title: Everyday life consequences of substance use in adult patients with a substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD): a patient's perspective.
abstract: BACKGROUND
  Although the prevalence of substance use disorder (SUD) with co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses. A recent study reported met- and unmet needs for several life domains regarding these patient groups. To improve treatment, it is necessary to identify the everyday life consequences of SUD and co-occurring ADHD or ASD in adult patients.
  
  
  METHODS
  Qualitative study using in-depth interviews. 11 SUD + ADHD and 12 SUD + ASD patients participated in the study. The interview transcripts were coded and analysed according to the seven steps for descriptive phenomenology by Colaizzi.
  
  
  RESULTS
  Both patients with ADHD and patients with ASD can get caught in a jumble of thoughts and emotions which can often lead to agitation and impulsivity in the case of ADHD or passivity and melancholia in the case of ASD with co-occurring SUD in both cases. Initially substance use ameliorates the symptoms and related problems, but both patient groups can later experience even greater problems: difficulties with the structuring of daily life due to a lack of planning (SUD + ADHD) or due to a lack of initiative (SUD + ASD). Both groups indicate that structure helps them function better. They also recognize that substance use disorganizes their lives and that an absence of structure contributes to substance use in what becomes a vicious circle which needs to be broken for effective treatment and care.
  
  
  CONCLUSIONS
  This study provides insight into the daily life consequences of SUD with a co-occurring ADHD or ASD. Substance use is reported to solve some ADHD- or ASD-related problems in the short run but have negative consequences in the long run (i.e., contribute to already impaired cognitive functioning). Insight is provided into what clinicians can do to break this vicious circle and thus help ADHD patients to refrain from action and ASD patients to take action.
authors.affiliation: Department of residency training MANP mental health, Dimence, Deventer, The Netherlands. l.kronenberg@dimence.nl.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kronenberg
authors.forename: Karin
authors.initials: K
authors.lastname: Slager-Visscher
authors.forename: Peter J J
authors.initials: PJ
authors.lastname: Goossens
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D003071:Cognition; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult