Francisco González-Saiz, Joan Trujols, Esperanza Vergara-Moragues
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引用次数: 0
摘要
可卡因的使用可能受到基于先前主观效果的药物预期的调节。一些患者在使用可卡因后会感觉到一种矛盾的镇静效果。本研究旨在探究被诊断为可卡因使用障碍的患者对可卡因效果的预期,这些患者可能同时患有或未患有成人注意力缺陷多动障碍(ADHD)。其次,我们试图根据经验确定共患成人注意力缺陷多动障碍的患者在使用可卡因后是否存在这种矛盾的镇静效果,以确定哪些人最有可能使用可卡因和复吸。横断面研究采用连续取样法,对象是在安达卢西亚(西班牙)公共治疗社区接受治疗的被诊断患有可卡因使用障碍的患者(n = 221)。参与者完成了一系列工具,以评估以下变量:可卡因效应预期、矛盾镇静效应、成人多动症和其他并发精神障碍。多变量二元逻辑回归分析表明,矛盾平静效应和反社会人格障碍(ASPD)这两个变量与被诊断为成人多动症的概率独立相关(OR = 3.43,95% CI = 1.88-6.26 和 OR = 3.42,95% CI = 1.30-8.95)。可卡因使用障碍患者出现对可卡因的矛盾性镇静反应和/或被诊断为ASPD,会增加并发成人多动症的诊断嫌疑。
Cocaine Effect Expectancies among Patients with Cocaine Use Disorder with and without Adult Attention Deficit Hyperactivity Disorder: Are There Any Relevant Differences?
Cocaine use could be modulated by drug expectancies based on previously experienced subjective effects. Some patients perceive a paradoxical calming effect after cocaine use. This study was performed to explore cocaine effect expectancies in patients diagnosed with cocaine use disorder, with and without co-occurring adult attention deficit hyperactivity disorder (ADHD). Secondly, we sought to empirically determine the presence of this paradoxical calming effect after cocaine use in patients with co-occurring adult ADHD to identify the individuals most at risk of cocaine use and relapse. Cross-sectional study using a consecutive sampling method of patients diagnosed with cocaine use disorder (n = 221) treated at public therapeutic communities in Andalusia (Spain). Participants completed a battery of instruments to assess the following variables: cocaine effect expectancies, paradoxical calming effect, adult ADHD, and other co-occurring psychiatric disorders. A multivariate binary logistic regression analysis showed that two variables, the paradoxical calming effect and antisocial personality disorder (ASPD), were independently associated with the probability of being diagnosed with adult ADHD (OR = 3.43, 95% CI = 1.88-6.26 and OR = 3.42, 95% CI = 1.30-8.95, respectively). The presence of a paradoxical calming reaction to cocaine and/or a diagnosis of ASPD in patients with cocaine use disorder increases the diagnostic suspicion of co-occurring adult ADHD.