It would be advisable for addiction treatment centres to screen patients for ADHD on admission. This is the conclusion of PhD student and psychiatric trainee Katelijne van Emmerik-van Oortmerssen. As many as one in five addicts have ADHD. Van Emmerik-van Oortmerssen developed an integrated treatment for this group that includes cognitive behavioural therapy for both the addiction and the ADHD. A comparison of this new approach to the standard treatment has shown that the integrated approach is better at reducing ADHD symptoms without the need for medication. Both treatments are equally good at tackling the addiction. Van Emmerik-van Oortmerssen will be awarded a PhD by the University of Groningen on 20 June.
Addiction to alcohol and/or drugs is a major cause of serious health problems around the world. Psychiatric comorbidity, the presence of several disorders, is common in many addicted patients and this can complicate treatment. Van Emmerik-van Oortmerssen’s thesis is about the comorbidity of ADHD and addiction. She first researched the prevalence of ADHD in patients with an addiction. This and previous research led her to conclude that the prevalence rate is high: on average in one in five patients with an addiction. This varies from country to country and depends, for instance, on the substance to which the patient is addicted. She also concluded that addicted patients with ADHD often have other psychiatric problems such as personality and mood disorders.
Effect of integrated treatment
In her thesis Van Emmerik-van Oortmerssen presents an integrated treatment with cognitive behavioural therapy for both the addiction and the ADHD. This treatment was specially developed for patients who have ADHD alongside their addiction, and consists of treatment for substance abuse together with modules that focus on treating ADHD. These train patients’ planning skills, for instance. In her research she compared this integrated treatment with the standard treatment, which focuses solely on addiction. She found a greater decrease in ADHD symptoms with the new approach than with the current approach, without using medication.
Advice: screen patients for ADHD
Based on her research, Van Emmerik-van Oortmerssen advises screening patients with an addiction for ADHD. She also recommends taking account of other possible personality and mood disorders.
Katelijne van Emmerik-van Oortmerssen (1978) has been a psychiatric trainee at GGZ InGeest since 2013. She carried out her research at Jellinek in Amsterdam (a subsidiary of Arkin) in collaboration with the Academic Medical Center Amsterdam and the University Medical Center Groningen. The research was partly funded by NutsOhra Fund. The title of her thesis is: ‘ADHD & Addiction. Prevalence, diagnostic assessment and treatment of ADHD in substance use disorder patients’.