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Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria☆☆

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Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria☆☆

Auteurs : Geurt Van De Glind [Pays-Bas] ; Maija Konstenius [Suède] ; Maarten W. J. Koeter [Pays-Bas] ; Katelijne Van Emmerik-Van Oortmerssen [Pays-Bas] ; Pieter-Jan Carpentier [Pays-Bas] ; Sharlene Kaye [Australie] ; Louisa Degenhardt [Australie] ; Arvid Skutle [Norvège] ; Johan Franck [Suède] ; Eli-Torild Bu [Norvège] ; Franz Moggi [Suisse] ; Geert Dom [Belgique] ; Sofie Verspreet [Belgique] ; Zsolt Demetrovics [Hongrie] ; Máté Kapitány-Fövény [Hongrie] ; Melina Fatséas [France] ; Marc Auriacombe [France] ; Arild Schillinger [Norvège] ; Merete M Ller [Norvège] ; Brian Johnson [États-Unis] ; Stephen V. Faraone [États-Unis] ; J. Antoni Ramos-Quiroga [Espagne] ; Miguel Casas [Espagne] ; Steve Allsop [Australie] ; Susan Carruthers [Australie] ; Robert A. Schoevers [Pays-Bas] ; Sara Wallhed [Suède] ; Csaba Barta [Hongrie] ; Peter Alleman [Suisse] ; Frances R. Levin [États-Unis] ; Wim Van Den Brink [Pays-Bas]

Source :

Drug and alcohol dependence [ 0376-8716 ] ; 2013.

RBID : PMC:4133781

Abstract

Background

Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed.

Methods

A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview.

Results

Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4–8.3) for Hungary to 31.3% (CI 95%:25.2–37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1–11.1) for Hungary to 32.6% (CI 95%: 26.4–38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2–83%→ 5.4–31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV.

