Attention Deficit Hyperactivity Disorder Increases Nicotine Addiction Severity in Adults Seeking Treatment for Substance Use Disorders: The Role of Personality Disorders

and the ICASA group, Natalie C Sánchez-García, Rafael A González, Josep A Ramos-Quiroga, Wim van den Brink, Mathias Luderer, Matthijs Blankers, Lara Grau-Lopez, Frances R Levin, Sharlene Kaye, Zsolt Demetrovics, Geurt van de Glind, Arnt Schellekens, María C Vélez-Pastrana

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

AIMS: To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients.

METHODS: In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD.

RESULTS: Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity.

CONCLUSIONS: SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.

Original languageEnglish
Pages (from-to)191-200
Number of pages10
JournalEuropean Addiction Research
Volume26
Issue number4-5
Early online date19 Jun 2020
DOIs
Publication statusPublished - Aug 2020

Bibliographical note

© 2020 S. Karger AG, Basel.

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