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Samal B, Senjam G, Ravan JR, Ningombam HS, Das RC, Das SK. Prevalence of adult ADHD in patients with substance use disorder in North East India. Ind Psychiatry J 2022; 31:214-220. [PMID: 36419685 PMCID: PMC9678150 DOI: 10.4103/ipj.ipj_250_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 01/06/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Attention deficit and hyperactive disorder (ADHD) often co-exist with substance use disorders (SUD) both in adolescents and adults. Untreated ADHD can lead to multiple relapses, sociooccupational dysfunction and may worsen the outcome of SUD. ADHD is often underdiagnosed in the adult population. Therefore, the present study was intended to determine the types, patterns, and factors related to drug dependence among different age groups and to estimate the prevalence of adult ADHD in SUD patients in North East India. MATERIALS AND METHODS This is a cross-sectional hospital-based study carried out in patients diagnosed with SUD as per the Diagnostic and Statistical Manual Disorders, 5th Edition. Adult ADHD Self-Report Scale (v1.1) Symptom Checklist was applied to screen for symptoms of adult ADHD in the patients. RESULTS In the age group of 18-29 years, 82.7% of patients were diagnosed with opioid use disorder (OUD), while 63.9% of the subjects in the age group of 30-49 years patients suffered from Alcohol Use Disorder (AUD). All patients of age 50 years and above were AUD. Our study showed that 24.3% of the total study population had the presence of adult ADHD. Symptoms of Adult ADHD were found in a higher proportion among OUD (28.7%) in comparison to OUD (11.5%). CONCLUSION The association of adult ADHD with OUD has been around three times than the AUD group. Hence young people (18-29 years) diagnosed with OUD need to be screened for adult ADHD and should be treated for the same for better abstinence and to prevent complications.
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Affiliation(s)
- Biswajeet Samal
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gojendra Senjam
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | | | | | - Rama Chandra Das
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Kumar Das
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Chronic exposure to cocaine is associated with persistent behavioral disturbances. A cross-sectional dimensional study in outpatients with multiple substance use disorders. Psychopharmacology (Berl) 2020; 237:3399-3407. [PMID: 32748030 DOI: 10.1007/s00213-020-05620-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Behavioral disturbances (BD) are prevalent in patients with substance use disorders (SUD). OBJECTIVES To test the hypothesis that chronic exposure to cocaine could favor the acquisition of BD that were not present in childhood. METHODS We used child and adult ADHD self-report screening scales (WURS-25 and ASRS-6, respectively, with their usual threshold) as assessment tools for significant BD. In a cross-sectional assessment of 382 patients with multiple SUD, we investigated BD and then "de novo" BD (i.e., by restricting the sample to patients below the threshold for childhood BD) (N = 214). We also tested for a gradient effect between patients' lifetime DSM IV cocaine and opioid dependence status and the prevalence of BD. RESULTS BD were found in 188/382 (42.9%) subjects and in 74/214 (34.6%) subjects. Three clinical factors were associated with BD in the whole sample: the number of cocaine dependence criteria (OR = 1.36 [1.14-1.64], p = 0.001), the number of opioid dependence criteria (OR = 0.69 [0.52-0.91], p = 0.010), and a personal history of using cocaine through rapid routes of administration (OR = 0.41 [0.19-0.88], p = 0.022). The same three factors were associated with "de novo" BD in the restricted sample: OR = 1.35 ([1.11-1.63], p = 0.002), OR = 0.83 ([0.70-0.99], p = 0.046), and OR 0.37 ([0.16-0.86], p = 0.022), respectively. There were significant gradients for BD according to the cocaine exposure categories in the whole (Mantel-Haenszel, p < 0.001) and in the restricted sample (Mantel-Haenszel, p = 0.002). CONCLUSIONS Cocaine exposure was positively associated with behavioral disturbances in a dose-dependent manner in this clinical sample, whilst opioid exposure showed a negative association.
