Kim Jae-Won, Park Churl-Soo, Hwang Jun-Won, Shin Min-Sup, Hong Kang-E, Cho Soo-Churl, Kim Boong-Nyun
Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, Seoul, Korea.
Alcohol Alcohol. 2006 Jul-Aug;41(4):407-11. doi: 10.1093/alcalc/agl034. Epub 2006 May 5.
To examine the clinical and genetic characteristics of Korean male alcoholics with and without attention deficit hyperactivity disorder (ADHD).
The present study included 85 male alcoholics who were diagnosed as having DSM-IV alcohol dependence. A total of 28 (32.9%) alcoholics were diagnosed as having DSM-IV ADHD with ongoing symptoms in adulthood. For the evaluation of their psychiatric conditions, the alcohol dependence scale (ADS), Beck depression inventory (BDI), Beck anxiety inventory (BAI), Barratt impulsiveness scale (BIS), brief anger-aggression questionnaire (BAQ), overt aggression scale (OAS), codependence test, and obsessive compulsive drinking scale (OCDS) were administered. The genotype frequencies of the dopamine type 2 receptor gene (DRD2), aldehyde dehydrogenase type 2 gene (ALDH2), functional polymorphism in the regulatory region of the serotonin transporter gene (5-HTTLPR), and catechol-O-methyltransferase gene (COMT) polymorphisms were examined.
Compared with alcoholics without ADHD, the mean ages for the onset of pathological drinking and alcohol withdrawal hallucinations were significantly earlier in alcoholics with ADHD. There was also a significant difference in the history of antisocial behaviour between the two groups. Compared with alcoholics without ADHD, the mean scores of the ADS, BDI, BAI, OAS, and OCDS were significantly higher in alcoholics with ADHD. With regard to the codependence test results, the mean scores of the interpersonal problem, low self-esteem and anxiety/fear subscales, and the mean total score of the codependence test were significantly higher in alcoholics with ADHD when compared with those without ADHD. There were no significant differences in the genotype frequencies of the DRD2, ALDH2, 5-HTTLPR, and COMT polymorphisms between alcoholics with and without ADHD.
The results of this study suggest that the comorbidity of alcohol dependence and ADHD in this Korean sample forms a distinct clinical phenotype that shows an increased severity of alcohol-related symptoms and behavioural/emotional problems and that ADHD is associated with an increased risk for the early onset of alcohol dependence in Korean male alcoholics.
研究患有和未患有注意力缺陷多动障碍（ADHD）的韩国男性酗酒者的临床和遗传特征。
本研究纳入了85名被诊断为患有DSM-IV酒精依赖的男性酗酒者。共有28名（32.9%）酗酒者被诊断为患有DSM-IV ADHD且在成年期仍有症状。为评估他们的精神状况，使用了酒精依赖量表（ADS）、贝克抑郁量表（BDI）、贝克焦虑量表（BAI）、巴拉特冲动性量表（BIS）、简短愤怒-攻击问卷（BAQ）、公开攻击量表（OAS）、共依存性测试和强迫性饮酒量表（OCDS）。检测了多巴胺2型受体基因（DRD2）、乙醛脱氢酶2型基因（ALDH2）、5-羟色胺转运体基因调控区功能性多态性（5-HTTLPR）以及儿茶酚-O-甲基转移酶基因（COMT）多态性的基因型频率。
与未患ADHD的酗酒者相比，患ADHD的酗酒者病理性饮酒和酒精戒断幻觉的平均发病年龄显著更早。两组在反社会行为史方面也存在显著差异。与未患ADHD的酗酒者相比，患ADHD的酗酒者的ADS、BDI、BAI、OAS和OCDS的平均得分显著更高。关于共依存性测试结果，与未患ADHD的酗酒者相比，患ADHD的酗酒者在人际问题、低自尊和焦虑/恐惧分量表的平均得分以及共依存性测试的平均总分显著更高。患ADHD和未患ADHD的酗酒者在DRD2、ALDH2、5-HTTLPR和COMT多态性的基因型频率上没有显著差异。
本研究结果表明，在这个韩国样本中，酒精依赖与ADHD的共病形成了一种独特的临床表型，其显示出与酒精相关症状以及行为/情绪问题的严重程度增加，并且ADHD与韩国男性酗酒者酒精依赖早期发病风险增加有关。
