Modestin J, Matutat B, Würmle O
Psychiatric University Hospital Zurich, Lenggstrasse 31, 8029 Zurich, Switzerland.
Eur Arch Psychiatry Clin Neurosci. 2001;251(1):42-7. doi: 10.1007/s004060170067.
Both attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) were explored as possible antecedents of opioid dependence and personality disorder. One hundred adult opioid-dependent, treatment-seeking male inpatients were explored; an extended clinical semistructured interview to collect sociodemographic, drug use related, and clinical data and the Structured Clinical Interview for DSM-IV personality disorders SCID-II were carried out. Four groups of patients, namely ADHD alone (4 patients), ADHD + CD (7 patients), CD alone (47 patients) and no ADHD/no CD (42 patients) were identified and compared with each other. The results indicate that ADHD alone does not predispose to the development of opioid dependence in male inpatients. Childhood ADHD may nevertheless be found more frequently in male opioid addicts due to its comorbidity with CD, which was identified in more than half of our sample. Patients with ADHD history seemed to go through the drug abuse career earlier and to develop more frequently histrionic and obsessive-compulsive personality disorder. Over half of the CD patients developed borderline and/or antisocial personality disorder; both ADHD and CD predispose significantly to the PD development. Early substance use preventive measures are necessary in children and adolescents suffering from CD and from ADHD comorbid with CD.
注意力缺陷多动障碍（ADHD）和品行障碍（CD）都被作为阿片类药物依赖和人格障碍可能的前驱因素进行了探讨。研究了100名寻求治疗的成年男性阿片类药物依赖住院患者；采用扩展的临床半结构化访谈来收集社会人口统计学、药物使用相关及临床数据，并开展了《精神疾病诊断与统计手册》第四版（DSM-IV）人格障碍的结构化临床访谈（SCID-II）。确定了四组患者，即单纯ADHD（4例患者）、ADHD+CD（7例患者）、单纯CD（47例患者）以及无ADHD/无CD（42例患者），并对这四组患者进行了相互比较。结果表明，单纯ADHD不会使男性住院患者易患阿片类药物依赖。然而，由于童年ADHD与CD共病，在男性阿片类成瘾者中可能更频繁地发现童年ADHD，在我们样本中超过一半的患者中发现了这种共病情况。有ADHD病史的患者似乎更早经历药物滥用过程，且更频繁地发展为表演型和强迫型人格障碍。超过一半的CD患者发展为边缘型和/或反社会型人格障碍；ADHD和CD均显著易患人格障碍。对于患有CD以及与CD共病的ADHD的儿童和青少年，早期采取预防药物使用的措施是必要的。
