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Adult ADHD and Non-Substance-Related Disorders

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The Burden of Adult ADHD in Comorbid Psychiatric and Neurological Disorders

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Abstract

The term “behavioral” addiction defines some syndromes that are similar to substance addiction but that are characterized by a behavioral focus instead of the ingestion of a psychoactive substance.

Gambling Disorder (GD) is the only behavioral addiction recognized by the DSM-5 and is characterized by maladaptive gambling behavior which persists despite serious adverse consequences, and - like SUDs - tolerance, withdrawal and craving. It seems that approximately 1% of the adult population in the United States suffers from a severe gambling problem, but such prevalence rate is much higher in young people.

The vast majority of people with a lifetime gambling disorder meet criteria for other psychiatric conditions, and ADHD is one of them. Indeed, people with problem gambling showed to be more than four times more likely of having ADHD in respect to controls, and people with ADHD showed to have nearly three times the likelihood of experience problem gambling in respect to those without ADHD. Moreover, ADHD is associated with more severe gambling problems.

The last decade showed a rapid increase in Internet use and gaming online that has been paralleled by the emergence of a phenomenon which is under study as a pathological condition, characterized by excessive use and impaired control over them. DSM-5 considers Internet Gaming Disorder (IGD) as a potential mental disorder defined as a compulsive and uncontrolled gaming online that exerts a negative impact on professional and/or social functioning. It is considered as a “Condition for Further Study” (APA 2013), requiring additional research in order to be recognized as a stand-alone condition, not secondary to other psychiatric disorders.

There is a growing body of evidence indicating an association between ADHD and problematic internet use and gaming addiction, probably because of their high reward dependence.

ADHD and IGD are characterized by a bidirectional relationship, with one worsening the other condition and vice versa and their relationship found support from pharmacological studies demonstrating the effectiveness of both methylphenidate and atomoxetine in the reduction of IGD symptomatology.

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    Stefano Pallanti & Luana Salerno

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Pallanti, S., Salerno, L. (2020). Adult ADHD and Non-Substance-Related Disorders. In: The Burden of Adult ADHD in Comorbid Psychiatric and Neurological Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-39051-8_17

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