Conclusions

Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133781

DOI: 10.1016/j.drugalcdep.2013.09.026
PubMed: 24156882
PubMed Central: 4133781

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<author><name sortKey="Johnson, Brian" sort="Johnson, Brian" uniqKey="Johnson B" first="Brian" last="Johnson">Brian Johnson</name>
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<author><name sortKey="Ramos Quiroga, J Antoni" sort="Ramos Quiroga, J Antoni" uniqKey="Ramos Quiroga J" first="J. Antoni" last="Ramos-Quiroga">J. Antoni Ramos-Quiroga</name>
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<author><name sortKey="Schoevers, Robert A" sort="Schoevers, Robert A" uniqKey="Schoevers R" first="Robert A." last="Schoevers">Robert A. Schoevers</name>
<affiliation wicri:level="1"><nlm:aff id="A17">Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff>
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<wicri:regionArea>Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea>
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<author><name sortKey="Wallhed, Sara" sort="Wallhed, Sara" uniqKey="Wallhed S" first="Sara" last="Wallhed">Sara Wallhed</name>
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<author><name sortKey="Barta, Csaba" sort="Barta, Csaba" uniqKey="Barta C" first="Csaba" last="Barta">Csaba Barta</name>
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<author><name sortKey="Levin, Frances R" sort="Levin, Frances R" uniqKey="Levin F" first="Frances R." last="Levin">Frances R. Levin</name>
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<wicri:regionArea>Columbia University/New York State Psychiatric Institute, New York City, NY</wicri:regionArea>
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<author><name sortKey="Van Den Brink, Wim" sort="Van Den Brink, Wim" uniqKey="Van Den Brink W" first="Wim" last="Van Den Brink">Wim Van Den Brink</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria<xref ref-type="fn" rid="FN3">☆☆</xref>
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<author><name sortKey="Van De Glind, Geurt" sort="Van De Glind, Geurt" uniqKey="Van De Glind G" first="Geurt" last="Van De Glind">Geurt Van De Glind</name>
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<country xml:lang="fr">Pays-Bas</country>
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<author><name sortKey="Konstenius, Maija" sort="Konstenius, Maija" uniqKey="Konstenius M" first="Maija" last="Konstenius">Maija Konstenius</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm</wicri:regionArea>
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<author><name sortKey="Koeter, Maarten W J" sort="Koeter, Maarten W J" uniqKey="Koeter M" first="Maarten W. J." last="Koeter">Maarten W. J. Koeter</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea>
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<author><name sortKey="Van Emmerik Van Oortmerssen, Katelijne" sort="Van Emmerik Van Oortmerssen, Katelijne" uniqKey="Van Emmerik Van Oortmerssen K" first="Katelijne" last="Van Emmerik-Van Oortmerssen">Katelijne Van Emmerik-Van Oortmerssen</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands</nlm:aff>
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<affiliation wicri:level="1"><nlm:aff id="A5">Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Arkin Mental Health and Addiction Treatment Center, Amsterdam</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A17">Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Carpentier, Pieter Jan" sort="Carpentier, Pieter Jan" uniqKey="Carpentier P" first="Pieter-Jan" last="Carpentier">Pieter-Jan Carpentier</name>
<affiliation wicri:level="1"><nlm:aff id="A6">Reinier van Arkel groep, ‘s-Hertogenbosch, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Reinier van Arkel groep, ‘s-Hertogenbosch</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kaye, Sharlene" sort="Kaye, Sharlene" uniqKey="Kaye S" first="Sharlene" last="Kaye">Sharlene Kaye</name>
<affiliation wicri:level="1"><nlm:aff id="A7">National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>National Drug and Alcohol Research Centre, University of New South Wales, Sydney</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Degenhardt, Louisa" sort="Degenhardt, Louisa" uniqKey="Degenhardt L" first="Louisa" last="Degenhardt">Louisa Degenhardt</name>
<affiliation wicri:level="1"><nlm:aff id="A7">National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>National Drug and Alcohol Research Centre, University of New South Wales, Sydney</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A21">Melbourne School of Population and Global Health, University of Melbourne, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Melbourne School of Population and Global Health, University of Melbourne</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Skutle, Arvid" sort="Skutle, Arvid" uniqKey="Skutle A" first="Arvid" last="Skutle">Arvid Skutle</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Bergen Clinics Foundation, Bergen, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Bergen Clinics Foundation, Bergen</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Franck, Johan" sort="Franck, Johan" uniqKey="Franck J" first="Johan" last="Franck">Johan Franck</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bu, Eli Torild" sort="Bu, Eli Torild" uniqKey="Bu E" first="Eli-Torild" last="Bu">Eli-Torild Bu</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Bergen Clinics Foundation, Bergen, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Bergen Clinics Foundation, Bergen</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Moggi, Franz" sort="Moggi, Franz" uniqKey="Moggi F" first="Franz" last="Moggi">Franz Moggi</name>
<affiliation wicri:level="1"><nlm:aff id="A9">University Hospital of Psychiatry Bern and Department of Psychology, University of Fribourg, Fribourg, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>University Hospital of Psychiatry Bern and Department of Psychology, University of Fribourg, Fribourg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Dom, Geert" sort="Dom, Geert" uniqKey="Dom G" first="Geert" last="Dom">Geert Dom</name>
<affiliation wicri:level="1"><nlm:aff id="A10">Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Verspreet, Sofie" sort="Verspreet, Sofie" uniqKey="Verspreet S" first="Sofie" last="Verspreet">Sofie Verspreet</name>
<affiliation wicri:level="1"><nlm:aff id="A10">Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Demetrovics, Zsolt" sort="Demetrovics, Zsolt" uniqKey="Demetrovics Z" first="Zsolt" last="Demetrovics">Zsolt Demetrovics</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Institute of Psychology, Eötvös Loránd University, Budapest, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Institute of Psychology, Eötvös Loránd University, Budapest</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kapitany Foveny, Mate" sort="Kapitany Foveny, Mate" uniqKey="Kapitany Foveny M" first="Máté" last="Kapitány-Fövény">Máté Kapitány-Fövény</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Institute of Psychology, Eötvös Loránd University, Budapest, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Institute of Psychology, Eötvös Loránd University, Budapest</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A22">Nyíro Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Nyíro Gyula Hospital Drug Outpatient and Prevention Center, Budapest</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fatseas, Melina" sort="Fatseas, Melina" uniqKey="Fatseas M" first="Melina" last="Fatséas">Melina Fatséas</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Laboratoire de psychiatrie, Sanpsy CNRS USR 3413, Université de Bordeaux, and Département d’addictologie, CH Ch. Perrens/CHU de Bordeaux, Bordeaux, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Laboratoire de psychiatrie, Sanpsy CNRS USR 3413, Université de Bordeaux, and Département d’addictologie, CH Ch. Perrens/CHU de Bordeaux, Bordeaux</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Auriacombe, Marc" sort="Auriacombe, Marc" uniqKey="Auriacombe M" first="Marc" last="Auriacombe">Marc Auriacombe</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Laboratoire de psychiatrie, Sanpsy CNRS USR 3413, Université de Bordeaux, and Département d’addictologie, CH Ch. Perrens/CHU de Bordeaux, Bordeaux, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Laboratoire de psychiatrie, Sanpsy CNRS USR 3413, Université de Bordeaux, and Département d’addictologie, CH Ch. Perrens/CHU de Bordeaux, Bordeaux</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schillinger, Arild" sort="Schillinger, Arild" uniqKey="Schillinger A" first="Arild" last="Schillinger">Arild Schillinger</name>
