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Attention-deficit/hyperactivity disorder subtypes and substance use and use disorders in NESARC

机译：NESARC中的注意缺陷/多动障碍亚型和物质使用与使用障碍

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Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with substance use and substance use disorders (SUD). However, relatively little is known about the relationship between DSM-IV ADHD subtypes and substance use or DSM-IV abuse/dependence in epidemiological samples. Methods: Data were obtained from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC, N. = 33,588). Respondents reported on ADHD symptoms (DSM-IV) for the period of time when they were 17. years or younger. Lifetime use and DSM-IV abuse/dependence of alcohol, nicotine, cannabis, cocaine, sedatives, stimulants and heroin/opiates were compared across those with ADHD symptoms but no diagnosis (ADHDsx; N. = 17,009), the Combined (ADHD-C; N. = 361), Predominantly Inattentive (ADHD-I; N. = 325), and the Predominantly Hyperactive-Impulsive (ADHD-HI; N. = 279) ADHD subtypes. Taking a more dimensional approach, inattentive and hyperactive-impulsive symptom counts and their associations with substance use and misuse were also examined. Results: After adjustments for conduct disorder, major depressive disorder, any anxiety disorder and other socio-demographic covariates, substance use and SUD were associated with ADHDsx, ADHD-C, ADHD-I and ADHD-HI. Overall, substance use and SUD were more weakly associated with the ADHDsx group compared to the three ADHD diagnostic groups.Statistically significant differences were not evident across the three diagnostic groups. Hyperactive-impulsive symptoms were more consistently associated with substance use and SUD compared to inattentive symptoms. Conclusions: ADHD subtypes are consistently associated with substance use and SUD. The relatively stronger association of hyperactive/impulsive symptoms with substance use and abuse/dependence is consistent with the extant literature noting impulsivity as a precursor of substance use and SUD.
机译：背景：注意缺陷/多动障碍（ADHD）与物质使用和物质使用障碍（SUD）相关。然而，对于流行病学样本中DSM-IV ADHD亚型与物质使用或DSM-IV滥用/依赖性之间的关系知之甚少。方法：数据来自全国酒精及相关疾病流行病学调查（NESARC，N。= 33,588）。受访者报告了17岁以下的ADHD症状（DSM-IV）。比较有ADHD症状但无诊断（ADHDsx; N = 17,009），合并使用（ADHD-C ; N。= 361），主要注意力不集中（ADHD-1; N. = 325）和主要是过度活跃冲动（ADHD-HI; N. = 279）ADHD亚型。采取了更多维的方法，还检查了注意力不集中和冲动型症状计数及其与物质使用和滥用的关联。结果：在对行为障碍，重度抑郁症，任何焦虑症和其他社会人口统计学协变量进行调整后，物质使用和SUD与ADHDsx，ADHD-C，ADHD-1和ADHD-HI相关。总体而言，与三个ADHD诊断组相比，ADHDsx组的物质使用和SUD关联较弱，三个诊断组之间的统计学差异不明显。与注意力不集中的症状相比，冲动性过度症状与药物使用和SUD的相关性更高。结论：ADHD亚型与药物使用和SUD持续相关。多动症/冲动症状与物质使用和滥用/依赖性的相对较强的关联性与现有文献一致认为冲动是物质使用和SUD的先驱。

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