ADHD and addictive behavior in crack-cocaine users |
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| Affiliation: | 1. Department de psychiatrie universitaire, CEReSS – Health Service Research and Quality of Life Center, hôpitaux universitaires de Marseille, EA 3279: Aix-Marseille université, 27, boulevard Jean-Moulin, 13005 Marseille, France;2. Fondation FondaMental, Créteil, France;3. Department of Psychiatry and Addictology, Fort-de-France University Hospital, Martinique, French West Indies;1. Department of Psychiatry, Ibn Alhassan Hospital, Hassan II University Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco;2. Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Fez, Morocco;3. Clinical Neurosciences laboratory, Faculty of medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Morocco;4. Health Sciences Research Laboratory, Ibn Zohr University, Agadir, Morocco;5. TELECOM Bretagne; IMT Atlantique Bretagne-Pays de la Loire, Campus de Brest, France;1. Pole psychiatrie, centre expert depression resistante et schizophrénie FondaMental, CHU La Conception, Marseille, France;2. Aix-Marseille university, CEReSS-health service research and quality of life center, 27, boulevard Jean-Moulin, 13005 Marseille, France;3. Centre hospitalier Montperrin, Aix en Provence, France;1. Faculty of Medicine, Saint Joseph University, Beirut, Lebanon;2. Hôtel Dieu de France Hospital, Beirut, Lebanon;3. CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France;1. Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia;2. Psychiatry Department “Ibn Omrane”, The Tunisian Center of Early Intervention in Psychosis, 1, rue des Orangers, 2010 Manouba, Tunisia;1. Hôpital de la santé mentale et des maladies psychiatriques, CHU Mohammed VI, Oujda, Maroc;2. Faculté de médecine et de pharmacie d’Oujda, université Mohammed 1er, Oujda, Maroc;1. Ancien interne au CPOA, GHU-Paris, 1, rue Cabanis, 75014 Paris, France;2. Direction des usagers et des affaires juridiques, GHU-Paris, 1, rue Cabanis, 75014 Paris, France;3. Psychiatre, chef de service du CPOA, Centre psychiatrique d’orientation et d’Accueil, GHU-Paris, 1, rue Cabanis, 75014 Paris, France |
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| Abstract: | BackgroundCrack consumption is a major public health issue in Martinique with a poor prognosis. A preliminary study has found a high prevalence of history of childhood ADHD (C-ADHD) in crack users.ObjectiveTo determine the prevalence of C-ADHD and adult ADHD (A-ADHD) in crack users and their potential associations with substance use behavior.MethodsAll consecutive patients consulting in the public academic hospital covering 376,000 inhabitants were included in the present study and received a comprehensive battery measuring addictive behavior, psychiatric and somatic comorbidities. C-ADHD groups and A-ADHD groups were defined with the Wender-Utah Rating Scale-25 and the Brown ADD Rating Scale, respectively. Impulsivity was evaluated with the Barratt Impulsiveness Scale (BIS-11).FindingsIn total, 111 participants were evaluated. Among them, 50 (45%) were classified in the C-ADHD group and 20 (18%) in the A-ADHD group. Compared to the patients without ADHD, those with ADHD were found to have higher impulsivity (C-ADHD: BIS total score 67.90 (10.1) vs. 63.28 (10.5), P = 0.021, BIS attentional score 17.5 (3.6) vs. 15.3 (3.4), P = 0.002, A-ADHD: BIS total score 75.1 (11.3) vs. 63.4 (9.2), P < 0.001, BIS motor impulsivity 26.9 (5.3) vs. 22.6 (4.3), P < 0.001, BIS attentional score 19.3 (3.3) vs. 15.6 (3.5), P < 0.001, BIS planification 28.9 (5.7) vs. 25.10 (4.7), P = 0.003). Fifty percent of A-ADHD patients were found with high impulsivity vs. 15% of patients without A-ADHD (P < 0.001). However, ADHD was not associated with more severe addictive behavior or history of legal consequences.InterpretationADHD prevalence is high in cocaine-crack users and associated with increased impulsivity. However, neither ADHD nor impulsivity explains addictive behaviors or legal consequences. |
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| Keywords: | Mental health Psychiatry Mood disorders Depressive disorders ADHD Addiction Santé mentale Psychiatrie Troubles de l’humeur Dépression TDAH Addiction |
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