HISTORY AND SIGNIFICANCE OF CHILDHOOD ATTENTION-DEFICIT DISORDER IN TREATMENT-SEEKING COCAINE ABUSERS
HISTORY AND SIGNIFICANCE OF CHILDHOOD ATTENTION-DEFICIT DISORDER IN TREATMENT-SEEKING COCAINE ABUSERS
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DOI：
10.1016/0010-440x(93)90050-e
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发表时间：
1993-03-01
影响因子：
7.3
通讯作者：
ROUNSAVILLE, BJ
中科院分区：
文献类型：
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作者：
CARROLL, KM;ROUNSAVILLE, BJ
298名寻求治疗的可卡因滥用者中有35%符合儿童注意缺陷多动障碍（ADHD）的DSM-III-R标准。儿童ADHD的研究对象多为男性（78%），符合品行障碍研究诊断标准（RDC）（93%）和反社会人格障碍（47%），并报告有一级亲属有品行障碍史。相对于那些没有这种疾病的人，不管是否与社会病态共存，患有儿童多动症的可卡因滥用者在接受治疗时更年轻，并且报告了更严重的物质使用，更早的可卡因滥用，更频繁和强烈的可卡因使用，鼻内而不是自由或静脉注射可卡因，更高的酒精中毒率，以及更多的既往治疗。这种可卡因使用模式与可卡因滥用者自我药物治疗ADHD残余症状的临床描述相一致。这项研究的数据表明，有ADHD病史的可卡因滥用者可能比以前在可卡因使用者的临床样本中认识到的要多，并且这些个体可能在临床意义上与那些没有儿童期ADHD的人不同。此外，本样本中ADHD患者较差的结果强调了识别和治疗可卡因滥用者ADHD残余症状的重要性。
Thirty-five percent of 298 treatment-seeking cocaine abusers met DSM-III-R criteria for childhood attention deficit hyperactivity disorder (ADHD). Subjects with childhood ADHD were likely to be male (78%), meet Research Diagnostic Criteria (RDC) for conduct disorder (93%) and antisocial personality disorder (47%), and report a history of conduct disorder in first-degree relatives. With respect to those without the disorder and regardless of co-occurrence with sociopathy, cocaine abusers with childhood ADHD were younger at presentation for treatment and reported more severe substance use, earlier onset of cocaine abuse, more frequent and intense cocaine use, intranasal rather than freebase or intravenous use of cocaine, higher rates of alcoholism, and more previous treatment. This pattern of cocaine use is consistent with clinical descriptions of self-medication of residual symptoms of ADHD in cocaine abusers. Data from this study suggest that there may be more cocaine abusers with a history of ADHD than previously recognized in clinical samples of cocaine users, and that these individuals may differ in clinically meaningful ways from those without childhood ADHD. Moreover, the poorer outcome of subjects with ADHD in this sample underlines the importance of identifying and treating residual symptoms of ADHD in cocaine abusers.