<affiliation wicri:level="1"><nlm:aff id="A13">Østfold Hospital Trust, Department for Substance Abuse Treatment, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Østfold Hospital Trust, Department for Substance Abuse Treatment</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="M Ller, Merete" sort="M Ller, Merete" uniqKey="M Ller M" first="Merete" last="M Ller">Merete M Ller</name>
<affiliation wicri:level="1"><nlm:aff id="A13">Østfold Hospital Trust, Department for Substance Abuse Treatment, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Østfold Hospital Trust, Department for Substance Abuse Treatment</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Johnson, Brian" sort="Johnson, Brian" uniqKey="Johnson B" first="Brian" last="Johnson">Brian Johnson</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Faraone, Stephen V" sort="Faraone, Stephen V" uniqKey="Faraone S" first="Stephen V." last="Faraone">Stephen V. Faraone</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ramos Quiroga, J Antoni" sort="Ramos Quiroga, J Antoni" uniqKey="Ramos Quiroga J" first="J. Antoni" last="Ramos-Quiroga">J. Antoni Ramos-Quiroga</name>
<affiliation wicri:level="1"><nlm:aff id="A15">Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, CIBERSAM, Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, CIBERSAM, Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Casas, Miguel" sort="Casas, Miguel" uniqKey="Casas M" first="Miguel" last="Casas">Miguel Casas</name>
<affiliation wicri:level="1"><nlm:aff id="A15">Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, CIBERSAM, Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, CIBERSAM, Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Allsop, Steve" sort="Allsop, Steve" uniqKey="Allsop S" first="Steve" last="Allsop">Steve Allsop</name>
<affiliation wicri:level="1"><nlm:aff id="A16">National Drug Research Institute/Curtin University of Technology, Perth, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>National Drug Research Institute/Curtin University of Technology, Perth</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Carruthers, Susan" sort="Carruthers, Susan" uniqKey="Carruthers S" first="Susan" last="Carruthers">Susan Carruthers</name>
<affiliation wicri:level="1"><nlm:aff id="A16">National Drug Research Institute/Curtin University of Technology, Perth, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>National Drug Research Institute/Curtin University of Technology, Perth</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schoevers, Robert A" sort="Schoevers, Robert A" uniqKey="Schoevers R" first="Robert A." last="Schoevers">Robert A. Schoevers</name>
<affiliation wicri:level="1"><nlm:aff id="A17">Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Wallhed, Sara" sort="Wallhed, Sara" uniqKey="Wallhed S" first="Sara" last="Wallhed">Sara Wallhed</name>
<affiliation wicri:level="1"><nlm:aff id="A18">Stockholm Centre for Dependency Disorders, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Stockholm Centre for Dependency Disorders</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Barta, Csaba" sort="Barta, Csaba" uniqKey="Barta C" first="Csaba" last="Barta">Csaba Barta</name>
<affiliation wicri:level="1"><nlm:aff id="A19">Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Alleman, Peter" sort="Alleman, Peter" uniqKey="Alleman P" first="Peter" last="Alleman">Peter Alleman</name>
<affiliation wicri:level="1"><nlm:aff id="A20">Alcohol Treatment Research, Kirchlindach and Ellikon, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Alcohol Treatment Research, Kirchlindach and Ellikon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Levin, Frances R" sort="Levin, Frances R" uniqKey="Levin F" first="Frances R." last="Levin">Frances R. Levin</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Columbia University/New York State Psychiatric Institute, New York City, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Columbia University/New York State Psychiatric Institute, New York City, NY</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Van Den Brink, Wim" sort="Van Den Brink, Wim" uniqKey="Van Den Brink W" first="Wim" last="Van Den Brink">Wim Van Den Brink</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Drug and alcohol dependence</title>
<idno type="ISSN">0376-8716</idno>
<idno type="eISSN">1879-0046</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P3">Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P4">A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P5">Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4–8.3) for Hungary to 31.3% (CI 95%:25.2–37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1–11.1) for Hungary to 32.6% (CI 95%: 26.4–38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2–83%→ 5.4–31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P6">Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">7513587</journal-id>
<journal-id journal-id-type="pubmed-jr-id">3445</journal-id>
<journal-id journal-id-type="nlm-ta">Drug Alcohol Depend</journal-id>
<journal-id journal-id-type="iso-abbrev">Drug Alcohol Depend</journal-id>
<journal-title-group><journal-title>Drug and alcohol dependence</journal-title>
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<issn pub-type="ppub">0376-8716</issn>
<issn pub-type="epub">1879-0046</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24156882</article-id>
<article-id pub-id-type="pmc">4133781</article-id>
<article-id pub-id-type="doi">10.1016/j.drugalcdep.2013.09.026</article-id>
<article-id pub-id-type="manuscript">NIHMS598057</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria<xref ref-type="fn" rid="FN3">☆☆</xref>
</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>van de Glind</surname>
<given-names>Geurt</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
<xref ref-type="aff" rid="A2">b</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
<xref ref-type="author-notes" rid="FN1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Konstenius</surname>
<given-names>Maija</given-names>
</name>
<xref ref-type="aff" rid="A3">c</xref>
<xref ref-type="author-notes" rid="FN1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Koeter</surname>
<given-names>Maarten W.J.</given-names>
</name>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Emmerik-van Oortmerssen</surname>
<given-names>Katelijne</given-names>
</name>
<xref ref-type="aff" rid="A2">b</xref>
<xref ref-type="aff" rid="A5">e</xref>
<xref ref-type="aff" rid="A17">q</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Carpentier</surname>
<given-names>Pieter-Jan</given-names>
</name>
<xref ref-type="aff" rid="A6">f</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kaye</surname>
<given-names>Sharlene</given-names>
</name>
<xref ref-type="aff" rid="A7">g</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Degenhardt</surname>
<given-names>Louisa</given-names>
</name>
<xref ref-type="aff" rid="A7">g</xref>
<xref ref-type="aff" rid="A21">u</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Skutle</surname>
<given-names>Arvid</given-names>
</name>
<xref ref-type="aff" rid="A8">h</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Franck</surname>
<given-names>Johan</given-names>
</name>
<xref ref-type="aff" rid="A3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bu</surname>
<given-names>Eli-Torild</given-names>
</name>
<xref ref-type="aff" rid="A8">h</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Moggi</surname>
<given-names>Franz</given-names>
</name>
<xref ref-type="aff" rid="A9">i</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dom</surname>
