Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical and Neuropsychological Characteristics of Adult Alcohol Use Disorder Patients with or without Attention-Deficit Hyperactivity Symptom

성인 알코올사용장애 환자에서 주의력결핍 과잉행동 증상 유무에 따른 임상적 및 신경심리학적 특성

  • Jo, Jung Min (Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation) ;
  • Lee, Dong Jun (Department of Psychiatry, Hanyang University College of Medicine) ;
  • Jung, Kyung Hi (Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation) ;
  • Oh, Song In (Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation) ;
  • Ahn, Dong Hyun (Department of Psychiatry, Hanyang University College of Medicine)
  • 조정민 (계요의료재단 계요병원 정신건강의학과) ;
  • 이동준 (한양대학교 의과대학 정신건강의학교실) ;
  • 정경희 (계요의료재단 계요병원 정신건강의학과) ;
  • 오송인 (계요의료재단 계요병원 정신건강의학과) ;
  • 안동현 (한양대학교 의과대학 정신건강의학교실)
  • Received : 2014.11.13
  • Accepted : 2014.12.04
  • Published : 2014.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : Alcohol use disorder (AUD) is often comorbid with adult attention-deficit hyperactivity disorder (ADHD) and other psychiatric illnesses. When associated with other mental problems, the prognosis of the AUD can be more serious. This study shows research on the clinical and neuropsychological characteristics according to whether or not ADHD symptoms and AUD were comorbid. Methods : A total of 64 adult inpatients who completed AUD scales about adult ADHD, alcohol dependence, depression, anxiety, and impulsiveness. They also completed neuropsychological tests about attention and executive function. According to the Adult ADHD Self-Report Scale score, patients were categorized into two groups (ADHD symptom positive/negative group). Results : Fourteen among the 64 subjects were part of the ADHD symptom positive group (21.9%). They had statistically significant shorter abstinence periods and a higher rate of history of 'rule violation during school' and 'physical damage in childhood' compared to the ADHD symptom negative group. Conclusion : The comorbidity rate with ADHD symptom in adult AUD is higher than the general population. The ADHD symptom positive group suffered from more severe and refractory AUD. Considering the more frequent history of rule violation during school in the ADHD symptom positive group, the association between ADHD and AUD may be mediated by conduct disorder. Therefore we suggest the necessity of careful evaluation and intervention in children and adolescents with ADHD and conduct disorder.

