Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch

Heval Özgen; Renske Spijkerman; Moritz Noack; Martin Holtmann; Arnt S. A. Schellekens; Geurt van de Glind; Tobias Banaschewski; Csaba Barta; Alex Begeman; Miguel Casas; Cleo L. Crunelle; Constanza Daigre Blanco; S. ren Dalsgaard; Zsolt Demetrovics; Jacomine den Boer; Geert Dom; Valsamma Eapen; Stephen V. Faraone; Johan Franck; Rafael A. González; Lara Grau-López; Annabeth P. Groenman; Malin Hemphälä; Romain Icick; Brian Johnson; Michael Kaess; M. té Kapitány-Fövény; John G. Kasinathan; Sharlene S. Kaye; Falk Kiefer; Maija Konstenius; Frances R. Levin; Mathias Luderer; Giovanni Martinotti; Frieda I. A. Matthys; Gergely Meszaros; Franz Moggi; Ashmita P. Munasur-Naidoo; Marianne Post; Sharon Rabinovitz; J. Antoni Ramos-Quiroga; Regina Sala; Abu Shafi; Ortal Slobodin; Wouter G. Staal; Rainer Thomasius; Ilse Truter; Michiel W. van Kernebeek; Maria C. Velez-Pastrana; Sabine Vollstädt-Klein; Florence Vorspan; Jesse T. Young; Amy Yule; Wim van den Brink; Vincent Hendriks

doi:https://doi.org/10.1024/1422-4917/a000828

Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch

Translated title of the contribution: International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder

Heval Özgen, Renske Spijkerman, Moritz Noack, Martin Holtmann, Arnt S. A. Schellekens, Geurt van de Glind, Tobias Banaschewski, Csaba Barta, Alex Begeman, Miguel Casas, Cleo L. Crunelle, Constanza Daigre Blanco, S. ren Dalsgaard, Zsolt Demetrovics, Jacomine den Boer, Geert Dom, Valsamma Eapen, Stephen V. Faraone, Johan Franck, Rafael A. GonzálezLara Grau-López, Annabeth P. Groenman, Malin Hemphälä, Romain Icick, Brian Johnson, Michael Kaess, M. té Kapitány-Fövény, John G. Kasinathan, Sharlene S. Kaye, Falk Kiefer, Maija Konstenius, Frances R. Levin, Mathias Luderer, Giovanni Martinotti, Frieda I. A. Matthys, Gergely Meszaros, Franz Moggi, Ashmita P. Munasur-Naidoo, Marianne Post, Sharon Rabinovitz, J. Antoni Ramos-Quiroga, Regina Sala, Abu Shafi, Ortal Slobodin, Wouter G. Staal, Rainer Thomasius, Ilse Truter, Michiel W. van Kernebeek, Maria C. Velez-Pastrana, Sabine Vollstädt-Klein, Florence Vorspan, Jesse T. Young, Amy Yule, Wim van den Brink, Vincent Hendriks

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Scopus)

Abstract

Background: Childhood attention-defi cit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not suffi cient to justify robust treatment recommendations. Objective: The aim of the study was to obtain a consensus statement based on a combination of scientifi c data and clinical experience. Method: A modifi ed Delphi study to reach consensus based upon the combination of scientifi c data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the fi rst-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD..

Translated title of the contribution	International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder
Original language	German
Pages (from-to)	54-67
Number of pages	14
Journal	Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie
Volume	50
Issue number	1
Early online date	2021
DOIs	https://doi.org/10.1024/1422-4917/a000828
Publication status	Published - Jan 2022

Keywords

Adolescents
Attention-deficit/hyperactivity
Consensus statement
Substance use disorder
disorder

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Özgen, H., Spijkerman, R., Noack, M., Holtmann, M., Schellekens, A. S. A., van de Glind, G., Banaschewski, T., Barta, C., Begeman, A., Casas, M., Crunelle, C. L., Daigre Blanco, C., Dalsgaard, S. R., Demetrovics, Z., den Boer, J., Dom, G., Eapen, V., Faraone, S. V., Franck, J., ... Hendriks, V. (2022). Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch. Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie, 50(1), 54-67. https://doi.org/10.1024/1422-4917/a000828

Özgen, Heval ; Spijkerman, Renske ; Noack, Moritz et al. / Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch. In: Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie. 2022 ; Vol. 50, No. 1. pp. 54-67.

@article{0a3f3014a9d24ad9992141ce5c02a91e,

title = "Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch",

abstract = "Background: Childhood attention-defi cit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not suffi cient to justify robust treatment recommendations. Objective: The aim of the study was to obtain a consensus statement based on a combination of scientifi c data and clinical experience. Method: A modifi ed Delphi study to reach consensus based upon the combination of scientifi c data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the fi rst-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD..",

keywords = "Adolescents, Attention-deficit/hyperactivity, Consensus statement, Substance use disorder, disorder",