<given-names>Geert</given-names>
</name>
<xref ref-type="aff" rid="A10">j</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Verspreet</surname>
<given-names>Sofie</given-names>
</name>
<xref ref-type="aff" rid="A10">j</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Demetrovics</surname>
<given-names>Zsolt</given-names>
</name>
<xref ref-type="aff" rid="A11">k</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kapitány-Fövény</surname>
<given-names>Máté</given-names>
</name>
<xref ref-type="aff" rid="A11">k</xref>
<xref ref-type="aff" rid="A22">v</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fatséas</surname>
<given-names>Melina</given-names>
</name>
<xref ref-type="aff" rid="A12">l</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Auriacombe</surname>
<given-names>Marc</given-names>
</name>
<xref ref-type="aff" rid="A12">l</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schillinger</surname>
<given-names>Arild</given-names>
</name>
<xref ref-type="aff" rid="A13">m</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Møller</surname>
<given-names>Merete</given-names>
</name>
<xref ref-type="aff" rid="A13">m</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Johnson</surname>
<given-names>Brian</given-names>
</name>
<xref ref-type="aff" rid="A14">n</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Faraone</surname>
<given-names>Stephen V.</given-names>
</name>
<xref ref-type="aff" rid="A14">n</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ramos-Quiroga</surname>
<given-names>J. Antoni</given-names>
</name>
<xref ref-type="aff" rid="A15">o</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Casas</surname>
<given-names>Miguel</given-names>
</name>
<xref ref-type="aff" rid="A15">o</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Allsop</surname>
<given-names>Steve</given-names>
</name>
<xref ref-type="aff" rid="A16">p</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Carruthers</surname>
<given-names>Susan</given-names>
</name>
<xref ref-type="aff" rid="A16">p</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schoevers</surname>
<given-names>Robert A.</given-names>
</name>
<xref ref-type="aff" rid="A17">q</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wallhed</surname>
<given-names>Sara</given-names>
</name>
<xref ref-type="aff" rid="A18">r</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Barta</surname>
<given-names>Csaba</given-names>
</name>
<xref ref-type="aff" rid="A19">s</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Alleman</surname>
<given-names>Peter</given-names>
</name>
<xref ref-type="aff" rid="A20">t</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Levin</surname>
<given-names>Frances R.</given-names>
</name>
<xref ref-type="aff" rid="A4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van den Brink</surname>
<given-names>Wim</given-names>
</name>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><collab>IASP Research Group</collab>
<xref ref-type="author-notes" rid="FN2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
Trimbos-instituut and ICASA Foundation, Utrecht, The Netherlands</aff>
<aff id="A2"><label>b</label>
Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands</aff>
<aff id="A3"><label>c</label>
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden</aff>
<aff id="A4"><label>d</label>
Columbia University/New York State Psychiatric Institute, New York City, NY, USA</aff>
<aff id="A5"><label>e</label>
Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands</aff>
<aff id="A6"><label>f</label>
Reinier van Arkel groep, ‘s-Hertogenbosch, The Netherlands</aff>
<aff id="A7"><label>g</label>
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia</aff>
<aff id="A8"><label>h</label>
Bergen Clinics Foundation, Bergen, Norway</aff>
<aff id="A9"><label>i</label>
University Hospital of Psychiatry Bern and Department of Psychology, University of Fribourg, Fribourg, Switzerland</aff>
<aff id="A10"><label>j</label>
Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout, Belgium</aff>
<aff id="A11"><label>k</label>
Institute of Psychology, Eötvös Loránd University, Budapest, Hungary</aff>
<aff id="A12"><label>l</label>
Laboratoire de psychiatrie, Sanpsy CNRS USR 3413, Université de Bordeaux, and Département d’addictologie, CH Ch. Perrens/CHU de Bordeaux, Bordeaux, France</aff>
<aff id="A13"><label>m</label>
Østfold Hospital Trust, Department for Substance Abuse Treatment, Norway</aff>
<aff id="A14"><label>n</label>
Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA</aff>
<aff id="A15"><label>o</label>
Servei de Psiquiatria, Hospital Universitari Vall d’Hebron, CIBERSAM, Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain</aff>
<aff id="A16"><label>p</label>
National Drug Research Institute/Curtin University of Technology, Perth, Australia</aff>
<aff id="A17"><label>q</label>
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</aff>
<aff id="A18"><label>r</label>
Stockholm Centre for Dependency Disorders, Sweden</aff>
<aff id="A19"><label>s</label>
Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary</aff>
<aff id="A20"><label>t</label>
Alcohol Treatment Research, Kirchlindach and Ellikon, Switzerland</aff>
<aff id="A21"><label>u</label>
Melbourne School of Population and Global Health, University of Melbourne, Australia</aff>
<aff id="A22"><label>v</label>
Nyíro Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary</aff>
<author-notes><corresp id="cor1"><label>*</label>
Corresponding author at: ICASA Foundation, Da Costakade 45, PO Box 725, 3500 AS Utrecht, The Netherlands. Tel.: +31 302971101; fax: +31 302971111. <email>gglind@trimbos.nl</email>
 (G. van de Glind)</corresp>
<fn id="FN1" fn-type="equal"><label>1</label>
<p id="P1">These authors contributed equally to this publication.</p>
</fn>
<fn id="FN2"><label>2</label>
<p id="P2">In addition to the authors of this paper, the following persons contributed to this study: Eva Karin Løvaas, Kari Lossius, Anneke van Wamel, Geert Bosma, David Hay, Marion Malivert, Romain Debrabant, Therese Dahl, Laura Stevens, Carlos Roncero, Constanza Daigre, Rutger-Jan van der Gaag, Joanne Cassar, Jesse Young.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>19</day>
<month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>05</day>
<month>10</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>1</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>15</day>
<month>8</month>
<year>2014</year>
</pub-date>
<volume>134</volume>
<fpage>158</fpage>
<lpage>166</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.drugalcdep.2013.09.026</pmc-comment>
      <permissions><copyright-statement>© 2013 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.</copyright-statement>
<copyright-year>2013</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P3">Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P4">A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P5">Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4–8.3) for Hungary to 31.3% (CI 95%:25.2–37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1–11.1) for Hungary to 32.6% (CI 95%: 26.4–38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2–83%→ 5.4–31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P6">Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD.</p>
</sec>
</abstract>
<kwd-group><kwd>Prevalence</kwd>
<kwd>Substance use disorder</kwd>
<kwd>Attention deficit hyperactivity disorder</kwd>
<kwd>DSM-5</kwd>
<kwd>Adults</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><table-wrap id="T1" position="float" orientation="landscape"><label>Table 1</label>
<caption><p id="P96">Main characteristics of the study population (<italic>N</italic>
= 1276).</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1">France<break></break>
(<italic>n</italic>
 = 157)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Hungary<break></break>
(<italic>n</italic>
 = 226)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Netherlands<break></break>
(<italic>n</italic>
= 129)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Norway<break></break>
(<italic>n</italic>
 = 220)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Spain<break></break>
(<italic>n</italic>
