Renforcement des projets de thèses doctorales dans la Collaboration internationale sur le TDAH et la toxicomanie (RING-PHD-CASA)

Context

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with typical onset before the age of 12, affecting 3.4% of the general population. It often persists into adulthood. In adults, the disorder is frequent, affecting 2.5% of the general population aged over 18. ADHD is devastating for both patients and families/caregivers, carrying a major burden for individuals and societies. Importantly, the clinical expression over the lifespan is highly heterogeneous.

Childhood ADHD is associated with a 3 to 5-fold increased risk of developing substance use disorders (SUDs). Not surprisingly, adult ADHD is highly prevalent in treatment-seeking SUD patients. The International ADHD in SUD Prevalence Study (IASP) recently found a DSM-IV (Diagnostis and Statistical Manual – Mental Disorders, fourth edition) ADHD prevalence of 13.9 % in adult treatment seeking substance users, whereas 16 % fulfilled DSM-V criteria for ADHD. In a recent meta-analysis, 23% of all treatment seeking SUD patients met diagnostic criteria for adult ADHD. Treating childhood ADHD results in better functioning, school achievement, family well-being, and reduces the incidence of substance use and SUDs. This is of utmost importance, since adults, who suffer from both disorders commonly show more severe forms of each of the disorders, compared to people with one or the other.

In summary, ADHD-SUD comorbidity is associated with multiple medical complications and reduced effectiveness of standard treatments, making proper diagnosis and treatment in adults with comorbid ADHD/SUD a challenge.

To address these major issues, the ICASA foundation aims to contribute to a substantial decrease in the proportion of ADHD patients developing an addiction/substance use disorder (SUD) and to substantially improve the detection, diagnosis and treatment of patients having both ADHD and SUD. There is a lack of knowledge regarding (i) the accuracy of the diagnostic procedures and (ii) the efficacy of treatments for combined ADHD/SUD. Thus:

– ICASA strives to use its own network and the network of its participants in order to improve access to researchers, clinicians and patients for research;

– ICASA strives to exchange knowledge on the topic of ‘ADHD and Substance Abuse’ both within the ICASA network and in contacts with other colleagues;

– ICASA will publish its research findings in peer reviewed Journals and will present these results at (inter)national conferences

The ICASA foundation already obtained major results regarding the comprehension of ADHD/SUD comorbidity and has published evidence for better clinical practice.

Research hypothesis

Find funding for network facilitation will greatly boost ICASA achievements, especially regarding PhD projects, and strengthen the collaboration with Paris INSERM team.

Methods

Throughout formal and informal discussion going on during bi-yearly in-person meetings, along with mail and telephone follow-ups on an « as needed » basis. The very diverse professional acquaintances of the ICASA members allow for a strong complementarity in each of the task that are ongoing in the network. The geographical/cultural diveristy of ICASA . This complementarity of expertise and culture is reflected in the WP that have been implemented to address the key objectives of ICASA.

The current project aims at recruiting a senior research assistant to facilitate these exchanges by improving network scientific and event animation.

Perspectives

A strong increase in scientific output from ICASA PhD students is expected, through short research stays at the Paris INSERM facilities.

Public health impact

The current project is expected to have public health impact on the longer-term, especially by providing clinicians with up-to-date guidelines to better treat the debilitating ADHD-SUD condition that is commonly encountered in psychiatry and addiction clinics.