High-dose use of benzodiazepines (BZDs) and Z-drugs was found to be associated with adult attention deficit/hyperactivity disorder (ADHD) and multidomain cognitive deficits, but the interplay between these factors and its effect on quality of life (QoL) is unclear. We explored (a) whether cognitive dysfunction differs in high-dose BZD/Z-drug users with and without adult ADHD and (b) the impact of cognitive deficits and adult ADHD on QoL in this substance-use disorder (SUD). From January 2015 to December 2019, we recruited 207 high-dose BZD/Z-drug users seeking treatment. We assessed the presence of adult ADHD with a screening tool, which was validated in SUD patients, and collected demographic, clinical and QoL data from the 76 included patients. A neuropsychological battery explored five cognitive domains. We found that: (a) screening for adult ADHD was frequently positive; (b) Short Form-36 (SF-36), a self-administered QoL questionnaire, was worse than the general population and worse in patients positive (ADHD+) vs. those negative (ADHD−) to ADHD screening tool; (c) executive function was significantly worse in ADHD+ than ADHD− patients; (d) some SF-36 dimensions were negatively influenced by executive dysfunction; (e) multivariate analysis showed an interplay between adult ADHD and cognitive dysfunction in worsening QoL. We documented a complex interplay between adult ADHD, cognitive dysfunction and QoL in high-dose BZD/Z-drug users. Assessing adult ADHD, neuropsychological measures and QoL may offer a full scenario of these patients, who are frequently impaired in everyday activities. Future research should explore whether pharmacological treatment might improve cognitive dysfunction and QoL in this SUD.

发现大剂量使用苯二氮卓类药物 (BZDs) 和 Z-药物与成人注意力缺陷/多动障碍 (ADHD) 和多领域认知缺陷有关，但这些因素之间的相互作用及其对生活质量 (QoL) 的影响是不清楚。我们探讨了 (a) 患有和不患有成人 ADHD 的高剂量 BZD/Z 药物使用者的认知功能障碍是否不同，以及 (b) 认知缺陷和成人 ADHD 对这种物质使用障碍 (SUD) 中生活质量的影响。从 2015 年 1 月到 2019 年 12 月，我们招募了 207 名寻求治疗的大剂量 BZD/Z 药物使用者。我们使用筛查工具评估成人 ADHD 的存在，该工具在 SUD 患者中得到验证，并收集了 76 名患者的人口统计学、临床和生活质量数据。神经心理学电池探索了五个认知领域。我们发现：(a) 成人多动症筛查经常呈阳性；(b) Short Form-36 (SF-36)，一种自我管理的生活质量问卷，比一般人群更差，在 ADHD 筛查工具阳性 (ADHD+) 患者与阴性 (ADHD-) 患者中更差；(c) ADHD+ 患者的执行功能明显低于 ADHD− 患者；(d) 一些 SF-36 维度受到执行功能障碍的负面影响；(e) 多变量分析显示，成人 ADHD 和认知功能障碍在 QoL 恶化方面存在相互作用。我们记录了大剂量 BZD/Z 药物使用者中成人 ADHD、认知功能障碍和生活质量之间复杂的相互作用。评估成人 ADHD、神经心理学测量和生活质量可能会提供这些患者的完整情况，这些患者在日常活动中经常受到损害。