Regnart Judith, Truter Ilse, Meyer Anneke
a Drug Utilization Research Unit (DURU), Department of Pharmacy , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
b Department of Psychology , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
Expert Rev Pharmacoecon Outcomes Res. 2017 Jun;17(3):275-282. doi: 10.1080/14737167.2017.1351878. Epub 2017 Jul 13.
Co-occurring disorders (CODs) describe a Substance Use Disorder (SUD) accompanied by a comorbid psychiatric disorder. Attention-Deficit/Hyperactivity Disorder (ADHD) and mood disorders are common CODs with high prevalence rates in SUD populations. It is proposed that literature on a tri-condition presentation of ADHD, mood disorder and SUD is limited. Areas covered: A literature search was conducted using a keyword search on EBSCOhost. Initially 2 799 records were identified, however, only two articles included all three conditions occurring concurrently in individuals. CODs constitute a major concern due to their overarching burden on society as a whole. Diagnosis and treatment of such patients is challenging. There is evidence that dysfunction of dopamine in the brain reward circuitry impacts the development or symptomology of all three disorders. Disparity exists regarding whether ADHD or mood disorders are greater modifiers for increased SUD severity. However, it has been reported that poor functional capacity may have a greater influence than comorbidities on SUD development. Expert commentary: Challenges exist which confound the clear distinction of CODs, however, with greater emergence of adult ADHD its screening in SUD populations should become standard practice to establish data on multi-condition presentations with the ultimate goal of improving clinical outcomes.
共病障碍（CODs）指的是伴有共病精神障碍的物质使用障碍（SUD）。注意力缺陷/多动障碍（ADHD）和情绪障碍是常见的共病障碍，在物质使用障碍人群中患病率很高。有人提出，关于ADHD、情绪障碍和物质使用障碍三者同时出现的文献有限。涵盖领域：使用EBSCOhost进行关键词搜索，开展了一项文献检索。最初识别出2799条记录，然而，只有两篇文章包含个体同时出现的所有三种情况。共病障碍是一个主要问题，因为它们给整个社会带来了总体负担。对此类患者的诊断和治疗具有挑战性。有证据表明，大脑奖赏回路中的多巴胺功能障碍会影响所有这三种障碍的发展或症状表现。关于ADHD或情绪障碍是否是物质使用障碍严重程度增加的更大调节因素，存在差异。然而，据报道，功能能力差可能比共病对物质使用障碍的发展有更大影响。专家评论：存在一些挑战，混淆了共病障碍的明确区分，然而，随着成人ADHD的更多出现，在物质使用障碍人群中对其进行筛查应成为标准做法，以建立关于多种情况表现的数据，最终目标是改善临床结果。