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Ventral striatal regulation of CREM mediates impulsive action and drug addiction vulnerability. Mol Psychiatry 2018; 23:1328-1335. [PMID: 28439100 PMCID: PMC5656565 DOI: 10.1038/mp.2017.80] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/26/2017] [Accepted: 02/13/2017] [Indexed: 01/01/2023]
Abstract
Impulsivity, a multifaceted behavioral hallmark of attention-deficit/hyperactivity disorder (ADHD), strongly influences addiction vulnerability and other psychiatric disorders that incur enormous medical and societal burdens yet the neurobiological underpinnings linking impulsivity to disease remain poorly understood. Here we report the critical role of ventral striatal cAMP-response element modulator (CREM) in mediating impulsivity relevant to drug abuse vulnerability. Using an ADHD rat model, we demonstrate that impulsive animals are neurochemically and behaviorally more sensitive to heroin and exhibit reduced Crem expression in the nucleus accumbens core. Virally increasing Crem levels decreased impulsive action, thus establishing a causal relationship. Genetic studies in seven independent human populations illustrate that a CREM promoter variant at rs12765063 is associated with impulsivity, hyperactivity and addiction-related phenotypes. We also reveal a role of Crem in regulating striatal structural plasticity. Together, these results highlight that ventral striatal CREM mediates impulsivity related to substance abuse and suggest that CREM and its regulated network may be promising therapeutic targets.
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Evren C, Alniak I, Karabulut V, Cetin T, Umut G, Agachanli R, Evren B. Relationship of Probable Attention Deficit Hyperactivity Disorder with Severity of Psychopathology and Impulsivity in a Sample of Male Patients with Opioid Use Disorder. Psychiatry Investig 2018; 15:164-171. [PMID: 29475216 PMCID: PMC5900394 DOI: 10.30773/pi.2017.05.14.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/17/2017] [Accepted: 05/14/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate relationship of probable attention deficit hyperactivity disorder (ADHD) with severity of psychopathology and the effect of impulsivity on this relationship in a sample of male patients with opioid use disorder (OUD). METHODS Participants included 234 patients (115 inpatients and 119 outpatients) with OUD. Participants were evaluated with the Adult ADHD Self-Report Scale (ASRS-v1.1), the Symptom Checklist-90-R (SCL-90-R) and the Short Form of Barratt Impulsiveness Scale (BIS-11-SF). RESULTS Psychopathology and impulsivity scores were higher among those with the probable ADHD. ADHD scores were midly to moderately correlated with impulsivity and psychopathology scores. In logistic regression analyses, while severity of general psychopathology and impulsivity predicted probable ADHD in the first Model, in the second Model, among dimensions of psychopathology obsessive compulsive (OC) dimension, whereas among dimensions of impulsivity non-planning and motor impulsivity predicted probable ADHD. CONCLUSION These findings suggest that probable ADHD is related with the severity of psychopathology, particularly OC dimension, while the severity of impulsivity may have an partial mediator (particularly non-planning and motor impulsivity) effect on this relationship among patients with OUD.
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Affiliation(s)
- Cuneyt Evren
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Izgi Alniak
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Vahap Karabulut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Turan Cetin
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Gokhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Ruken Agachanli
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Bilge Evren
- Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey
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Evren C, Alniak I, Karabulut V, Cetin T, Umut G, Agachanli R, Evren B. Relationship of probable ADHD with novelty seeking, severity of psychopathology and borderline personality disorder in a sample of patients with opioid use disorder. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1395312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Cuneyt Evren
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Izgi Alniak
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Vahap Karabulut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Turan Cetin
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Gokhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Ruken Agachanli
- Department of Psychiatry, Ardahan State Hospital, Ardahan, Turkey
| | - Bilge Evren
- Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey
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Liao YT, Chen CY, Ng MH, Huang KY, Shao WC, Lin TY, Chen VCH, Gossop M. Depression and severity of substance dependence among heroin dependent patients with ADHD symptoms. Am J Addict 2016; 26:26-33. [PMID: 27997065 DOI: 10.1111/ajad.12487] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/30/2016] [Accepted: 12/04/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Comorbid attention deficit hyperactivity disorder (ADHD) symptoms are highly prevalent among heroin-dependent patients. We aim to investigate differences in dependence severity, depression, and quality of life between heroin-dependent patients with and without ADHD-screened positive. METHODS Heroin-dependent participants (n = 447) entering methadone maintenance treatment were divided into ADHD-screened positive (ADHD-P) and ADHD-screened negative (ADHD-N) groups according to scores of Adult ADHD Self-Report Scale (ASRS). Mini-International Neuropsychiatric Interview was used to identify current and lifetime depressive episodes and suicidality. Substance use disorder, depression, family support, and quality of life in two groups were also assessed. RESULTS About 7.8% (n = 35) scored 24 or higher of ASRS indicating highly likely Adult ADHD. More heroin-dependent patients of ADHD-P had a current depressive episode (p = .02). They had higher Center for Epidemiological Studies Depression (CESD) scores (p = .003), and more severe heroin dependence (p = .006). Poorer family support and quality of life in physical, and psychological domains were found in patients of ADHD-P compared to ADHD-N. DISCUSSION AND CONCLUSIONS Heroin-dependent patients of ADHD-P represent a vulnerable minority. They were comorbid with regard to depression, greater substance dependence severity, and poorer quality of life. SCIENTIFIC SIGNIFICANCE Assessment for ADHD symptoms in heroin-dependent patients may be indicated for the effective management of the complex problems of these patients. (Am J Addict 2017;26:26-33).