Keywords

References

  1. Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004;291:2581-2590. https://doi.org/10.1001/jama.291.21.2581
  2. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593-602. https://doi.org/10.1001/archpsyc.62.6.593
  3. Kimura M, Itoh M, Yonemoto T, Yoshimura A, Maesato H, Sakuma H, et al. The prevalence of comorbid psychiatric disorders in Japanese inpatients with alcohol dependence. Alcohol Alcohol 2014;49 Suppl 1:i57.
  4. Goldstein BI, Shamseddeen W, Spirito A, Emslie G, Clarke G, Wagner KD, et al. Substance use and the treatment of resistant depression in adolescents. J Am Acad Child Adolesc Psychiatry 2009;48: 1182-1192. https://doi.org/10.1097/CHI.0b013e3181bef6e8
  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed., text revision. Washington, DC: American Psychiatric Association;2000.
  6. Wilens TE, Biederman J, Spencer TJ. Attention deficit/hyperactivity disorder across the lifespan. Annu Rev Med 2002;53:113-131. https://doi.org/10.1146/annurev.med.53.082901.103945
  7. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006;163:716-723. https://doi.org/10.1176/ajp.2006.163.4.716
  8. Biederman J, Wilens T, Mick E, Milberger S, Spencer TJ, Faraone SV. Psychoactive substance use disorders in adults with attention deficit hyperactivity disorder (ADHD): effects of ADHD and psychiatric comorbidity. Am J Psychiatry 1995;152:1652-1658. https://doi.org/10.1176/ajp.152.11.1652
  9. Wilens TE. AOD use and attention deficit/hyperactivity disorder. Alcohol Health Res World 1998;22:127-130.
  10. Lee SS, Humphreys KL, Flory K, Liu R, Glass K. Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clin Psychol Rev 2011;31:328-341. https://doi.org/10.1016/j.cpr.2011.01.006
  11. Gau SS, Tseng WL, Tseng WY, Wu YH, Lo YC. Association between microstructural integrity of frontostriatal tracts and school functioning: ADHD symptoms and executive function as mediators. Psychol Med 2014:1-15.
  12. Span SA, Earleywine M. Cognitive functioning moderates the relation between Attention Deficit Hyperactivity Disorder symptoms and alcohol use in women. Addict Behav 2004;29:1605-1613. https://doi.org/10.1016/j.addbeh.2004.03.016
  13. Tuithof M, ten Have M, van den Brink W, Vollebergh W, de Graaf R. The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2. Drug Alcohol Depend 2012;123:115-121. https://doi.org/10.1016/j.drugalcdep.2011.10.030
  14. Kuperman S, Schlosser SS, Kramer JR, Bucholz K, Hesselbrock V, Reich T, et al. Developmental sequence from disruptive behavior diagnosis to adolescent alcohol dependence. Am J Psychiatry 2001; 158:2022-2026. https://doi.org/10.1176/appi.ajp.158.12.2022
  15. Knop J, Penick EC, Jensen P, Nickel EJ, Gabrielli WF, Mednick SA, et al. Risk factors that predicted problem drinking in Danish men at age thirty. J Stud Alcohol 2003;64:745-755. https://doi.org/10.15288/jsa.2003.64.745
  16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association;2013.
  17. Lee D, Shin J, Yun S, Byun W. A reliability and validity study of the Korean version of the alcohol dependence scale in alcoholics. J Korean Acad Addict Psychiatry 2000;4:30-37.
  18. Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005;35:245-256. https://doi.org/10.1017/S0033291704002892
  19. Kim JH, Lee EH, Joung YS. The WHO Adult ADHD Self-Report Scale: reliability and validity of the Korean version. Psychiatry Investig 2013;10:41-46. https://doi.org/10.4306/pi.2013.10.1.41
  20. Park S, Cho MJ, Chang SM, Jeon HJ, Cho SJ, Kim BS, et al. Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: results of the Korean epidemiologic catchment area study. Psychiatry Res 2011;186:378-383. https://doi.org/10.1016/j.psychres.2010.07.047
  21. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
  22. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of Beck Depression Inventory in Korea. J Korean Neuropsychiatr Assoc 1986;25:487-500.
  23. Yook SP, Kim ZS. A clinical study on the Korean version of Beck Anxiety Inventory: comparative study of patient and non-patient. Korean J Clin Psychol 1997;16:185-197.
  24. Barratt ES. Anxiety and impulsiveness related to psychomotor efficiency. Percept Mot Skills 1959;9:191-198. https://doi.org/10.2466/pms.1959.9.3.191
  25. Lee HS. Impulsivity Test. Seoul: Korean Guidance;1992.
  26. Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep 1962;10:799-812. https://doi.org/10.2466/pr0.1962.10.3.799
  27. Ha KS, Kwon JS, Lyoo IK. Development and standardization of the computerized attention assessment for Korean adults. J Korean Neuropsychiatr Assoc 2002;41:335-346.
  28. Lyoo IK, Kwon JS, Ha KS. Development and standardization of the computerized higher cortical function assessment for Korean adults. J Korean Neuropsychiatr Assoc 2002;41:538-550.
  29. Berg EA. A simple objective technique for measuring flexibility in thinking. J Gen Psychol 1948;39:15-22. https://doi.org/10.1080/00221309.1948.9918159
  30. Milner B. Effects of different brain lesions on card sorting: the role of the frontal lobes. Arch Neurol 1963;9:90-100. https://doi.org/10.1001/archneur.1963.00460070100010
  31. Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. Wisconsin card sort test manual: Revised and expanded. Odessa, FL: Psychological Assessment Resources Inc.;1993.
  32. Kim JW, Park CS, Hwang JW, Shin MS, Hong KE, Cho SC, et al. Clinical and genetic characteristics of Korean male alcoholics with and without attention deficit hyperactivity disorder. Alcohol Alcohol 2006;41:407-411. https://doi.org/10.1093/alcalc/agl034
  33. Knop J, Penick EC, Nickel EJ, Mortensen EL, Sullivan MA, Murtaza S, et al. Childhood ADHD and conduct disorder as independent predictors of male alcohol dependence at age 40. J Stud Alcohol Drugs 2009;70:169-177. https://doi.org/10.15288/jsad.2009.70.169
  34. Disney ER, Elkins IJ, McGue M, Iacono WG. Effects of ADHD, conduct disorder, and gender on substance use and abuse in adolescence. Am J Psychiatry 1999;156:1515-1521. https://doi.org/10.1176/ajp.156.10.1515

Cited by

  1. The Effects of Attention-Deficit/Hyperactivity Disorder Symptom and Impulsivity on Abstinence Period of Male Patients with Alcohol Use Disorder vol.55, pp.4, 2016, https://doi.org/10.4306/jknpa.2016.55.4.443
  2. Serial Progression from Attention-Deficit/Hyperactivity Disorder to Alcohol Use Disorder: Serial Multiple Mediated Effects of Externalizing Disorders and Depression vol.16, pp.3, 2014, https://doi.org/10.9758/cpn.2018.16.3.267