背景:注意缺陷/多动障碍(ADHD)症状可能会对药物使用和精神障碍的充分治疗提出挑战。关于接受阿片类药物激动剂治疗(OAT)的患者中此类症状的程度的文献很少。这项研究使用ADHD自我报告量表(ASRS)检查了ADHD症状,以及接受OAT的患者的“ASRS记忆”和“ASRS注意力”得分与物质使用和社会人口统计学特征之间的关联。
方法:我们使用来自挪威患者队列的评估访视数据。总的来说,从2017年5月至2022年3月纳入701例患者。所有患者对评估记忆力和注意力的两个ASRS问题至少回答了一次,分别。进行有序回归分析,以调查两个获得的分数是否与年龄相关,性别,经常使用药物,注射使用,住房状况,和基线教育程度,即,第一次评估,随着时间的推移。结果以比值比(OR)和95%置信区间(CI)表示。此外,225名患者的子样本完成了扩展访谈,包括ASRS筛选器和从医疗记录中收集登记的精神障碍诊断。标准截止值用于定义每个ASRS症状或ASRS筛查阳性(\'ASRS阳性\')的存在。
结果:在基线时,428名(61%)和307名(53%)患者在“ASRS记忆”和“ASRS注意力”上得分超过截止值,\'分别。与较少或不使用大麻相比,频繁使用大麻与较高的“ASRS记忆”(OR:1.7,95%CI:1.1-2.6)和“ASRS注意力”(1.7,1.1-2.5)得分相关基线,尽管随着时间的推移,“ASRS记忆”上的分数降低了(0.7,0.6-1.0)。在基线,频繁使用兴奋剂(1.8,1.0-3.2)和低教育程度(0.1,0.0-0.8)与较高的ASRS记忆评分相关.在满足ASRS筛选器的子样本中,45%的患者为ASRS阳性,其中13%患有ADHD诊断。
结论:我们的发现说明了ASRS记忆和注意力评分与频繁使用大麻和兴奋剂之间的关系。此外,近一半的子样本为ASRS阳性。接受OAT的患者可能会从进一步评估ADHD中受益,但需要改进的诊断方法。
Attention-deficit/hyperactivity disorder (ADHD) symptoms may challenge sufficient treatment of substance use and mental disorders. The literature on the extent of such symptoms among patients receiving opioid agonist therapy (OAT) is scarce. This study examined ADHD symptoms using the ADHD self-report scale (ASRS) and the association between the \'ASRS-memory\' and \'ASRS-attention\' scores and substance use and sociodemographic characteristics among patients receiving OAT.
We used data from assessment visits of a cohort of patients in Norway. In total, 701 patients were included from May 2017 to March 2022. All patients responded at least once to two ASRS questions assessing memory and attention, respectively. Ordinal regression analyses were performed to investigate whether the two obtained scores were associated with age, sex, frequent substance use, injecting use, housing status, and educational attainment at baseline, i.e., the first assessment, and over time. The results are presented as odds ratios (OR) with 95% confidence intervals (CI). Additionally, a subsample of 225 patients completed an extended interview, including the ASRS-screener and collection of registered mental disorder diagnoses from the medical records. Standard cutoffs were used to define the presence of each ASRS symptom or a positive ASRS-screener (\'ASRS-positive\').
At baseline, 428 (61%) and 307 (53%) patients scored over the cutoffs on the \'ASRS-memory\' and \'ASRS-attention,\' respectively. Frequent cannabis use was associated with higher \'ASRS-memory\' (OR: 1.7, 95% CI: 1.1-2.6) and \'ASRS-attention\' (1.7, 1.1-2.5) scores compared with less or no use at baseline, though reduced score on the \'ASRS-memory\' over time (0.7, 0.6-1.0). At baseline, frequent stimulant use (1.8, 1.0-3.2) and low educational attainment (0.1, 0.0-0.8) were associated with higher \'ASRS-memory\' scores. In the subsample fulfilling the ASRS-screener, 45% of the patients were \'ASRS-positive,\' of whom 13% with a registered ADHD diagnosis.
Our findings illustrate a relationship between the ASRS-memory and -attention scores and frequent cannabis and stimulant use. Furthermore, nearly half of the subsample was \'ASRS-positive.\' Patients receiving OAT might benefit from being further assessed for ADHD, but improved diagnostic methods are required.