Levin F R, Kleber H D
Department of Psychiatry, Columbia University, New York, N.Y., USA.
Harv Rev Psychiatry. 1995 Jan-Feb;2(5):246-58. doi: 10.3109/10673229509017144.
Attention-deficit hyperactivity disorder (ADHD) and substance-use disorders are related to each other in a variety of ways. Although within the child-psychiatry literature earlier investigations were inconsistent regarding such a link, recent prospective studies that followed hyperactive children and normal controls into adulthood have found that hyperactive adults with a history of ADHD are more likely than controls to have substance-use disorders. The substance-abuse literature is less consistent regarding the potential association between ADHD and substance abuse. However, recent studies suggest that persons with a substance-use disorder, and particularly those with a cocaine-use disorder, may be more likely than the general population to have a childhood history of ADHD. Some of the inconsistency regarding this association is due to differences in diagnostic criteria, type of assessments used, and reliability of information obtained. Each of the potential relationships that may exist between ADHD and substance abuse has treatment implications for the clinician. Pharmacological as well as nonpharmacological approaches deserve further investigation. Because pharmacotherapy is a central component in the treatment of childhood ADHD, clinicians designing a strategy to treat both a substance-use disorder and ADHD need to consider pharmacological interventions. At present, the literature on pharmacological treatment for childhood ADHD is extensive and that for adult ADHD is growing; information regarding the treatment of cocaine abuse and concomitant ADHD symptoms remains limited.
注意力缺陷多动障碍（ADHD）与物质使用障碍在多种方面相互关联。尽管在儿童精神病学文献中，早期关于这种联系的研究结果并不一致，但最近对多动症儿童和正常对照进行随访直至成年的前瞻性研究发现，有ADHD病史的多动成年人比对照组更有可能患有物质使用障碍。物质滥用文献中关于ADHD与物质滥用之间的潜在关联也不太一致。然而，最近的研究表明，患有物质使用障碍的人，尤其是患有可卡因使用障碍的人，比一般人群更有可能有ADHD的童年病史。这种关联存在一些不一致之处，是由于诊断标准、所用评估类型以及所获信息的可靠性存在差异。ADHD与物质滥用之间可能存在的每一种潜在关系，对临床医生的治疗都有启示。药物治疗以及非药物治疗方法都值得进一步研究。由于药物治疗是儿童ADHD治疗的核心组成部分，临床医生在设计治疗物质使用障碍和ADHD的策略时，需要考虑药物干预措施。目前，关于儿童ADHD药物治疗的文献很多，关于成人ADHD药物治疗的文献也在不断增加；关于可卡因滥用及伴随的ADHD症状治疗的信息仍然有限。
