Guilan University, Rasht, Iran.
J Atten Disord. 2012 May;16(4):325-32. doi: 10.1177/1087054710387265. Epub 2011 Nov 29.
To assess the pattern of substance use disorder (SUD) in adolescents with and without history of attention - deficit / hyperactivity disorder (ADHD) using an Iranian sample in the context of a cultural background and drug availability is differing from Western countries.
In this case- control study, the participants were interviewed by a child psychiatrist and the measures included: kiddie Schedule for Affective Disorder and Schizophrenia for school age children (K-SADS), Opium Treatment Index (OTI) and Global Assessment Functioning (GAF). Data were analyzed with chi square test and T test and fisher exact test by EPI.6 soft ware.
Adolescents with ADHD were younger at the time of starting cigarette smoking, substance use, abuse and dependency (p = 0.0001), a shorter period between their first-time substance use and substance dependence or abuse (p = 0.0001), more severe substance use (for cannabis, heroine, cigarette and drugs such as benzodiazepines p < 0.05) and more functional impairment (p = 0.0007). Average number of co morbid disorders were higher in ADHD group. (p = 0.03)
Although the pattern and type of substance use may be different in Iranian culture, our findings about the relationship between ADHD and SUD are similar to other western and non western countries. The presence of ADHD may over-ride cultural barriers and lower availability of drugs to the development of SUD in Iranian adolescents. Early diagnosis and treatment of ADHD may propose with better prognosis of SUD and subsequent decrease in the prevalence of SUD and the costs of SUD-related pathology in this population.
在伊朗这个文化背景和药物可及性与西方国家不同的国家，评估有和无注意力缺陷/多动障碍（ADHD）病史的青少年物质使用障碍（SUD）的模式。
在这项病例对照研究中，儿童精神科医生对参与者进行了访谈，所用的评估工具包括：儿童心境障碍和精神分裂症诊断性访谈表修订版（Kiddie Schedule for Affective Disorder and Schizophrenia for school age children，K-SADS）、阿片类物质治疗指数（Opium Treatment Index，OTI）和总体功能评估（Global Assessment Functioning，GAF）。采用 EPI.6 软件的卡方检验、T 检验和 Fisher 确切概率法对数据进行分析。
有 ADHD 的青少年首次吸烟、使用物质、滥用和依赖的时间更早（p=0.0001），首次使用物质到物质依赖或滥用的时间间隔更短（p=0.0001），物质使用更严重（大麻、海洛因、香烟和苯二氮䓬类药物等，p<0.05），功能损害更严重（p=0.0007）。ADHD 组共病障碍的平均数量更高（p=0.03）。
尽管伊朗文化中物质使用的模式和类型可能不同，但我们关于 ADHD 与 SUD 之间关系的发现与其他西方国家和非西方国家相似。ADHD 的存在可能会克服文化障碍，并降低伊朗青少年发生 SUD 的药物可及性。早期诊断和治疗 ADHD 可能会改善 SUD 的预后，并随后降低该人群 SUD 的患病率以及与 SUD 相关的病理的费用。
