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成人注意力缺陷多动障碍及其与阿片类药物依赖患者的相关性:一项探索性研究。

Adult attention-deficit hyperactivity disorders and its correlates in patients with opioid dependence: An exploratory study.

作者信息

Gupta Snehil, Bhatia Gayatri, Sarkar Siddharth, Chatterjee Biswadip, Balhara Yatan Pal Singh, Dhawan Anju

机构信息

Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Psychiatry. 2020 Sep-Oct;62(5):501-508. doi: 10.4103/psychiatry.IndianJPsychiatry_705_19. Epub 2020 Oct 10.

Abstract

BACKGROUND

Adult attention-deficit hyperactivity disorder (ADHD) often remains undiagnosed and undertreated among patients with substance use disorders (SUDs). Research is lacking with regard to adult ADHD in individuals with SUD. The current work was intended to study the prevalence of adult ADHD among individuals with opioid dependence and its correlates, and to assess the attitude of the individuals with adult ADHD toward its treatment.

METHODS

This cross-sectional survey was conducted in 132 consecutive inpatients with opioid-dependence syndrome. Patients were assessed using the Mini International Neuropsychiatric Interview. 5.0, adult ADHD Self-Report Screening Scale, and Maudsley Addiction Profile. Those who screened positive for adult ADHD (ADHD+) were compared with those screened negative (ADHD) on a number of sociodemographic, substance use, and clinical variable. Furthermore, attitude toward the treatment for ADHD was assessed among the ADHD+ individuals.

RESULTS

About a fifth (=24, 18.2%) of the patients with opioid dependence screened positive for adult ADHD. One-third of the participants (=8, 33.3%) were willing for the treatment of any kind, and only a half (=3) was willing to pay. Earlier age of onset of opioid use (relative risk: 0.01; 95% confidence interval: 0.003, 0.85; = 0.036) had higher likelihood to ADHD+ status.

CONCLUSION

Despite a high rate of ADHD screen positivity among individuals with opioid dependence, a majority were not willing to receive the treatment. Sensitization of: (1) addiction psychiatrist to routinely screen for ADHD, especially in the presence of certain correlates and (2) patients-caregivers about the potential benefit of treatment in effectively addressing the symptoms of ADHD effectively in this population.

摘要

背景

成人注意力缺陷多动障碍(ADHD)在物质使用障碍(SUD)患者中常常未被诊断和治疗。关于患有SUD的个体中的成人ADHD的研究尚缺。当前的研究旨在探讨阿片类药物依赖个体中成人ADHD的患病率及其相关因素,并评估成人ADHD个体对其治疗的态度。

方法

对132例连续的阿片类药物依赖综合征住院患者进行了这项横断面调查。使用迷你国际神经精神访谈5.0版、成人ADHD自我报告筛查量表和莫兹利成瘾量表对患者进行评估。将成人ADHD筛查呈阳性(ADHD+)的患者与筛查呈阴性(ADHD-)的患者在一些社会人口学、物质使用和临床变量方面进行比较。此外,还对ADHD+个体对ADHD治疗的态度进行了评估。

结果

约五分之一(=24,18.2%)的阿片类药物依赖患者成人ADHD筛查呈阳性。三分之一的参与者(=8,33.3%)愿意接受任何形式的治疗,只有一半(=3)愿意付费。阿片类药物使用起始年龄较早(相对风险:0.01;95%置信区间:0.003,0.85;P = 0.036)的患者更有可能处于ADHD+状态。

结论

尽管阿片类药物依赖个体中ADHD筛查阳性率较高,但大多数人不愿意接受治疗。需要提高(1)成瘾精神科医生对常规筛查ADHD的认识,尤其是在存在某些相关因素的情况下,以及(2)患者及其照顾者对治疗在有效解决该人群ADHD症状方面潜在益处的认识。

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