychiat, Mannheim, Germany

[7] Semmelweis Univ, Dept Med Chem Mol Biol & Pathobiochem, Budapest, Hungary

[8] Pazmany Peter Catholic Univ, Fac Humanities & Social Sci, Inst Psychol, Budapest, Hungary

[9] De Hoop GGZ, Dordrecht, Netherlands

[10] Autonomous Univ Barcelona, Dept Psychiat & Legal Med, Barcelona, Spain

[11] Univ Hosp Brussels, Dept Psychiat, Brussels, Belgium

[12] Hosp Univ Vall dHebron, Dept Psychiat Mental Hlth & Addict, Addict & Dual Diag Sect, Barcelona, Spain

[13] Vall dHebron Res Inst VHIR, Grp Psychiat Mental Hlth & Addict, Barcelona, Spain

[14] Biomed Network Res Ctr Mental Hlth CIBERSAM, Barcelona, Spain

[15] Aarhus Univ, Dept Econ & Business Econ, Aarhus, Denmark

[16] Eotvos Lorand Univ, Inst Psychol, Budapest, Hungary

[17] Antwerp Univ UA, Collaborat Antwerp Psychiat Res Inst CAPRI, Antwerp, Belgium

[18] Univ New South Wales, Acad Unit Infant Child Adolescent Psychiat South, Sydney, NSW, Australia

[19] SUNY Upstate Med Univ, Dept Psychiat, Syracuse, NY 13210 USA

[20] Pitea Hosp, Child & Adolescent Dept, Region Norrbotten, Pitea, Sweden

[21] Imperial Coll London, Ctr Mental Hlth, Dept Med, Div Brain Sci, London, England

[22] East London NHS Fdn Trust, Child & Adolescent Mental Hlth Serv CAMHS ADHD Cl, London, England

[23] Univ Amsterdam, Dept Psychol, Amsterdam, Netherlands

[24] Univ Groningen, Univ Med Ctr Groningen, Dept Child & Adolescent Psychiat, Groningen, Netherlands

[25] Grp Hosp St Louis Lariboisiere Fernand Widal, Assistance Publ Hop Paris AP HP, Paris, France

[26] INSERM, U1144, Paris, France

[27] Univ Paris, INSERM, UMR S1144, Paris, France

[28] Univ Bern, Univ Hosp Child & Adolescent Psychiat & Psychothe, Bern, Switzerland

[29] Univ Hosp Heidelberg, Ctr Psychosocial Med, Dept Child & Adolescent Psychiat, Heidelberg, Germany

[30] Semmelweis Univ, Fac Hlth Sci, Budapest, Hungary

[31] Nyiro Gyula Natl Inst Psychiat & Addict, Drug Outpatient Ctr, Budapest, Hungary

[32] Adolescent Mental Hlth Justice Hlth & Forens Ment, Sydney, NSW, Australia

[33] Univ New South Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW, Australia

[34] Cent Inst Mental Hlth, Dept Addict Behav & Addict Med, Mannheim, Germany

[35] Columbia Univ, Dept Psychiat, New York State Psychiat Inst, New York, NY USA

[36] Goethe Univ, Univ Hosp, Dept Psychiat Psychosomat Med & Psychotherapy, Frankfurt, Germany

[37] Univ G dAnnunzio, Dept Neurosci Imaging Clin Sci, Chieti, Italy

[38] Vrije Univ Brussel VUB, Dept Psychiat, UZ Brussel, Brussels, Belgium

[39] Semmelweis Univ, Fac Med, Dept Psychiat & Psychotherapy, Budapest, Hungary

[40] Univ Bern, Univ Hosp Psychiat, Bern, Switzerland

[41] Nelson Mandela Univ, Dept Pharm, Port Elizabeth, South Africa

[42] Cipla Medpro Pharmaceut, Durban, South Africa

[43] Parnassia Psychiat Inst, Brijder Youth Addict Treatment, The Hague, Netherlands

[44] Univ Haifa, Ctr Rehabil Res, Sch Criminol, Haifa, Israel

[45] Univ Haifa, Ctr Rehabil Res, Unit Excellence Res & Study Addict ERSA, Haifa, Israel

[46] Hosp Univ Vall dHebron, Dept Psychiat, Barcelona, Spain

[47] Univ Autonoma Barcelona, Dept Psychiat & Forens Med, Barcelona, Spain

[48] Queen Mary Univ London, Ctr Psychiat, Barts & London Sch Med & Dent, Wolfson Inst, London, England

[49] East London NHS Fdn Trust, London, England

[50] Ben Gurion Univ Negev, Dept Educ, Beer Sheva, Israel

来源：

EUROPEAN ADDICTION RESEARCH | 2020年 / 26卷 / 4-5期

关键词：

Adolescents; Consensus statement; Attention-deficit; hyperactivity disorder; Substance use disorder; DEFICIT HYPERACTIVITY DISORDER; GUANFACINE EXTENDED-RELEASE; RANDOMIZED CONTROLLED-TRIAL; SCHOOL-BASED TREATMENT; DOUBLE-BLIND; PHARMACOLOGICAL-TREATMENT; FOLLOW-UP; ADHD; METHYLPHENIDATE; CHILDREN;

D O I：

10.1159/000508385

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background:Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations.Objective:The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience.Method:A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD.Results:After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n= 4), risk of developing SUD (n= 3), screening and diagnosis (n= 7), psychosocial treatment (n= 5), pharmacological treatment (n= 11), and complementary treatments (n= 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion.Conclusion:This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.

引用

页码：223 / 232

页数：10

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