Substance Use Disorder patients with and without Attention Deficit Hyperactivity Disorder: Exploring differences in personality, substance use-related aspects and quality of life in a naturalistic follow-up study

Background. About 15% of adults seeking substance use disorder (SUD) treatment also have Attention Deficit Hyperactivity Disorder (ADHD). SUD+ADHD patients often present more severe substance use (SU) and may be more difficult to treat. Research on SUD+ADHD has mostly focused on the reduction of ADHD and SUD symptoms and less on other relevant factors in the context of SUD treatment. Aims. To compare SUD+ADHD vs SUD-ADHD patients on personality, SU-related aspects (i.e., readiness to change SU, positive and negative aspects of SU, and treatment goals) and quality of life (QoL). Materials and Methods. Patients consecutively entering SUD treatment between 2010 and 2012 were assessed at baseline and followed-up 12 months after SUD treatment. Personality was measured by self-report questionnaires. SU-related aspects were investigated by self-report questionnaires and qualitative interviews. QoL was measured by self-report questionnaires and compared with a Norwegian population sample (NPS). Substance use was measured by self-report questionnaires. Results. The study sample consisted of 16 SUD+ADHD and 87 SUD-ADHD patients with a mean age of 43.3 ± 11.1. Concerning personality SUD+ADHD patients reported lower fear of uncertainty, higher eagerness to effort, ambition and self-forgetfulness, compared to SUD-ADHD patients. Regarding SU-related aspects, SUD+ADHD patients reported lower readiness to change than SUD+ADHD patients. Additionally, SUD+ADHD patients more commonly perceived SU as positive, had more variable treatment goals than SUD-ADHD patients. Both SUD groups reported low QoL at baseline compared to the NPS. At follow-up, only SUD+ADHD patients reported an improved QoL, however not significantly different compared to SUD-ADHD patients or the NPS. Conclusions. SUD+ADHD patients differed from SUD-ADHD patients on personality, SU-related aspects and QoL. More studies are needed to confirm our findings and investigate what might contribute to a better QoL in SUD+/- ADHD patients. SUD+ADHD and SUD-ADHD patients may benefit from individualized treatment strategies