Abstract

Objective

Attention-deficit/hyperactivity disorder (ADHD) is an established risk factor for developing alcohol use disorder (AUD), and AUD-ADHD comorbidity is associated with additional psychiatric diagnoses. Several lines of evidence support the role of impulsivity as a pathway of these relationships; however, impulsivity is not a unitary construct. Thus, we sought to explore whether separate aspects of impulsivity may explain the relationship between ADHD symptoms and psychiatric comorbidity among inpatients (N = 136) with AUD. Methods: We assessed ADHD symptoms (childhood ADHD [Wender Utah Rating Scale], adult ADHD [Adult ADHD self-report scale]), health-related quality of life (HRQL; EQ-5D-5L), psychiatric comorbidity (Mini International Neuropsychiatric Interview), and impulsive personality traits (Urgency, Premeditation, Perseverance, Sensation seeking [UPPS] scale). Results: 19% of patients screened positive in the retrospective assessment of childhood ADHD, and 17% for adult ADHD. Participants reported moderate levels of problem severity in the HRQL dimensions, and 65% had ≥1 current psychiatric disorders other than AUD and ADHD. Multiple mediation indicated that there was a significant direct effect of childhood ADHD symptoms on psychiatric comorbidity (β = 0.224, 95% CI [0.080, 1.114]), and indirect effects of both reacting impetuously when experiencing negative emotions (negative urgency; β = 0.999, 95% CI [0.043, 0.461]) and the tendency to not finish tasks (lack of perseverance; β = 0.075, 95% CI [0.002, 0.297]). Conclusions: The subcomponents of impulsivity to react rashly when experiencing negative emotions and the tendency to not persist in activities seem to contribute to the relationship between ADHD symptoms (particularly those in childhood) and psychiatric comorbidity among patients with severe AUD.

中文翻译：

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冲动型人格特质介导严重酒精使用障碍患者注意力缺陷/多动障碍症状与精神共病之间的关系

摘要

客观的

注意缺陷/多动障碍 (ADHD) 是发展酒精使用障碍 (AUD) 的既定风险因素，并且 AUD-ADHD 合并症与其他精神疾病诊断有关。一些证据支持冲动作为这些关系的途径的作用；然而，冲动不是一个单一的结构。因此，我们试图探索冲动的不同方面是否可以解释 ADHD 症状 与 AUD住院患者（N = 136）精神共病之间的关系。方法：我们评估了 ADHD 症状（儿童 ADHD [Wender Utah Rating Scale]、成人 ADHD [Adult ADHD 自我报告量表]）、健康相关的生活质量（HRQL；EQ-5D-5L）、精神病合并症（Mini International Neuropsychiatric Interview）和冲动的人格特质（紧迫感、预谋、毅力、感觉寻求 [UPPS] 量表）。结果： 19% 的患者在儿童 ADHD 的回顾性评估中筛查为阳性，17% 的患者为成人 ADHD。参与者报告 HRQL 维度的问题严重程度中等，65% 的人目前患有 ≥ 1 种除 AUD 和 ADHD 以外的精神疾病。多重中介表明儿童多动症症状对精神共病有显着的直接影响（β = 0.224, 95% CI [0.080, 1.114])，以及在经历负面情绪时冲动反应的间接影响（消极紧迫感；β  = 0.999, 95% CI [0.043, 0.461]）和无法完成任务的倾向（缺乏毅力；β  = 0.075, 95% CI [0.002, 0.297])。结论：当经历负面情绪时，冲动做出轻率反应和不坚持活动的倾向似乎有助于 ADHD 症状（尤其是儿童期）与重度 AUD 患者的精神共病之间的关系。