Norwegian Centre for Addiction Research (SERAF), Faculty of Medicine, Oslo, Norway.
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Oslo, Norway.
Eur Addict Res. 2017;23(6):298-305. doi: 10.1159/000484240. Epub 2018 Jan 10.
Knowledge of attention deficit hyperactivity disorder (ADHD) symptoms among patients in opioid maintenance treatment (OMT) is important for treatment optimization and yet limited. We investigated the prevalence of ADHD symptoms, and factors associated with high ADHD symptom burden in a group of Norwegian OMT patients.
We interviewed individuals entering OMT across Norway in 2 steps between 2012 and 2016. ADHD symptoms were measured by the Adult ADHD Self-Report Scale (ASRS; n = 175). We compared 2 groups of individuals who scored above or below the clinical cutoff score. Mental distress was measured with the General Symptom Index (GSI) of the Hopkin's Symptom Check-List-25.
A total of 33% of the OMT patients screened positively for ADHD on the ASRS. Participants who scored above the clinical cutoff were younger, and reported more severe substance use and mental distress. When controlling for other significant variables in a logistic regression analysis, scoring above cutoff on the ASRS was associated with higher GSI (OR 1.61; 95% CI 1.03-2.50) and use of stimulants (OR 2.55; 1.13-5.76).
ADHD symptoms were common in these OMT patients. High ADHD symptom burden was associated with higher mental distress and use of stimulants. This underlines a need of more systematic focus on ADHD in OMT to plan treatment accordingly.
了解阿片类药物维持治疗（OMT）患者的注意力缺陷多动障碍（ADHD）症状对于优化治疗非常重要，但目前这方面的知识有限。我们调查了挪威一组 OMT 患者中 ADHD 症状的患病率，以及与高 ADHD 症状负担相关的因素。
我们在 2012 年至 2016 年期间分两步对挪威各地接受 OMT 的个体进行了访谈。ADHD 症状通过成人 ADHD 自我报告量表（ASRS；n=175）进行测量。我们比较了 ASRS 得分高于或低于临床临界值的两组个体。使用霍普金斯症状检查表-25 的一般症状指数（GSI）来衡量精神困扰。
共有 33%的 OMT 患者 ASRS 筛查结果呈 ADHD 阳性。得分高于临界值的参与者年龄较小，且报告了更严重的物质使用和精神困扰。在逻辑回归分析中控制其他重要变量后，ASRS 得分高于临界值与更高的 GSI（OR 1.61；95%CI 1.03-2.50）和兴奋剂使用（OR 2.55；1.13-5.76）相关。
这些 OMT 患者中常见 ADHD 症状。高 ADHD 症状负担与更高的精神困扰和兴奋剂使用相关。这突显了在 OMT 中更加系统地关注 ADHD 的必要性，以便相应地规划治疗。
