Does attention-deficit hyperactivity disorder impact the developmental course of drug and alcohol abuse and dependence?
Does attention-deficit hyperactivity disorder impact the developmental course of drug and alcohol abuse and dependence?
复制标题
DOI：
10.1016/s0006-3223(97)00406-x
复制
发表时间：
1998-08-15
影响因子：
10.6
通讯作者：
Spencer, T
中科院分区：
文献类型：
--
作者：
Biederman, J;Wilens, TE;Spencer, T
背景资料：注意力缺陷多动障碍（ADHD）和精神活性物质使用障碍（PSUD）在成人中的共同发生一直是许多临床和科学调查的焦点。在这项研究中，我们研究了ADHD对从药物滥用到依赖的过渡以及不同类别的药物滥用之间的影响。方法：将239名连续转诊的成人ADHD样本与268名非ADHD健康成人进行比较，其中239名成年人的临床诊断为儿童期发作和持续性DSM-III-R ADHD，经结构化访谈证实。ADHD与PSUD风险增加两倍相关，ADHD受试者比对照组更容易从酒精使用障碍转变为药物使用障碍（危险比= 3.8），并且在依赖期后继续滥用药物的可能性明显更大。结论：ADHD与一系列PSUD相关，其中早期酒精使用障碍增加随后药物使用障碍的风险，早期物质依赖增加随后物质滥用的风险。如果得到证实，这种发展途径可能会导致预防和早期干预策略，旨在降低ADHD受试者的PSUD风险。生物精神病学1998;44：269-273（C）1998年生物精神病学学会。
Background: The co-occurrence of attention-deficit hyperactivity disorder (ADHD) and psychoactive substance use disorder (PSUD) in adults has been the focus of much clinical and scientific inquiry. In this study we examine the effects of ADHD on the transitions from substance abuse to dependence and between different classes of agents of abuse.Methods: An ADHD sample of 239 consecutively referred adults of both genders with a clinical diagnosis of childhood-onset and persistent DSM-III-R ADHD confirmed by structured interview were compared with 268 non-ADHD healthy adults.Results: ADHD was associated with a twofold increased risk for PSUD, ADHD subjects were significantly more likely than comparisons to make the transition from an alcohol use disorder to a drug use disorder (hazard ratio = 3.8) and were significantly more likely to continue to abuse substances following a period of dependence (hazard ratio = 4.9).Conclusions: ADHD is associated with a sequence of PSUD in which early alcohol use disorder increases the risk for subsequent drug use disorder and early substance dependence increases the risk for subsequent substance abuse. If confirmed such developmental pathways might lead to preventive and early intervention strategies aimed at reducing the risk for PSUD in ADHD subjects. Biol Psychiatry 1998;44:269-273 (C) 1998 Society of Biological Psychiatry.