Prevalence and factors associated with attention deficit/hyperactivity disorder among patients with substance use disorders attending Butabika Hospital, Kampala.

Abstract

Introduction: In the general population, the prevalence of Attention-deficit/hyperactivity disorder (ADHD) among adults is estimated to be 2-3%. Among patients with substance use Disorders (SUD) however, the prevalence is as high as 40.9%. The co morbidity of ADHD and SUD is very impairing but not many studies of the co morbidity have been conducted in Sub Saharan Africa. Objective: To determine the prevalence of ADHD and factors associated with ADHD among adults seeking treatment for SUD in Butabika Hospital. Methods: This was a cross-sectional study carried out at Butabika National Referral Mental Hospital among adults with SUD both at the inpatient wards and outpatient clinics. Following informed consent, consecutive sampling was carried out to obtain a sample size of 385 participants over March 2021 to May 2021. ADHD was assessed using the Mini International Neuropsychiatric Interview (MINI) module for hyperactivity disorders. A standardized questionnaire was used to assess demographic, clinical and psychosocial factors among the study participants. Bivariate and multivariate logistic regression models were used to evaluate factors independently associated with ADHD. Data was collected using qualtircs and analyzed using STATA 14.1. Results: Among the 281 participants, 89.0 % were males. The mean age of participants was 32.34 (SD= 10.6) years. Approximately 209 (55%) were single. The majority (49.7%) had secondary level of education or less and almost 102 (26.8%) met diagnostic criteria for Antisocial personality disorder. The prevalence of ADHD was 10.8%(N=41). The only factor independently associated with ADHD was employment status. Those employed had significantly less odds (aOR 0.30, 95% CI 0.13-0.67, p-value 0.003) of meeting criteria for ADHD. Conclusion: The prevalence of ADHD was substantially elevated among adult patients receiving treatment for SUD at Butabika hospital. Unemployment was the only factor independently associated with ADHD. Assessment for ADHD should be part and parcel of the routine evaluation of patients presenting with substance use disorders.