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Affiliation(s)
- Yin-To Liao
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chi-Yen Chen
- Department of Health, Tsaotun Psychiatric Center, Nantou, Taiwan
| | - Mei-Hing Ng
- Department of Health, Tsaotun Psychiatric Center, Nantou, Taiwan
| | - Kuo-You Huang
- School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
| | - Wen-Chuan Shao
- Department of Health, Tsaotun Psychiatric Center, Nantou, Taiwan
| | - Tsang-Yaw Lin
- Department of Health, Tsaotun Psychiatric Center, Nantou, Taiwan
| | - Vincent Chin-Hung Chen
- Chang Gung University, Kwei-shan, Taiwan.,Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Michael Gossop
- King's College London, Institute of Psychiatry, London, United Kingdom
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Ornoy A, Finkel-Pekarsky V, Peles E, Adelson M, Schreiber S, Ebstein PR. ADHD risk alleles associated with opiate addiction: study of addicted parents and their children. Pediatr Res 2016; 80:228-36. [PMID: 27064247 DOI: 10.1038/pr.2016.78] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/02/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Polymorphisms in genes such as DAT1, 5HTTLPR, D4DR4, and MAO-A have been linked to attention deficit hyperactivity disorder (ADHD) and susceptibility for opiate addiction. We investigated in opiate-addicted parents and their children the rate of ADHD and genetic markers that could predict susceptibility to ADHD and/or opiate addiction. METHODS We studied 64 heroin-addicted, methadone-maintained parents, and their 94 children who had or had not been exposed prenatally to opiates. DNA extracted from mouthwash was assessed for genetic polymorphism for six polymorphic sites of four different genes. Study subjects also filled a variety of questionnaires assessing the rate of ADHD in the parents and children and the children's intelligence quotient. RESULTS Children of opiate-dependent mothers had a higher rate of ADHD compared to those of the opiate-dependent fathers. Opiate-dependent parents have a high risk of being carriers of most risk alleles examined except DRD4EX3 (allele 7). There was no difference whether the addicted parents had or did not have ADHD. CONCLUSIONS Serotonergic and dopaminergic risk alleles seem to be mainly related to opiate dependence with no effect on the occurrence of ADHD. People carrying those polymorphisms are susceptible to opioid addiction and not necessarily to ADHD.
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Affiliation(s)
- Asher Ornoy
- Laboratory of Teratology, Department of Medical Neurobiology, Canada Israel Institute of Medical Research, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Victoria Finkel-Pekarsky
- Laboratory of Teratology, Department of Medical Neurobiology, Canada Israel Institute of Medical Research, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Einat Peles
- Adelson clinic for drug abuse treatment & Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Miriam Adelson
- Adelson clinic for drug abuse treatment & Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shaul Schreiber
- Adelson clinic for drug abuse treatment & Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - P Richard Ebstein
- Department of Psychology, National University of Singapore, Singapore, Singapore
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Cooperman NA, Lu SE, Richter KP, Bernstein SL, Williams JM. Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment. J Dual Diagn 2016; 12:118-28. [PMID: 27064523 PMCID: PMC5079427 DOI: 10.1080/15504263.2016.1172896] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. METHODS Participants (N = 116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory-III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. RESULTS Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall, narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI [0.66, 0.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI [0.70, 0.88]). CONCLUSIONS Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking.