 = 222)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Sweden<break></break>
(<italic>n</italic>
 = 168)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Switzerland<break></break>
(<italic>n</italic>
= 154)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Total<break></break>
(<italic>N</italic>
 = 1276)</th>
<th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1"><italic>p</italic>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Age <italic>M</italic>
 (SD)</td>
<td align="left" rowspan="1" colspan="1">36.8 (10.6)</td>
<td align="left" rowspan="1" colspan="1">43.1 (12.1)</td>
<td align="left" rowspan="1" colspan="1">40.4 (10.3)</td>
<td align="left" rowspan="1" colspan="1">38.1 (10.7)</td>
<td align="left" rowspan="1" colspan="1">37.0 (9.8)</td>
<td align="left" rowspan="1" colspan="1">42.6(11.6)</td>
<td align="left" rowspan="1" colspan="1">42.5 (10.8)</td>
<td align="left" rowspan="1" colspan="1">40.0 (11.2)</td>
<td align="left" rowspan="1" colspan="1"><italic>F</italic>
(6, 1265)= 11.55</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">ASRS screen positive<break></break>
(%)</td>
<td align="left" valign="top" rowspan="1" colspan="1">40.1</td>
<td align="left" valign="top" rowspan="1" colspan="1">20.8</td>
<td align="left" valign="top" rowspan="1" colspan="1">53.5</td>
<td align="left" valign="top" rowspan="1" colspan="1">65.9</td>
<td align="left" valign="top" rowspan="1" colspan="1">35.6</td>
<td align="left" valign="top" rowspan="1" colspan="1">37.5</td>
<td align="left" valign="top" rowspan="1" colspan="1">28.6</td>
<td align="left" valign="top" rowspan="1" colspan="1">40.0</td>
<td align="left" valign="top" rowspan="1" colspan="1">Wald(6) = 89.01</td>
<td align="left" valign="top" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Female (%)</td>
<td align="left" rowspan="1" colspan="1">44 (28.0)</td>
<td align="left" rowspan="1" colspan="1">55 (24.3)</td>
<td align="left" rowspan="1" colspan="1">23 (17.8)</td>
<td align="left" rowspan="1" colspan="1">69 (31.3)</td>
<td align="left" rowspan="1" colspan="1">46(20.7)</td>
<td align="left" rowspan="1" colspan="1">52 (31.0)</td>
<td align="left" rowspan="1" colspan="1">51 (33.6)</td>
<td align="left" rowspan="1" colspan="1">340 (26.7)</td>
<td align="left" rowspan="1" colspan="1">Wald(6)= 16.64</td>
<td align="left" rowspan="1" colspan="1">.010</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Employed (%)</td>
<td align="left" rowspan="1" colspan="1">51 (32.5)</td>
<td align="left" rowspan="1" colspan="1">53 (24.0)</td>
<td align="left" rowspan="1" colspan="1">68 (53.1)</td>
<td align="left" rowspan="1" colspan="1">55 (26.4)</td>
<td align="left" rowspan="1" colspan="1">81 (36.7)</td>
<td align="left" rowspan="1" colspan="1">56 (35.9)</td>
<td align="left" rowspan="1" colspan="1">20(13.4)</td>
<td align="left" rowspan="1" colspan="1">384 (31.0)</td>
<td align="left" rowspan="1" colspan="1">Wald(6) = 54.80</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Homeless/shelter (%)</td>
<td align="left" rowspan="1" colspan="1">9 (5.7)</td>
<td align="left" rowspan="1" colspan="1">27 (13.2)</td>
<td align="left" rowspan="1" colspan="1">10(7.8)</td>
<td align="left" rowspan="1" colspan="1">14 (6.9)</td>
<td align="left" rowspan="1" colspan="1">19(8.6)</td>
<td align="left" rowspan="1" colspan="1">18 (5.9)</td>
<td align="left" rowspan="1" colspan="1">9(11.0)</td>
<td align="left" rowspan="1" colspan="1">106 (8.6)</td>
<td align="left" rowspan="1" colspan="1">Wald(6)= 11.56</td>
<td align="left" rowspan="1" colspan="1">.073</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Married/partner (%)</td>
<td align="left" rowspan="1" colspan="1">35 (22.3)</td>
<td align="left" rowspan="1" colspan="1">71 (31.7)</td>
<td align="left" rowspan="1" colspan="1">30(23.3)</td>
<td align="left" rowspan="1" colspan="1">39 (18.4)</td>
<td align="left" rowspan="1" colspan="1">58 (26.4)</td>
<td align="left" rowspan="1" colspan="1">47 (28.7)</td>
<td align="left" rowspan="1" colspan="1">47 (30.9)</td>
<td align="left" rowspan="1" colspan="1">327 (25.9)</td>
<td align="left" rowspan="1" colspan="1">Wald(6)= 14.57</td>
<td align="left" rowspan="1" colspan="1">.024</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Main substance<break></break>
(missing):</td>
<td align="left" valign="top" rowspan="1" colspan="1">0</td>
<td align="left" valign="top" rowspan="1" colspan="1">0</td>
<td align="left" valign="top" rowspan="1" colspan="1">0</td>
<td align="left" valign="top" rowspan="1" colspan="1">6</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
<td align="left" valign="top" rowspan="1" colspan="1">3</td>
<td align="left" valign="top" rowspan="1" colspan="1">2</td>
<td align="left" valign="top" rowspan="1" colspan="1">12</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Alcohol (%)</td>
<td align="left" rowspan="1" colspan="1">79 (50.3)</td>
<td align="left" rowspan="1" colspan="1">169 (74.8)</td>
<td align="left" rowspan="1" colspan="1">79 (61.2)</td>
<td align="left" rowspan="1" colspan="1">68 (31.8)</td>
<td align="left" rowspan="1" colspan="1">57 (25.8)</td>
<td align="left" rowspan="1" colspan="1">92 (55.8)</td>
<td align="left" rowspan="1" colspan="1">146(96.1)</td>
<td align="left" rowspan="1" colspan="1">690 (54.6)</td>
<td align="left" rowspan="1" colspan="1">Wald(6)= 189.31</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Stimulants (%)</td>
<td align="left" rowspan="1" colspan="1">10(6.4)</td>
<td align="left" rowspan="1" colspan="1">13 (5.8)</td>
<td align="left" rowspan="1" colspan="1">12 (9.3)</td>
<td align="left" rowspan="1" colspan="1">57 (26.6)</td>
<td align="left" rowspan="1" colspan="1">81 (36.7)</td>
<td align="left" rowspan="1" colspan="1">16 (9.7)</td>
<td align="left" rowspan="1" colspan="1">2(1.3)</td>
<td align="left" rowspan="1" colspan="1">191 (15.1)</td>
<td align="left" rowspan="1" colspan="1">Wald(6)= 117.16</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Opiates (%)</td>
<td align="left" rowspan="1" colspan="1">15 (9.6)</td>
<td align="left" rowspan="1" colspan="1">8 (3.5)</td>
<td align="left" rowspan="1" colspan="1">1 (0.8)</td>
<td align="left" rowspan="1" colspan="1">37 (17.3)</td>
<td align="left" rowspan="1" colspan="1">39(17.6)</td>
<td align="left" rowspan="1" colspan="1">35 (21.2)</td>
<td align="left" rowspan="1" colspan="1">2(1.3)</td>
<td align="left" rowspan="1" colspan="1">137 (10.8)</td>
<td align="left" rowspan="1" colspan="1">Wald(6) = 51.79</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Cannabis (%)</td>
<td align="left" rowspan="1" colspan="1">32 (20.4)</td>
<td align="left" rowspan="1" colspan="1">4(1.8)</td>
<td align="left" rowspan="1" colspan="1">31 (24.0)</td>
<td align="left" rowspan="1" colspan="1">30 (14.0)</td>
<td align="left" rowspan="1" colspan="1">30(13.6)</td>
<td align="left" rowspan="1" colspan="1">10 (6.1)</td>
<td align="left" rowspan="1" colspan="1">0(0.0)</td>
<td align="left" rowspan="1" colspan="1">137 (10.8)</td>
<td align="left" rowspan="1" colspan="1">Wald(6) = 39.25</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Other drugs (%)</td>
<td align="left" rowspan="1" colspan="1">21 (13.4)</td>
<td align="left" rowspan="1" colspan="1">32 (14.2)</td>
<td align="left" rowspan="1" colspan="1">6 (4.7)</td>
<td align="left" rowspan="1" colspan="1">22 (10.3)</td>
<td align="left" rowspan="1" colspan="1">14(6.3)</td>
<td align="left" rowspan="1" colspan="1">12 (7.3)</td>
<td align="left" rowspan="1" colspan="1">2(1.3)</td>
<td align="left" rowspan="1" colspan="1">109 (8.6)</td>
<td align="left" rowspan="1" colspan="1">Wald(6) = 24.77</td>
<td align="left" rowspan="1" colspan="1"><.001</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T2" position="float" orientation="landscape"><label>Table 2</label>
<caption><p id="P97">Prevalence of childhood (retrospective) and adult (current) ADHD and ADHD-NOS according to DSM-IV criteria and to DSM-5 criteria.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1">France<break></break>
(<italic>n</italic>
 = 157)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Hungary<break></break>
(<italic>n</italic>
 = 226)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Netherlands<break></break>
