Levin F R, Evans S M, Kleber H D
Division on Substance Abuse, New York State Psychiatric Institute, NY 10032, USA.
Drug Alcohol Depend. 1998 Sep 1;52(1):15-25. doi: 10.1016/s0376-8716(98)00049-0.
In this study, 281 cocaine abusers seeking treatment were assessed for adult attention-deficit hyperactivity disorder (ADHD). Structured assessments included the SCID for DSM-IV, a SCID-like module for ADHD, and a pattern of drug use questionnaire. The sample consisted of 82% men, 67% African-Americans, 19% Hispanics, and 14% Caucasians identified at several treatment sites. Average age was 33.7 +/- .4 years. Twelve percent (n = 34) of the sample met DSM-IV criteria for childhood ADHD. Of the entire sample, 10% (n = 27), or 79% of the patients diagnosed with childhood ADHD, had adult ADHD. A history of conduct disorder and antisocial personality disorder were prevalent among those with adult ADHD (63% and 52%, respectively). This subpopulation of cocaine abusers may be one of the most difficult-to-treat cocaine-abusing groups, particularly if the ADHD remains undetected. To provide effective treatment for cocaine abusers, clinicians may need to identify subpopulations of patients, such as those with ADHD, and target both pharmacologic and nonpharmacologic interventions for these groups.
在本研究中，对281名寻求治疗的可卡因滥用者进行了成人注意力缺陷多动障碍（ADHD）评估。结构化评估包括《精神疾病诊断与统计手册》第四版（DSM-IV）的定式临床检查、一个类似ADHD定式临床检查的模块以及一份用药模式调查问卷。该样本由在多个治疗地点确定的82%男性、67%非裔美国人、19%西班牙裔和14%高加索人组成。平均年龄为33.7±0.4岁。样本的12%（n = 34）符合儿童期ADHD的DSM-IV标准。在整个样本中，10%（n = 27）即被诊断为儿童期ADHD的患者中的79%患有成人ADHD。品行障碍和反社会人格障碍病史在患有成人ADHD的患者中很常见（分别为63%和52%）。这一可卡因滥用亚群体可能是最难治疗的可卡因滥用群体之一，尤其是如果ADHD未被发现的话。为了给可卡因滥用者提供有效的治疗，临床医生可能需要识别患者亚群体，比如患有ADHD的患者，并针对这些群体进行药物和非药物干预。
