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Screening for substance use disorders in neurodevelopmental disorders: a clinical routine?
Margita Palmqvist1, Gunnar Edman, Sven Bölte
1Neuropsychiatric Unit, Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden.
European Child & Adolescent Psychiatry
|August 17, 2013
Summary
Substance use disorder screening is infrequent in ADHD and autism assessments, particularly in child psychiatry. This suggests potential underdiagnosis of SUD in neurodevelopmental disorders.
Area of Science:
- Psychiatry
- Neurodevelopmental Disorders
- Addiction Medicine
Background:
- Substance use disorders (SUD) are frequently underdiagnosed in psychiatric settings.
- Neurodevelopmental disorders like ADHD and ASD may have higher rates of co-occurring SUD.
- Clinical guidelines increasingly recommend SUD screening in these populations.
Purpose of the Study:
- To assess the routine implementation of drug and alcohol screening for ADHD and ASD.
- To compare screening practices between child and adolescent vs. adult psychiatric outpatient departments.
Main Methods:
- A survey of 34 child and adolescent and 29 adult psychiatric outpatient departments in Stockholm County, Sweden.
- Structured telephone interviews with department representatives regarding SUD screening procedures.
- Data collection focused on the use of screening questionnaires and toxicology tests.
Main Results:
- Only 6% of child/adolescent departments regularly used SUD screening questionnaires for ADHD/ASD.
- In contrast, 55% of adult departments routinely used such questionnaires.
- Toxicology tests were used routinely or in specific cases in 66% of adult units, versus 15% in child/adolescent units.
Conclusions:
- SUD screening is not consistently integrated into routine clinical assessments for ADHD and ASD in psychiatric settings.
- Underdiagnosis of SUD is likely, especially within child and adolescent psychiatry.
- Current practices fall short of recommended clinical guidelines for SUD screening in neurodevelopmental disorders.
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