Clinical and Neuropsychological Correlates of Substance Use Disorders in a Sample of Egyptian Adolescents with Attention Deficit Hyperactivity Disorder

Background Attention deficit hyperactivity disorder (ADHD) has a high comorbidity with substance use disorders (SUDs). The overlap between ADHD and SUD in both adolescents and adults is one of the areas of increasing clinical and public health interest. The current study aimed to investigate the demographic and clinical characteristics of individual with ADHD and comorbid SUDs during the adolescence period in comparison to those with ADHD without SUDs. Thirty adolescents aged 13–21 with ADHD, half of them with comorbid SUD, were interviewed using the Kiddie Schedule of affective disorders and schizophrenia. The Arabic version of Conners' Parent Rating Scale, urine screening for substances of abuse and the electronic version of the Continuous performance test − 3 (X-version) (CPT3-X) were used to evaluate the adolescents. Results subjects with ADHD and SUD were more likely to be males (86.7%) older than 17 years old (73.3%). They showed higher impulsivity and lower vigilance on CPT3-X than those with ADHD alone. The hyperactive/impulsive subtype of ADHD was the most significant variable that predicted comorbid SUD (p = 0.016), followed by comorbid conduct disorder (p = 0.017), then severe degree of ADHD (p = 0.018), and finally commission errors which indicates impulsivity in ADHD patients in CPT3-X (P-value 0.029). Conclusions Older males with severe ADHD, prominent hyperactive/impulsive symptoms, and comorbid conduct problems are at a specifically high risk to use substances during adolescence. High commission errors and high variability of performance in CPT might also distinguish youth with ADHD + SUD from those with ADHD only. Early intervention programs should be put in place to identify and protect these subjects from substance use in their early years of adolescence.