(<italic>n</italic>
 = 129)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Norway<break></break>
(<italic>n</italic>
 = 220)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Spain<break></break>
(<italic>n</italic>
 = 222)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Sweden<break></break>
(<italic>n</italic>
 = 168)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Switzerland<break></break>
(<italic>n</italic>
 = 154)</th>
<th align="right" valign="top" rowspan="1" colspan="1">Range<break></break>
(<italic>N</italic>
 = 1276)</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Childhood ADHD<break></break>
DSM-IV %</td>
<td align="left" valign="top" rowspan="1" colspan="1">21.3</td>
<td align="left" valign="top" rowspan="1" colspan="1">12. 9</td>
<td align="left" valign="top" rowspan="1" colspan="1">15.0</td>
<td align="left" valign="top" rowspan="1" colspan="1">41.0</td>
<td align="left" valign="top" rowspan="1" colspan="1">10.6</td>
<td align="left" valign="top" rowspan="1" colspan="1">27.7</td>
<td align="left" valign="top" rowspan="1" colspan="1">15.1</td>
<td align="right" valign="top" rowspan="1" colspan="1">10.6–41.0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(CI 95%)</td>
<td align="left" rowspan="1" colspan="1">(14.9–27.7)</td>
<td align="left" rowspan="1" colspan="1">(8.6–17.3)</td>
<td align="left" rowspan="1" colspan="1">(8.9–21.2)</td>
<td align="left" rowspan="1" colspan="1">(34.5–47–5)</td>
<td align="left" rowspan="1" colspan="1">(6.5–14.6)</td>
<td align="left" rowspan="1" colspan="1">(20.9–34.5)</td>
<td align="left" rowspan="1" colspan="1">(9.4–20.8)</td>
<td align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Childhood ADHD<break></break>
DSM-5</td>
<td align="left" valign="top" rowspan="1" colspan="1">23.2</td>
<td align="left" valign="top" rowspan="1" colspan="1">12.9</td>
<td align="left" valign="top" rowspan="1" colspan="1">15.0</td>
<td align="left" valign="top" rowspan="1" colspan="1">42.3</td>
<td align="left" valign="top" rowspan="1" colspan="1">13.0</td>
<td align="left" valign="top" rowspan="1" colspan="1">29.1</td>
<td align="left" valign="top" rowspan="1" colspan="1">15.6</td>
<td align="right" valign="top" rowspan="1" colspan="1">12.9–42.3</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Age of onset <12% (CI<break></break>
95%)</td>
<td align="left" rowspan="1" colspan="1">(16.6–29.8)</td>
<td align="left" rowspan="1" colspan="1">(8.6–17.3)</td>
<td align="left" rowspan="1" colspan="1">(8.9–21.2)</td>
<td align="left" rowspan="1" colspan="1">(35.7–48.8)</td>
<td align="left" rowspan="1" colspan="1">(8.5–17.4)</td>
<td align="left" rowspan="1" colspan="1">(22.2–36.0)</td>
<td align="left" rowspan="1" colspan="1">(9.8–21.3)</td>
<td align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Adult ADHD DSM-IV</td>
<td align="left" rowspan="1" colspan="1">11.2</td>
<td align="left" rowspan="1" colspan="1">5.4</td>
<td align="left" rowspan="1" colspan="1">10.1</td>
<td align="left" rowspan="1" colspan="1">31.3</td>
<td align="left" rowspan="1" colspan="1">9.2</td>
<td align="left" rowspan="1" colspan="1">19.7</td>
<td align="left" rowspan="1" colspan="1">6.1</td>
<td align="right" rowspan="1" colspan="1">5.4–31.3</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">% (CI 95%)<xref ref-type="table-fn" rid="TFN1">a</xref>
</td>
<td align="left" rowspan="1" colspan="1">(6.3–16.2)</td>
<td align="left" rowspan="1" colspan="1">(2.4–8.3)</td>
<td align="left" rowspan="1" colspan="1">(4.9–15.3)</td>
<td align="left" rowspan="1" colspan="1">(25.2–37.5)</td>
<td align="left" rowspan="1" colspan="1">(5.4–13.0)</td>
<td align="left" rowspan="1" colspan="1">(13.7–25.7)</td>
<td align="left" rowspan="1" colspan="1">(2.3–9.9)</td>
<td align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Adult ADHD DSM-5<xref ref-type="table-fn" rid="TFN2">b</xref>
</td>
<td align="left" rowspan="1" colspan="1">16.2</td>
<td align="left" rowspan="1" colspan="1">7.6</td>
<td align="left" rowspan="1" colspan="1">11.8</td>
<td align="left" rowspan="1" colspan="1">32.6</td>
<td align="left" rowspan="1" colspan="1">10.6</td>
<td align="left" rowspan="1" colspan="1">22.4</td>
<td align="left" rowspan="1" colspan="1">7.7</td>
<td align="right" rowspan="1" colspan="1">7.6–32.6</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Age of onset <12 and #<break></break>
symptoms 5/9% (CI<break></break>
95%)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(10.5–22.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(4.1–11.1)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(6.2–17.3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(26.4–38.8)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(6.6–14.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(16.1–28.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(3.5–12.0)</td>
<td align="right" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Adult ADHD DSM-IV<break></break>
ADHD-NOS)<xref ref-type="table-fn" rid="TFN2">b</xref>
</td>
<td align="left" rowspan="1" colspan="1">16.9</td>
<td align="left" rowspan="1" colspan="1">8.9</td>
<td align="left" rowspan="1" colspan="1">12.3</td>
<td align="left" rowspan="1" colspan="1">34.5</td>
<td align="left" rowspan="1" colspan="1">10.6</td>
<td align="left" rowspan="1" colspan="1">22.4</td>
<td align="left" rowspan="1" colspan="1">8.2</td>
<td align="right" rowspan="1" colspan="1">8.2–34.5</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Combined: age of onset<break></break>
<12 and # symptoms<break></break>
4/9% (CI 95%)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(11.0–22.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(5.2–12.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(6.7–18.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(28.2–40.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(6.6–14.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(16.1–28.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">(3.9–12.5)</td>
<td align="right" valign="top" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="TFN1"><label>a</label>
<p id="P98">Prerequisite: Diagnosed Childhood ADHD based on CAADID retrospective diagnosis; DSM-IV criteria for Childhood ADHD.</p>
</fn>
<fn id="TFN2"><label>b</label>
<p id="P99">Prerequisite: Diagnosed Childhood ADHD based on CAADID retrospective diagnosis; DSM-5: adjusted age of onset <12 criterion for childhood.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T3" position="float" orientation="landscape"><label>Table 3</label>
<caption><p id="P100">Prevalence of ADHD (DSM-IV).</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="5" align="left" valign="bottom" rowspan="1">Inpatients alcohol (n=339)<xref ref-type="table-fn" rid="TFN4">a</xref>
, weighted data<hr></hr>
</th>
<th colspan="5" align="left" valign="bottom" rowspan="1">Inpatients drugs (n = 109<xref ref-type="table-fn" rid="TFN4">a</xref>
), weighted data<hr></hr>
</th>
</tr>
<tr><th align="left" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Childhood DSM-IV<hr></hr>
</th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Adult ADHD DSM-IV<hr></hr>
</th>
<th align="left" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Childhood DSM-IV<hr></hr>
</th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Adult ADHD DSM-IV<hr></hr>
</th>
</tr>
<tr><th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">Prevalence</th>
<th align="center" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN5">b</xref>
</th>
<th align="center" rowspan="1" colspan="1">Prevalence</th>
<th align="center" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN5">b</xref>
</th>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">Prevalence</th>
<th align="center" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN5">b</xref>
</th>
<th align="center" rowspan="1" colspan="1">Prevalence</th>
<th align="center" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN5">b</xref>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Hungary (169<xref ref-type="table-fn" rid="TFN4">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">12%</td>
<td align="center" rowspan="1" colspan="1">7–18</td>
