Silver Hill Hospital, New Canaan, CT, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
J Affect Disord. 2020 Apr 1;266:338-340. doi: 10.1016/j.jad.2020.01.087. Epub 2020 Jan 22.
Attentional deficits, substance misuse, and affective lability are all common features among adults with bipolar disorder, but little research has attempted to parse their inter-relationships.
Using standardized scales and semi-structured interviews, we evaluated adult ADHD features and affective lability in 113 dually-diagnosed mood/substance use disorder inpatients (mean age 32.6 years, 63% female) drawn from one private suburban academically affiliated inpatient treatment program.
24% of bipolar subjects had above-threshold ADHD screens. Affective Lability Scale (ALS) total and subscores were significantly associated with ADHD scores (univariate r's ranging from 0.38-0.63). ALS total and most subscale scores were significantly higher among bipolar subjects having above- (versus below-) threshold ADHD ratings. Linear regressions to predict affective lability revealed significant partial correlations between bipolar diagnoses and ALS total, depression, elation, and anger subscores, while controlling for significant effects from ADHD comorbidity. Inclusion of current substances of abuse did not change goodness-of-fit.
Subjects were drawn from a single private institution, potentially limiting generalizability.
Comorbid ADHD appears to moderate multiple domains of affective lability in bipolar disorder inpatients, independent of current substance misuse.
注意力缺陷、物质滥用和情感不稳定都是双相情感障碍患者的常见特征，但很少有研究试图分析它们之间的关系。
我们使用标准化量表和半结构化访谈，评估了来自一个私人郊区学术附属住院治疗项目的 113 名双相情感障碍/物质使用障碍共病住院患者（平均年龄 32.6 岁，63%为女性）的成人注意缺陷多动障碍特征和情感不稳定。
24%的双相情感障碍患者有 ADHD 筛查得分超过阈值。情感不稳定量表（ALS）总分和分量表得分与 ADHD 评分显著相关（单变量 r 值范围为 0.38-0.63）。ALS 总分和大多数分量表得分在 ADHD 评分高于（而非低于）阈值的双相情感障碍患者中显著较高。线性回归预测情感不稳定，控制 ADHD 共病的显著影响后，发现双相情感障碍诊断与 ALS 总分、抑郁、兴奋和愤怒分量表之间存在显著的部分相关。纳入当前物质滥用并没有改变拟合优度。
研究对象来自单一的私人机构，可能限制了其普遍性。
共病 ADHD 似乎独立于当前物质滥用，调节了双相情感障碍住院患者多个情感不稳定领域。
