ADHD: prevalence and effect on opioid use disorder treatment outcome in a French sample of patients receiving medication for opioid use disorder—the influence of impulsivity as a mediating factor

IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Harm Reduction Journal Pub Date : 2024-09-09 DOI:10.1186/s12954-024-01079-7
Auxane Beslot, Marie Grall-Bronnec, Marianne Balem, Benoit Schreck, Edouard-Jules Laforgue, Caroline Victorri-Vigneau, Morgane Guillou-Landreat, Juliette Leboucher, Gaëlle Challet-Bouju, Clémence Cabelguen
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Abstract

Opioid use disorder (OUD) poses a global health challenge, and despite medications for opioid use disorder (MOUD) and psychosocial interventions, relapse remains a significant concern. Comorbid psychiatric disorders, including attention deficit hyperactivity disorder (ADHD), are one of the major factors associated with poor OUD treatment outcome. We aimed to estimate the frequency of probable ADHD (in childhood and in adulthood) in patients with OUD; to assess the factors associated with this comorbidity; and to explore the factors that mediate the relationship between ADHD and OUD treatment outcome. We conducted an observational study using a sample of 229 patients aged 18 years and older who were diagnosed with OUD and had received MOUD for at least six months. Participants were assessed through a structured interview and self-report questionnaires. Multivariate logistic regressions and a mediation analysis were performed. Almost half of the participants reported probable ADHD in childhood, and ADHD persisted into adulthood among two-thirds of the patients. The factors associated with poor OUD treatment outcome included earlier onset of OUD, lower education, and greater impulsivity. There was no direct effect of probable ADHD in childhood on OUD treatment outcome, but there was an indirect effect through negative urgency, the tendency to respond impulsively to negatively connoted emotional experiences. The findings suggest that ADHD symptoms, particularly impulsivity, may contribute to vulnerability in opioid use and play a crucial role in treatment outcomes for this population. Trial registration: ClinicalTrials identifier NCT01847729.
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多动症:在法国接受阿片类药物治疗的患者样本中的患病率及其对阿片类药物使用障碍治疗结果的影响--冲动性作为中介因素的影响
阿片类药物使用障碍(OUD)是一项全球性的健康挑战,尽管有治疗阿片类药物使用障碍(MOUD)的药物和社会心理干预措施,复发仍然是一个令人严重关切的问题。包括注意缺陷多动障碍(ADHD)在内的合并精神障碍是导致 OUD 治疗效果不佳的主要因素之一。我们的目的是估算 OUD 患者中可能患有多动症(儿童期和成年期)的频率;评估与这种合并症相关的因素;并探讨多动症与 OUD 治疗效果之间的中介因素。我们对 229 名年龄在 18 岁及以上、被诊断为 OUD 并接受 MOUD 治疗至少 6 个月的患者进行了抽样观察研究。我们通过结构化访谈和自我报告问卷对参与者进行了评估。研究人员进行了多变量逻辑回归和中介分析。近一半的受试者表示在童年时可能患有多动症,三分之二的患者在成年后仍患有多动症。与 OUD 治疗效果不佳相关的因素包括 OUD 发病时间较早、受教育程度较低以及冲动性较强。儿童时期可能患有的多动症对 OUD 治疗效果没有直接影响,但通过消极的紧迫感(即对具有负面含义的情绪体验做出冲动反应的倾向)会产生间接影响。研究结果表明,多动症症状,尤其是冲动性,可能会导致阿片类药物使用的脆弱性,并对这一人群的治疗效果起到至关重要的作用。试验注册:临床试验标识符 NCT01847729。
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来源期刊
Harm Reduction Journal
Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.90
自引率
9.10%
发文量
126
审稿时长
26 weeks
期刊介绍: Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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