Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
BMC Psychiatry. 2023 Jul 24;23(1):537. doi: 10.1186/s12888-023-05034-x.
Amphetamine use disorder (AMPH) and attention deficit-hyperactivity disorder (ADHD) often co-occur and are associated with poor treatment outcomes. Elevated impulsivity is a core feature in both disorders. Little is known however about the specific neurocognitive profile regarding different facets of impulsivity, and specifically impulsive choice, in comorbid populations.
Three groups (ADHD + AMPH, ADHD only and healthy controls (HC)) were assessed with self-reported impulsivity and cognitive tasks of impulsive choice, operationalized as delay aversion (DA) and reflection impulsivity.
Twenty-nine participants with comorbid ADHD + AMPH, 25 participants with ADHD only and 116 HC completed screening, including self-rating scales, and cognitive testing. 20, 16 and 114 participants completed computerized cognitive tasks in the ADHD + AMPH group, ADHD group and HC group, respectively. The ADHD + AMPH group reported significantly higher motor, attentional and non-planning impulsiveness, and showed a significantly higher degree of impulsive choice, compared to both groups. There were no differences in task-related impulsiveness between ADHD only and HC.
The current findings suggest that individuals with ADHD + AMPH have overall elevated levels of impulsivity compared to individuals with ADHD only. In addition, that ADHD + AMPH is specifically associated with impairments in task-related impulsive choice, which was not found in ADHD only compared to HC. The neurocognitive profile in this specific patient group may represent a need for more systematic screening within healthcare settings in order to develop effective and targeted treatment for comorbid patients.
EudraCT, 2012-004298-20.
安非他命使用障碍（AMPH）和注意力缺陷多动障碍（ADHD）常同时发生，且与较差的治疗效果相关。冲动性增高是这两种疾病的核心特征。然而，关于共病人群不同冲动性特征，特别是冲动选择的具体神经认知特征，人们知之甚少。
三组人群（ADHD+AMPH、ADHD 组和健康对照组（HC））接受了自我报告的冲动性和冲动选择的认知任务评估，操作性定义为延迟回避（DA）和反射冲动性。
29 名共病 ADHD+AMPH 患者、25 名 ADHD 患者和 116 名 HC 完成了筛查，包括自我评定量表和认知测试。20、16 和 114 名参与者分别在 ADHD+AMPH 组、ADHD 组和 HC 组完成了计算机化认知任务。与两组相比，ADHD+AMPH 组报告的运动性、注意力和非计划性冲动性明显更高，且冲动选择程度明显更高。ADHD 组和 HC 组之间在与任务相关的冲动性方面没有差异。
目前的研究结果表明，与仅患有 ADHD 的个体相比，患有 ADHD+AMPH 的个体总体上具有更高水平的冲动性。此外，ADHD+AMPH 与与任务相关的冲动选择受损有关，而在 ADHD 组中未发现与 HC 相比存在这种差异。在这种特定患者群体中，神经认知特征可能代表在医疗保健环境中需要更系统的筛查，以便为共病患者制定有效的、有针对性的治疗方案。
EudraCT，2012-004298-20。
