Natalie C Sánchez-García1, Rafael A González2,3, Josep A Ramos-Quiroga4,5,6, Wim van den Brink7, Mathias Luderer8, Matthijs Blankers9,10,11, Lara Grau-Lopez4,6, Frances R Levin12,13, Sharlene Kaye14,15, Zsolt Demetrovics16, Geurt van de Glind17,18, Arnt Schellekens17,18, María C Vélez-Pastrana19. 1. PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico. 2. National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom. 3. Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom. 4. Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain. 5. Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain. 6. Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. 7. Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands. 8. Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany. 9. Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands. 10. Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. 11. Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. 12. Department of Psychiatry, Columbia University Medical Center, New York, New York, USA. 13. CUMC/Herbert Pardes Building, New York State Psychiatric Institute, New York, New York, USA. 14. Research Unit, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia. 15. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. 16. Department of Clinical Psychology and Addictions, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. 17. Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands. 18. Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands. 19. PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, mvelez@sju.albizu.edu.
Abstract
AIMS: To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients. METHODS: In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD. RESULTS: Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity. CONCLUSIONS: SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.
AIMS: To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients. METHODS: In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD. RESULTS: Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity. CONCLUSIONS: SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.
Authors: Geurt Van de Glind; Christoffer Brynte; Arvid Skutle; Sharlene Kaye; Maija Konstenius; Frances Levin; Frieda Mathys; Zsolt Demetrovics; Franz Moggi; Josep Antoni Ramos-Quiroga; Arnt Schellekens; Cleo Crunelle; Geert Dom; Wim van den Brink; Johan Franck Journal: Eur Addict Res Date: 2020-06-29 Impact factor: 3.015
Authors: Edith López-Toro; Casper J H Wolf; Rafael A González; Wim van den Brink; Arnt Schellekens; María C Vélez-Pastrana Journal: J Clin Med Date: 2022-05-19 Impact factor: 4.964