<td align="center" rowspan="1" colspan="1">5%</td>
<td align="center" rowspan="1" colspan="1">02–10</td>
<td align="left" rowspan="1" colspan="1">Hungary (57<xref ref-type="table-fn" rid="TFN4">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">16%</td>
<td align="center" rowspan="1" colspan="1">8–28</td>
<td align="center" rowspan="1" colspan="1">5%</td>
<td align="center" rowspan="1" colspan="1">1–15</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Norway (24<xref ref-type="table-fn" rid="TFN4">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">43%</td>
<td align="center" rowspan="1" colspan="1">23–64</td>
<td align="center" rowspan="1" colspan="1">22%</td>
<td align="center" rowspan="1" colspan="1">08–44</td>
<td align="left" rowspan="1" colspan="1">Norway (52<xref ref-type="table-fn" rid="TFN4">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">57%</td>
<td align="center" rowspan="1" colspan="1">42–71</td>
<td align="center" rowspan="1" colspan="1">52%</td>
<td align="center" rowspan="1" colspan="1">37–66</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Switzerland (146<xref ref-type="table-fn" rid="TFN4">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">15%</td>
<td align="center" rowspan="1" colspan="1">09–21</td>
<td align="center" rowspan="1" colspan="1">5%</td>
<td align="center" rowspan="1" colspan="1">02–10</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–All countries<xref ref-type="table-fn" rid="TFN9">f</xref>
</td>
<td align="center" rowspan="1" colspan="1">15%</td>
<td align="center" rowspan="1" colspan="1">12–20</td>
<td align="center" rowspan="1" colspan="1">6%</td>
<td align="center" rowspan="1" colspan="1">4–10</td>
<td align="left" rowspan="1" colspan="1">– All countries<xref ref-type="table-fn" rid="TFN9">f</xref>
</td>
<td align="center" rowspan="1" colspan="1">35%</td>
<td align="center" rowspan="1" colspan="1">26–44</td>
<td align="center" rowspan="1" colspan="1">27%</td>
<td align="center" rowspan="1" colspan="1">19–36</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Without Nordic<xref ref-type="table-fn" rid="TFN8">e</xref>
</td>
<td align="center" rowspan="1" colspan="1">13%</td>
<td align="center" rowspan="1" colspan="1">10–17</td>
<td align="center" rowspan="1" colspan="1">5%</td>
<td align="center" rowspan="1" colspan="1">3–8</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">43%</td>
<td align="center" rowspan="1" colspan="1">23–64</td>
<td align="center" rowspan="1" colspan="1">22%</td>
<td align="center" rowspan="1" colspan="1">8–44</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Observed range</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"><italic>Observed range</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–All countries</td>
<td align="center" rowspan="1" colspan="1">12–43%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">5–22%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">–All countries</td>
<td align="center" rowspan="1" colspan="1">16–57%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">5–52%</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Without Nordic</td>
<td align="center" rowspan="1" colspan="1">12–15%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">5.1–5.4%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">n.a.<xref ref-type="table-fn" rid="TFN7">d</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">n.a.<xref ref-type="table-fn" rid="TFN7">d</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Effect country</italic>
<xref ref-type="table-fn" rid="TFN6">c</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"><italic>Effect country</italic>
<xref ref-type="table-fn" rid="TFN6">c</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–All countries Wald(2); (<italic>p</italic>
)</td>
<td align="center" rowspan="1" colspan="1">16.67 (<.001)</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">8.00 (.018)</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">–All countries Wald(1); (<italic>p</italic>
)</td>
<td align="center" rowspan="1" colspan="1">10.58 (.001)</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">14.13 (<.001)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Without Nordic Wald(1); (<italic>p</italic>
)</td>
<td align="center" rowspan="1" colspan="1">.024 (.878)</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">.585 (.444)</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">n.a.<xref ref-type="table-fn" rid="TFN7">d</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">n.a.<xref ref-type="table-fn" rid="TFN7">d</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="TFN3"><p id="P101">Inpatients alcohol (n=339) and inpatients drugs (<italic>n</italic>
= 109), weighted data.</p>
</fn>
<fn id="TFN4"><label>a</label>
<p id="P102">Presented is the non-weighted <italic>n</italic>
.</p>
</fn>
<fn id="TFN5"><label>b</label>
<p id="P103">Exact binomial confidence interval using the approach by <xref rid="R26" ref-type="bibr">Morisette and Khorram (1998)</xref>
.</p>
</fn>
<fn id="TFN6"><label>c</label>
<p id="P104">Effect of country on prevalence adjusted for age, sex, occupational status, housing and marital status.</p>
</fn>
<fn id="TFN7"><label>d</label>
<p id="P105">Not applicable.</p>
</fn>
<fn id="TFN8"><label>e</label>
<p id="P106">Nordic countries: Norway and Sweden.</p>
</fn>
<fn id="TFN9"><label>f</label>
<p id="P107">All countries: meaning all countries with subjects in this setting.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T4" position="float" orientation="landscape"><label>Table 4</label>
<caption><p id="P108">Prevalence of ADHD (DSM-IV).</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="5" align="left" valign="bottom" rowspan="1">Outpatients alcohol (<italic>n</italic>
 = 351<xref ref-type="table-fn" rid="TFN11">a</xref>
), weighted data<hr></hr>
</th>
<th colspan="5" align="left" valign="bottom" rowspan="1">Outpatients drugs (n = 454<xref ref-type="table-fn" rid="TFN11">a</xref>
), weighted data<hr></hr>
</th>
</tr>
<tr><th align="left" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Childhood DSM-IV<hr></hr>
</th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Adult ADHD DSM-IV<hr></hr>
</th>
<th align="left" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Childhood DSM-IV<hr></hr>
</th>
<th colspan="2" align="left" valign="bottom" rowspan="1">Adult ADHD DSM-IV<hr></hr>
</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1"></th>
<th align="center" valign="bottom" rowspan="1" colspan="1">Prevalence</th>
<th align="center" valign="bottom" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN12">b</xref>
</th>
<th align="center" valign="bottom" rowspan="1" colspan="1">Prevalence</th>
<th align="center" valign="bottom" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN12">b</xref>
</th>
<th align="center" valign="bottom" rowspan="1" colspan="1"></th>
<th align="center" valign="bottom" rowspan="1" colspan="1">Prevalence</th>
<th align="center" valign="bottom" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN12">b</xref>
</th>
<th align="center" valign="bottom" rowspan="1" colspan="1">Prevalence</th>
<th align="center" valign="bottom" rowspan="1" colspan="1">95% ci<xref ref-type="table-fn" rid="TFN12">b</xref>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">France(79<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">12%</td>
<td align="center" rowspan="1" colspan="1">6–22</td>
<td align="center" rowspan="1" colspan="1">6%</td>
<td align="center" rowspan="1" colspan="1">2–14</td>
<td align="left" rowspan="1" colspan="1">France (78<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">30%</td>
<td align="center" rowspan="1" colspan="1">20–42</td>
<td align="center" rowspan="1" colspan="1">16%</td>
<td align="center" rowspan="1" colspan="1">9–27</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Netherlands (79<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">14%</td>
<td align="center" valign="top" rowspan="1" colspan="1">7–23</td>
<td align="center" valign="top" rowspan="1" colspan="1">10%</td>
<td align="center" valign="top" rowspan="1" colspan="1">5–19</td>
<td align="left" valign="top" rowspan="1" colspan="1">Netherlands<break></break>