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Affiliation(s)
- Nina A. Cooperman
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School
| | - Shou-En Lu
- Department of Biostatistics, Rutgers School of Public Health,
| | - Kimber P. Richter
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center,
| | | | - Jill M. Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School,
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A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study). Psychopharmacology (Berl) 2016; 233:1203-13. [PMID: 26753792 DOI: 10.1007/s00213-016-4202-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/31/2015] [Indexed: 01/09/2023]
Abstract
RATIONALE/OBJECTIVES Sleep disturbance is frequent in opioid-dependent patients. To date, no data are available about the impact of methadone maintenance treatment on sleep disturbance. Using 1-year follow-up data from the Methaville trial, we investigated the impact of methadone initiation and other correlates on sleep disturbance in opioid-dependent patients. METHODS Sleep disturbance severity was evaluated using two items from different scales (Center for Epidemiological Studies Depression Scale for depression and Opiate Treatment Index). We assessed the effect of methadone and other correlates on sleep disturbance severity during follow-up (months 0, 6, and 12) using a mixed multinomial logistic regression model. RESULTS We included 173 patients who had 1-year follow-up data on sleep disturbance, corresponding to 445 visits. At enrolment, 60.5 % reported medium to severe sleep disturbance. This proportion remained stable during methadone treatment: 54.0 % at month 6 and 55.4 % at month 12. The final multivariate model indicated that younger patients (odds ratio (OR) [95 % CI] 0.95 [0.90-1.00]), patients with pain (OR [95 % CI] 2.45 [1.13-5.32]), patients with high or very high nicotine dependence (OR [95 % CI] 5.89 [2.41-14.39]), and patients at suicidal risk (2.50 [1.13-5.52]) had a higher risk of severe sleep disturbance. Because of collinearity between suicidal risk and attention deficit hyperactivity disorder (ADHD) symptoms, ADHD was not associated with sleep disturbance in the final model. Receiving methadone treatment had no significant effect on sleep disturbance. CONCLUSIONS Sleep disturbance is frequent among opioid-dependent patients. It can be regarded as an important signal of more complex psychiatric comorbidities such as suicidal risk and ADHD. However, sleep disturbance should not be considered an obstacle to methadone maintenance treatment (MMT) initiation or continuation.
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Peles E, Schreiber S, Linzy S, Domani Y, Adelson M. Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics. J Subst Abuse Treat 2014; 54:44-9. [PMID: 25605438 DOI: 10.1016/j.jsat.2014.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 12/13/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p < 0.0005), with no difference in age, gender, duration in MMT, cannabis, opiates, and cocaine abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study.
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Affiliation(s)
- Einat Peles
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Department of Psychiatry, Tel-Aviv Sourasky Medical Center & Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel.
| | - Shaul Schreiber
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Department of Psychiatry, Tel-Aviv Sourasky Medical Center & Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Shirley Linzy
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Las Vegas, NV, USA
| | - Yoav Domani
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Department of Psychiatry, Tel-Aviv Sourasky Medical Center & Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Miriam Adelson
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Las Vegas, NV, USA
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Stroop task among patients with obsessive-compulsive disorder (OCD) and pathological gambling (PG) in methadone maintenance treatment (MMT). CNS Spectr 2014; 19:509-18. [PMID: 24360394 DOI: 10.1017/s1092852913000862] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate the impaired attention selection (Stroop interference effect) and general performance [reaction times (RTs)] on the Stroop task among methadone maintenance treatment (MMT) patients with obsessive compulsive disorder (OCD), pathological gambling (PG), both PG/OCD or none, and the influence if having ADHD. METHODS Eighty-six patients and 15 control subjects underwent the Stroop task, which measured RTs of condition-related words (color, obsessive compulsive disorder, pathological gambling, addiction) and neutral words. RESULTS MMT patients had longer RTs on the Stroop task compared with controls. RTs were longer among patients with OCD and in those who abused drugs on the study day. The combined PG/OCD group had the longest RTs, but they were also characterized as abusing more drugs, being older, and having worse cognitive status. Stroop color interference differed only among MMT patients with ADHD, and it was higher among those with OCD than those without OCD. The modified condition-related Stroop did not show any interference effect of OCD, addiction, or gambling words. CONCLUSIONS MMT patients had generally poorer performance, as indicated by longer RTs, that were related to clinical OCD, drug abuse, poor cognitive state, and older age. Patients with both clinical OCD and ADHD had a higher Stroop interference effect, which is a reflection of an attention deficit. In order to improve clinical approach and treatment of MMT patients, OCD and ADHD should be evaluated (and treated as needed).
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Abstract
Compulsivity and impulsivity are cross-cutting, dimensional symptom domains that span traditional diagnostic boundaries. We examine compulsivity and impulsivity from several perspectives and present implications for these symptom domains as they relate to classification. We describe compulsivity and impulsivity as general concepts, from the perspectives of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) Research Planning Agenda, and from the DSM-5 workgroups, literature reviews, and field trials. Finally, we detail alternative modes of classification for compulsivity and impulsivity in line with the Research Domain Criteria (RDoC) and International Classification of Diseases (ICD-11).
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Endocannabinoid/GABA interactions in the entopeduncular nucleus modulates alcohol intake in rats. Brain Res Bull 2013; 91:31-7. [DOI: 10.1016/j.brainresbull.2012.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 11/27/2012] [Accepted: 11/28/2012] [Indexed: 01/31/2023]
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