Luquiens Amandine, Mura Thibault, Dereux Alexandra, Louville Patrice, Donnadieu Hélène, Bronnec Marie, Benyamina Amine, Perney Pascal, Carré Arnaud
Department of Addiction, CHU Nîmes, Univ Montpellier, Nîmes, France; CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, Univ. Montpellier, Nîmes, France.
J Psychiatr Res. 2025 Jan;181:463-469. doi: 10.1016/j.jpsychires.2024.12.012. Epub 2024 Dec 7.
The emotion dysregulation and impulsivity are highly associated with alcohol use disorder (AUD). This study explored the role of impulsivity and emotion dysregulation and the interaction with adult probable ADHD on alcohol-related quality of life (QoL). In this observational trial, we analyzed data from the randomized TRAIN study, which compared efficacy of two cognitive training programs in patients AUD recently detoxified at 5 centers in France from February 2019 to February 2023, and who completed child and adult ADHD screening data (WURS + ARSR, n = 206 of 226). We collected baseline data on AUD severity, age, sex, quality of life (AQoLS), cognitive impairment (MoCA), impulsive behavior (UPPS-P) and emotion dysregulation (ERQ expressive suppression subscore, DERS-impulse). Patients with probable and without ADHD were compared. We performed multiple linear regression explaining the total AQoLS score (dependent variable) by impulsivity (UPPS-P score), emotion regulation (DERS-impulse), and expressive suppression (ERQ expressive suppression subscore), and their interaction with ADHD, adjusted on MoCA, sex, age. Forty (19%) patients were above the screening threshold for ADHD. The impact of alcohol on QoL was greater in them than in those without ADHD (57.3 (21.9) vs. 46.4 (19.6), p = 0.002). High impulsivity and emotion dysregulation dimensions were both significantly associated with poorer QoL. ADHD interacted significantly with expressive suppression to worsen the impact of alcohol on QoL (p = 0.04). The dysfunctional attempts to compensate for the strong dysregulation of emotions in ADHD lowers QoL in AUD.
情绪调节障碍和冲动性与酒精使用障碍（AUD）高度相关。本研究探讨了冲动性和情绪调节障碍的作用，以及它们与成人可能患有的注意力缺陷多动障碍（ADHD）对酒精相关生活质量（QoL）的相互作用。在这项观察性试验中，我们分析了来自随机TRAIN研究的数据，该研究比较了2019年2月至2023年2月在法国5个中心近期戒酒的AUD患者中两种认知训练项目的疗效，这些患者还完成了儿童和成人ADHD筛查数据（WURS + ARSR，226例中有206例）。我们收集了关于AUD严重程度、年龄、性别、生活质量（AQoLS）、认知障碍（MoCA）、冲动行为（UPPS-P）和情绪调节障碍（ERQ表达抑制子量表、DERS-冲动）的基线数据。对可能患有和未患有ADHD的患者进行了比较。我们进行了多元线性回归，以冲动性（UPPS-P评分）、情绪调节（DERS-冲动）和表达抑制（ERQ表达抑制子量表）及其与ADHD的相互作用来解释总AQoLS评分（因变量），并根据MoCA、性别、年龄进行了调整。40名（19%）患者高于ADHD筛查阈值。酒精对他们生活质量的影响比对没有ADHD的患者更大（57.3（21.9）对46.4（19.6），p = 0.002）。高冲动性和情绪调节障碍维度均与较差的生活质量显著相关。ADHD与表达抑制有显著相互作用，会加剧酒精对生活质量的影响（p = 0.04）。ADHD中为弥补强烈情绪调节障碍而进行的功能失调尝试会降低AUD患者的生活质量。