author = "Heval {\"O}zgen and Renske Spijkerman and Moritz Noack and Martin Holtmann and Schellekens, {Arnt S. A.} and {van de Glind}, Geurt and Tobias Banaschewski and Csaba Barta and Alex Begeman and Miguel Casas and Crunelle, {Cleo L.} and {Daigre Blanco}, Constanza and Dalsgaard, {S. ren} and Zsolt Demetrovics and {den Boer}, Jacomine and Geert Dom and Valsamma Eapen and Faraone, {Stephen V.} and Johan Franck and Gonz{\'a}lez, {Rafael A.} and Lara Grau-L{\'o}pez and Groenman, {Annabeth P.} and Malin Hemph{\"a}l{\"a} and Romain Icick and Brian Johnson and Michael Kaess and Kapit{\'a}ny-F{\"o}v{\'e}ny, {M. t{\'e}} and Kasinathan, {John G.} and Kaye, {Sharlene S.} and Falk Kiefer and Maija Konstenius and Levin, {Frances R.} and Mathias Luderer and Giovanni Martinotti and Matthys, {Frieda I. A.} and Gergely Meszaros and Franz Moggi and Munasur-Naidoo, {Ashmita P.} and Marianne Post and Sharon Rabinovitz and Ramos-Quiroga, {J. Antoni} and Regina Sala and Abu Shafi and Ortal Slobodin and Staal, {Wouter G.} and Rainer Thomasius and Ilse Truter and {van Kernebeek}, {Michiel W.} and Velez-Pastrana, {Maria C.} and Sabine Vollst{\"a}dt-Klein and Florence Vorspan and Young, {Jesse T.} and Amy Yule and {van den Brink}, Wim and Vincent Hendriks",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s).",

year = "2022",

month = jan,

doi = "https://doi.org/10.1024/1422-4917/a000828",

language = "German",

volume = "50",

pages = "54--67",

journal = "Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie",

issn = "1422-4917",

publisher = "Hogrefe Publishing",

number = "1",

}

Özgen, H, Spijkerman, R, Noack, M, Holtmann, M, Schellekens, ASA, van de Glind, G, Banaschewski, T, Barta, C, Begeman, A, Casas, M, Crunelle, CL, Daigre Blanco, C, Dalsgaard, SR, Demetrovics, Z, den Boer, J, Dom, G, Eapen, V, Faraone, SV, Franck, J, González, RA, Grau-López, L, Groenman, AP, Hemphälä, M, Icick, R, Johnson, B, Kaess, M, Kapitány-Fövény, MT, Kasinathan, JG, Kaye, SS, Kiefer, F, Konstenius, M, Levin, FR, Luderer, M, Martinotti, G, Matthys, FIA, Meszaros, G, Moggi, F, Munasur-Naidoo, AP, Post, M, Rabinovitz, S, Ramos-Quiroga, JA, Sala, R, Shafi, A, Slobodin, O, Staal, WG, Thomasius, R, Truter, I, van Kernebeek, MW, Velez-Pastrana, MC, Vollstädt-Klein, S, Vorspan, F, Young, JT, Yule, A, van den Brink, W & Hendriks, V 2022, 'Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch', Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie, vol. 50, no. 1, pp. 54-67. https://doi.org/10.1024/1422-4917/a000828

Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch. / Özgen, Heval; Spijkerman, Renske; Noack, Moritz et al.
In: Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie, Vol. 50, No. 1, 01.2022, p. 54-67.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch

AU - Özgen, Heval

AU - Spijkerman, Renske

AU - Noack, Moritz

AU - Holtmann, Martin

AU - Schellekens, Arnt S. A.

AU - van de Glind, Geurt

AU - Banaschewski, Tobias

AU - Barta, Csaba

AU - Begeman, Alex

AU - Casas, Miguel

AU - Crunelle, Cleo L.

AU - Daigre Blanco, Constanza

AU - Dalsgaard, S. ren

AU - Demetrovics, Zsolt

AU - den Boer, Jacomine

AU - Dom, Geert

AU - Eapen, Valsamma

AU - Faraone, Stephen V.

AU - Franck, Johan

AU - González, Rafael A.

AU - Grau-López, Lara

AU - Groenman, Annabeth P.

AU - Hemphälä, Malin

AU - Icick, Romain

AU - Johnson, Brian

AU - Kaess, Michael

AU - Kapitány-Fövény, M. té

AU - Kasinathan, John G.

AU - Kaye, Sharlene S.

AU - Kiefer, Falk

AU - Konstenius, Maija

AU - Levin, Frances R.

AU - Luderer, Mathias

AU - Martinotti, Giovanni

AU - Matthys, Frieda I. A.

AU - Meszaros, Gergely

AU - Moggi, Franz

AU - Munasur-Naidoo, Ashmita P.

AU - Post, Marianne

AU - Rabinovitz, Sharon

AU - Ramos-Quiroga, J. Antoni

AU - Sala, Regina

AU - Shafi, Abu

AU - Slobodin, Ortal

AU - Staal, Wouter G.

AU - Thomasius, Rainer

AU - Truter, Ilse

AU - van Kernebeek, Michiel W.

AU - Velez-Pastrana, Maria C.

AU - Vollstädt-Klein, Sabine

AU - Vorspan, Florence

AU - Young, Jesse T.

AU - Yule, Amy

AU - van den Brink, Wim

AU - Hendriks, Vincent

PY - 2022/1

Y1 - 2022/1

N2 - Background: Childhood attention-defi cit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not suffi cient to justify robust treatment recommendations. Objective: The aim of the study was to obtain a consensus statement based on a combination of scientifi c data and clinical experience. Method: A modifi ed Delphi study to reach consensus based upon the combination of scientifi c data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the fi rst-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD..

AB - Background: Childhood attention-defi cit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not suffi cient to justify robust treatment recommendations. Objective: The aim of the study was to obtain a consensus statement based on a combination of scientifi c data and clinical experience. Method: A modifi ed Delphi study to reach consensus based upon the combination of scientifi c data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the fi rst-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD..

KW - Adolescents

KW - Attention-deficit/hyperactivity

KW - Consensus statement

KW - Substance use disorder

KW - disorder

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Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens ASA, van de Glind G et al. Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch. Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie. 2022 Jan;50(1):54-67. Epub 2021. doi: https://doi.org/10.1024/1422-4917/a000828

Internationale Konsenserklarung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung und gleichzeitigen Storungen durch Substanzgebrauch

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