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在酒精使用障碍(AUD)门诊患者群体中检测注意力缺陷多动障碍(ADHD)的共病情况:人格特质、首次饮酒年龄和渴望程度的作用

Detecting the comorbidity of attention deficit hyperactivity disorder (ADHD) in a population of outpatients with alcohol use disorder (AUD): The role of personality traits, age at first alcohol use and level of craving.

作者信息

Roman Monica L, Vansteene Clément, Poupon Daphnée, Gorwood Philip

机构信息

GHU Paris Psychiatrie et Neurosciences, Clinique des Maladies Mentales et de l'Encéphale, Hôpital Sainte Anne, 1 rue Cabanis, 75014 Paris, France.

GHU Paris Psychiatrie et Neurosciences, Clinique des Maladies Mentales et de l'Encéphale, Hôpital Sainte Anne, 1 rue Cabanis, 75014 Paris, France; Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team "Vulnerability to Psychiatric and Addictive Disorders", 75014 Paris, France.

出版信息

Alcohol. 2025 Feb;122:63-70. doi: 10.1016/j.alcohol.2024.11.001. Epub 2024 Nov 4.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) commonly affects individuals with alcohol use disorder (AUD). However, despite the negative outcomes associated with this comorbidity, ADHD is underdiagnosed in this population. We aim to identify clinical parameters and propose cutoff scores enabling the detection of ADHD among patients with AUD. We retrospectively analyzed data from 199 patients, out of a global sample of 412 who were consecutively admitted to a day hospital for alcohol-related problems between 2009 and 2022. We found that lower level of self-directedness, higher levels of novelty seeking, self-transcendence, harm avoidance and craving, and earlier first alcohol consumption could accurately predict the presence of ADHD in AUD (AUC = 0.926). Self-directedness and novelty seeking had the best predictive abilities: a self-directedness score below 52 was associated with an accuracy of 82% and, combined with a novelty seeking score over 53, the accuracy reached 85%. Such findings could be useful to help clinicians detect ADHD in patients with AUD so that they can receive the adequate care.

摘要

注意力缺陷多动障碍(ADHD)通常会影响患有酒精使用障碍(AUD)的个体。然而,尽管这种共病会带来负面后果,但ADHD在该人群中仍未得到充分诊断。我们旨在确定临床参数并提出临界值,以便在患有AUD的患者中检测出ADHD。我们回顾性分析了199名患者的数据,这些患者来自2009年至2022年间连续入住日间医院治疗酒精相关问题的412名全球样本。我们发现,较低的自我导向水平、较高的寻求新奇、自我超越、避免伤害和渴望水平,以及较早的首次饮酒年龄,能够准确预测AUD患者中ADHD的存在(曲线下面积 = 0.926)。自我导向和寻求新奇具有最佳预测能力:自我导向得分低于52与82%的准确率相关,与寻求新奇得分超过53相结合时,准确率达到85%。这些发现可能有助于临床医生在患有AUD的患者中检测出ADHD,以便他们能够得到适当的治疗。

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