(50<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">17%</td>
<td align="center" rowspan="1" colspan="1">7–32</td>
<td align="center" rowspan="1" colspan="1">10%</td>
<td align="center" rowspan="1" colspan="1">3–22</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Norway (44<xref ref-type="table-fn" rid="TFN11">a</xref>
 )</td>
<td align="center" rowspan="1" colspan="1">25%</td>
<td align="center" rowspan="1" colspan="1">14–40</td>
<td align="center" rowspan="1" colspan="1">14%</td>
<td align="center" rowspan="1" colspan="1">6–27</td>
<td align="left" rowspan="1" colspan="1">Norway (89<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">41%</td>
<td align="center" rowspan="1" colspan="1">30–52</td>
<td align="center" rowspan="1" colspan="1">33%</td>
<td align="center" rowspan="1" colspan="1">23–43</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Spain (57<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">4%</td>
<td align="center" rowspan="1" colspan="1">0.5–13</td>
<td align="center" rowspan="1" colspan="1">4%</td>
<td align="center" rowspan="1" colspan="1">1–13</td>
<td align="left" rowspan="1" colspan="1">Spain (164<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">12%</td>
<td align="center" rowspan="1" colspan="1">8–19</td>
<td align="center" rowspan="1" colspan="1">11%</td>
<td align="center" rowspan="1" colspan="1">7–17</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Sweden (92<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">17%</td>
<td align="center" rowspan="1" colspan="1">10–27</td>
<td align="center" rowspan="1" colspan="1">13%</td>
<td align="center" rowspan="1" colspan="1">6–21</td>
<td align="left" rowspan="1" colspan="1">Sweden (73<xref ref-type="table-fn" rid="TFN11">a</xref>
)</td>
<td align="center" rowspan="1" colspan="1">37%</td>
<td align="center" rowspan="1" colspan="1">26–49</td>
<td align="center" rowspan="1" colspan="1">26%</td>
<td align="center" rowspan="1" colspan="1">16–37</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–All countries<xref ref-type="table-fn" rid="TFN16">f</xref>
</td>
<td align="center" rowspan="1" colspan="1">14%</td>
<td align="center" rowspan="1" colspan="1">11–18</td>
<td align="center" rowspan="1" colspan="1">9%</td>
<td align="center" rowspan="1" colspan="1">7–13</td>
<td align="left" rowspan="1" colspan="1">–All countries<xref ref-type="table-fn" rid="TFN16">f</xref>
</td>
<td align="center" rowspan="1" colspan="1">26%</td>
<td align="center" rowspan="1" colspan="1">21–30</td>
<td align="center" rowspan="1" colspan="1">18%</td>
<td align="center" rowspan="1" colspan="1">15–22</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">–Without Nordic<xref ref-type="table-fn" rid="TFN15">e</xref>
</td>
<td align="center" valign="top" rowspan="1" colspan="1">11%</td>
<td align="center" valign="top" rowspan="1" colspan="1">7–16</td>
<td align="center" valign="top" rowspan="1" colspan="1">7%</td>
<td align="center" valign="top" rowspan="1" colspan="1">4–12</td>
<td align="left" valign="top" rowspan="1" colspan="1">–Without<break></break>
Nordic<xref ref-type="table-fn" rid="TFN15">e</xref>
</td>
<td align="center" valign="top" rowspan="1" colspan="1">14%</td>
<td align="center" valign="top" rowspan="1" colspan="1">14–23</td>
<td align="center" valign="top" rowspan="1" colspan="1">12%</td>
<td align="center" valign="top" rowspan="1" colspan="1">9–17</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">20%</td>
<td align="center" rowspan="1" colspan="1">14–28</td>
<td align="center" rowspan="1" colspan="1">13%</td>
<td align="center" rowspan="1" colspan="1">8–20</td>
<td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">39%</td>
<td align="center" rowspan="1" colspan="1">32–47</td>
<td align="center" rowspan="1" colspan="1">29%</td>
<td align="center" rowspan="1" colspan="1">22–37</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Observed range</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"><italic>Observed range</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–All countries<xref ref-type="table-fn" rid="TFN15">e</xref>
</td>
<td align="center" rowspan="1" colspan="1">4–25%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">4–14%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">–All countries<xref ref-type="table-fn" rid="TFN16">f</xref>
</td>
<td align="center" rowspan="1" colspan="1">12–41%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">10–33%</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">–Without Nordic<xref ref-type="table-fn" rid="TFN14">d</xref>
</td>
<td align="center" valign="top" rowspan="1" colspan="1">4–12%</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">4–10%</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">–Without<break></break>
Nordic<xref ref-type="table-fn" rid="TFN15">e</xref>
</td>
<td align="center" valign="top" rowspan="1" colspan="1">12–30%</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">10–16%</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">17.25%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">13–14%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">–Only Nordic</td>
<td align="center" rowspan="1" colspan="1">37–41%</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">26–33%</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Effect country</italic>
<xref ref-type="table-fn" rid="TFN13">c</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"><italic>Effect country</italic>
<xref ref-type="table-fn" rid="TFN13">c</xref>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">–All countries Wald(4); (<italic>p</italic>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">10.23 (.037)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">7.06 (.133)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">–All countries<break></break>
Wald(4); (<italic>p</italic>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">30.54 (<.001)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">18.47 (.001)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">–Without Nordic Wald(2); (<italic>p</italic>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">4.62 (.099)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">2.79 (.248)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">–Without<break></break>
Nordic<break></break>
Wald(2); (<italic>p</italic>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">9.33 (.009)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">1.60 (.449)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">–Only Nordic Wald(1); (<italic>p</italic>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">.003 (.957)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">.60 (.440)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">–Only Nordic<break></break>
Wald(1); (<italic>p</italic>
)</td>
<td align="center" valign="top" rowspan="1" colspan="1">.15 (.699)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="center" valign="top" rowspan="1" colspan="1">.016 (.889)</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="TFN10"><p id="P109">Outpatients alcohol (<italic>n</italic>
 = 351) and outpatients drugs (<italic>n</italic>
 = 454), weighted data.</p>
</fn>
<fn id="TFN11"><label>a</label>
<p id="P110">Presented is the non–weighted <italic>n</italic>
.</p>
</fn>
<fn id="TFN12"><label>b</label>
<p id="P111">Exact binomial confidence interval using the approach by <xref rid="R26" ref-type="bibr">Morisette and Khorram (1998)</xref>
<sup>30</sup>
</p>
</fn>
<fn id="TFN13"><label>c</label>
<p id="P112">Effect of country on prevalence adjusted for age, sex, occupational status, housing and marital status.</p>
</fn>
<fn id="TFN14"><label>d</label>
<p id="P113">Not applicable.</p>
</fn>
<fn id="TFN15"><label>e</label>
<p id="P114">Nordic countries: Norway and Sweden.</p>
</fn>
<fn id="TFN16"><label>f</label>
<p id="P115">All countries: meaning all countries with subjects in this setting.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>

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Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria☆☆

Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria☆☆

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