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注意缺陷多动障碍(ADHD),尤其是注意力缺陷特征,对酒精依赖个体病程的影响。

Influence of ADHD, especially attention-deficit characteristics, on the course of alcohol-dependent individuals.

机构信息

National Hospital Organization, Kurihama Medical and Addiction Center, Yokosuka, Japan.

Division of Psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Japan.

出版信息

BMC Psychiatry. 2022 Dec 19;22(1):803. doi: 10.1186/s12888-022-04455-4.

Abstract

BACKGROUND

While several studies have revealed that neurodevelopmental disorders have a high probability of overlapping with substance use disorders, the effects of neurodevelopmental disorders on the courses of substance use disorders have hardly been examined.

METHODS

This study targeted 637 alcohol-dependent individuals who received inpatient treatment and whose drinking situations were followed for 12 months after hospital discharge using mailed questionnaires. The comorbidity of psychiatric disorders and the characteristics associated with the neurodevelopmental disorders were assessed using several measurements at the time of hospital admission. The effects of neurodevelopmental disorders on the drinking courses of the subjects were then estimated.

RESULTS

The presence of a current depressive episode or any anxiety disorder significantly lowered the abstinence rates during the follow-up period (p = 0.0195 and p = 0.0214, respectively). ADHD traits as assessed using the ADHD Self-report Scale (ASRS) predicted a significantly poorer abstinence rate (p = 0.0296). Similarly, attention-deficit characteristics assessed objectively through interviews predicted a significantly lower abstinence rate (p = 0.0346), and a sensitivity analysis enhanced these results (p = 0.0019). When the drinking patterns were classified into three groups, the subjects with attention-deficit characteristics had a significantly higher rate of "Recurrence" and lower rates of "Abstinence" and "Controlled drinking" (p = 0.013). In a multivariate proportional hazards analysis, the ASRS score was significantly correlated with the re-drinking risk (p = 0.003).

CONCLUSION

ADHD traits had significant effects on not only abstinence rates, but also on drinking pattern. The presence of ADHD traits, especially attention-deficit characteristics, influenced the drinking courses of alcohol-dependent individuals after hospital treatment.

摘要

背景

虽然有几项研究表明神经发育障碍与物质使用障碍有很高的重叠概率,但神经发育障碍对物质使用障碍病程的影响几乎没有被研究过。

方法

本研究以 637 名接受住院治疗的酒精依赖个体为研究对象,在出院后通过邮寄问卷对他们的饮酒情况进行了 12 个月的随访。在入院时使用多项测量评估了精神障碍的共病情况和与神经发育障碍相关的特征。然后,评估了神经发育障碍对研究对象饮酒情况的影响。

结果

目前存在抑郁发作或任何焦虑障碍的患者在随访期间的戒酒率显著降低(p=0.0195 和 p=0.0214)。使用 ADHD 自我报告量表(ASRS)评估的 ADHD 特征预测戒酒率显著降低(p=0.0296)。同样,通过访谈客观评估的注意力缺陷特征也预测戒酒率显著降低(p=0.0346),且敏感性分析增强了这些结果(p=0.0019)。当将饮酒模式分为三组时,具有注意力缺陷特征的患者“复发”的比率显著更高,“戒酒”和“控制饮酒”的比率显著更低(p=0.013)。在多变量比例风险分析中,ASRS 评分与重新饮酒的风险显著相关(p=0.003)。

结论

ADHD 特征不仅对戒酒率有显著影响,而且对饮酒模式也有显著影响。ADHD 特征的存在,尤其是注意力缺陷特征,影响了酒精依赖个体出院后的饮酒情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6f9/9762023/9684b90a8efd/12888_2022_4455_Fig1_HTML.jpg

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