ADHD Outpatient Program - Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
J Psychiatr Res. 2011 Jun;45(6):829-34. doi: 10.1016/j.jpsychires.2010.10.012. Epub 2010 Nov 18.
The prevalence of smoking is significantly increased among adults with Attention-Deficit/Hyperactivity Disorder (ADHD), and this association has a significant impact in both disorders, ascribed to either self-medication or behavioral disinhibition hypotheses. However, little is known about clinical variables associated with cigarette smoking among patients with ADHD. The present study evaluates comorbidity, demographic and personality profiles of patients with ADHD in relation to smoking status.
Patients (n422) were evaluated in the adult ADHD outpatient clinic of Hospital de Clínicas de Porto Alegre. Diagnoses were based on DSM-IV criteria and interviews were performed with Portuguese version of K-SADS-E for ADHD and Oppositional-Defiant Disorder. Axis I psychiatric comorbidities were evaluated with the SCID-I and smoking behavior with Fagerström Test for Nicotine Dependence (FTND). Personality was evaluated with Cloninger's Temperament and Character Inventory (TCI).
The presence of smoking was strongly associated with externalizing characteristics as antisocial personality disorder (OR4.2) and substance dependence (OR6.5), but not with internalizing disorders. Moreover, smoking was associated with higher novelty seeking and lower harm avoidance scores.
Smoking initiation among patients with ADHD is consistent with a behavioral disinhibition profile beyond the possible role of self-medication in smoking persistence. Smoking in these patients is strongly associated with externalizing comorbid disorders.
注意力缺陷多动障碍（ADHD）患者的吸烟率显著升高，这种关联在两种疾病中都具有重要意义，归因于自我治疗或行为抑制假说。然而，人们对 ADHD 患者吸烟与临床变量之间的关系知之甚少。本研究评估了 ADHD 患者的合并症、人口统计学和人格特征与吸烟状况的关系。
在阿雷格里港临床医院的成人 ADHD 门诊对患者（n=422）进行评估。诊断基于 DSM-IV 标准，并使用葡萄牙语版 K-SADS-E 对 ADHD 和对立违抗障碍进行访谈。使用 SCID-I 评估轴 I 精神共病，使用尼古丁依赖 Fagerström 测试（FTND）评估吸烟行为。人格采用 Cloninger 的气质与性格量表（TCI）进行评估。
吸烟的存在与外向特征（如反社会人格障碍[OR4.2]和物质依赖[OR6.5]）强烈相关，但与内向障碍无关。此外，吸烟与更高的新奇寻求和更低的回避危害得分相关。
ADHD 患者的吸烟起始与行为抑制特征有关，而不仅仅是可能的自我治疗对吸烟持续存在的作用。这些患者的吸烟与外向共病障碍密切相关。
