Demographic and clinical differences in A-ADHD patients with and without Dual Disor- der.

Demographic and clinical differences in A-ADHD patients with and without Dual Disor- der.

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While the association between adult Attention Deficit/Hyperactivity Disorder (A-ADHD) and Substance Use Disorders (SUDs) has been widely explored, less attention has been dedicated to the various substance use variants. In a previous paper, we identified two variants: type 1 (use of stimulants/alcohol) and type 2 (use of cannabinoids). In this stud...

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... and "b" letters denotes a subset of categories whose column proportions differ significantly from each other at the 0.05 level. Table 2 shows clinical and functional differences. In evaluating ADHD-specific symptomatology by the CAARS-O:S, no differences were found in the scores for the severity of inattentiveness or in the combined scores. ...

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Background Symptoms of attention deficit hyperactivity disorder (ADHD) are commonly comorbid with depression This study aimed to examine the relationship between ADHD symptoms and depression through perceived family support and to explore whether the magnitude of the relationship depended on the type of family climate of medical students. Methods...

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... In another study when university students with ADHD escalated their substance use, they increasingly skipped classes and reductions in their academic grades were observed [149]. Although similar problems are seen in clinical practice with other drugs of abuse such as cocaine [150], some drugs are used to control symptoms of ADHD. For example, cannabis may help reduce some ADHD related problems such as restlessness, EL and problems getting to sleep [151]. ...
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Background Attention deficit hyperactivity disorder (ADHD) is associated with poor educational outcomes that can have long-term negative effects on the mental health, wellbeing, and socio-economic outcomes of university students. Mental health provision for university students with ADHD is often inadequate due to long waiting times for access to diagnosis and treatment in specialist National Health Service (NHS) clinics. ADHD is a hidden and marginalised disability, and within higher education in the UK, the categorisation of ADHD as a specific learning difference (or difficulty) may be contributing to this. Aims This consensus aims to provide an informed understanding of the impact of ADHD on the educational (or academic) outcomes of university students and highlight an urgent need for timely access to treatment and management. Methods The UK Adult ADHD Network (UKAAN) convened a meeting of practitioners and experts from England, Wales, and Scotland, to discuss issues that university students with ADHD can experience or present with during their programme of studies and how best to address them. A report on the collective analysis, evaluation, and opinions of the expert panel and published literature about the impact of ADHD on the educational outcomes of university students is presented. Results A consensus was reached that offers expert advice, practical guidance, and recommendations to support the medical, education, and disability practitioners working with university students with ADHD. Conclusions Practical advice, guidance, and recommendations based on expert consensus can inform the identification of ADHD in university students, personalised interventions, and educational support, as well as contribute to existing research in this topic area. There is a need to move away from prevailing notions within higher education about ADHD being a specific learning difference (or difficulty) and attend to the urgent need for university students with ADHD to have timely access to treatment and support. A multimodal approach can be adapted to support university students with ADHD. This approach would view timely access to treatment, including reasonable adjustments and educational support, as having a positive impact on the academic performance and achievement of university students with ADHD.
... Aktywacja tych struktur w badaniach obrazowych była opisywana jako wyższa u osób używających konopi indyjskich w porównaniu z osobami nie używającymi, jednak tylko w grupach osób bez stwierdzonej ADHD 15 . W interakcje z endokannabinoidami może wchodzić kilka innych neuroprzekaźników, takich jak glutaminian, kwas γ-aminomasłowy i N-metylo-Dasparaginian, a także receptory CB2, co może mieć wpływ w modulacji impulsywności 13,16 . Coraz więcej dowodów wskazuje na istotną rolę ECS w regulacji funkcjonowania poznawczego i behawioralnego, sugerując jego potencjał terapeutyczny w leczeniu chorób psychiatrycznych 16 . ...
... W interakcje z endokannabinoidami może wchodzić kilka innych neuroprzekaźników, takich jak glutaminian, kwas γ-aminomasłowy i N-metylo-Dasparaginian, a także receptory CB2, co może mieć wpływ w modulacji impulsywności 13,16 . Coraz więcej dowodów wskazuje na istotną rolę ECS w regulacji funkcjonowania poznawczego i behawioralnego, sugerując jego potencjał terapeutyczny w leczeniu chorób psychiatrycznych 16 . ...
... W przypadku długotrwałego stosowania kannabinoidów możemy obserwować zahamowanie układu dopaminergicznego, zmniejszenie napędu motywacyjnego, co może prowadzić do późniejszego zubożenia funkcji wykonawczych, takich jak planowanie czy zapamiętywanie krótkoterminowe. Pacjenci z ADHD mogą zatem odnieść pozytywne skutki po zastosowaniu kannabinoidów, chociaż długoterminowe efekty ostatecznie mogą doprowadzić do pogorszenia objawów związanych z ADHD 16 . Z badania Rasmussen J. et al. wynika, że wpływ ADHD na rozwój ośrodkowego układu nerwowego wydaje się mieć większe znacznie na zachowania behawioralne związane z impulsywnością niż ekspozycja na konopie indyjskie 15 . ...
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Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a common problem in adolescents and adults around the world. ADHD is particularly characterized by inattention, impulsiveness and hyperactivity, and in order to deal with these problems, patients often resort to other methods of treatment in addition to classic pharmacotherapy. Increasing numbers of ADHD patients are self-medicating with cannabis, despite the lack of specific evidence on its efficacy and safety. Aim of the study: The purpose of this study was to review the most recent available literature on the use of cannabidiol in the treatment of ADHD. For this purpose, PubMed and scopus databases were reviewed. The phrase "cannabidiol and ADHD" was used in the database search. After reviewing the titles and abstracts, 15 articles and articles cited in them were obtained and analyzed in detail. Results: Cannabinoids are reported to have pharmacological anxiolytic, neuroprotective, antidepressant, antipsychotic and hypnotic effects. Single-case studies of patients treated with them show that cannabinoids reduced hyperactivity, improved focus and control of impulsive behavior. Patients also reported side effects of cannabis use, the most common being mild short-term memory problems, dry mouth, sleepiness, and occasional experiences of constant thirst and greater forgetfulness. Most of the acute side effects were related to neuropsychiatric symptoms and were associated with cardiac sympathomimetic effects Conclusion: There is evidence for the effects of cannabinoids on ADHD symptoms as well as the influence of the cannabinoid system on involvement in neurological and psychiatric disorders. However, more controlled clinical trials are needed to determine the effect of cannabis use on ADHD symptoms and the norms of its use in this indication. Keywords cannabidiol, ADHD, literature review
... In this regard, cocaine acts on different brain circuits, including those implicated in reward (accumbens and ventral pallidum), working memory (hippocampus and amygdala), control (cingulated gyrus and prefrontal cortex), and volition (orbitofrontal and subcallosal cortices), which are compromised in ADHD patients and are therefore the primary targets of pharmacological treatments [46,47]. However, with regard to legal problems, ADHD patients abusing alcohol, cocaine, and other stimulants show a higher frequency of violent behaviours as well as antisocial conduct [48]. Even though substance use in subjects with ADHD can be considered a way to alleviate symptoms, the combined use of stimulants and alcohol may have the opposite result, leading to aggressiveness, behavioural disturbances, and legal consequences [49]. ...
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Background: Attention-deficit/hyperactivity disorder (ADHD) is a disabling disorder. High rates of ADHD have been consistently reported among prisoners. The main objectives were (1) to estimate the prevalence of ADHD symptoms in a sample of male inmates and (2) to investigate the relationship between ADHD symptoms and socio-demographic/clinical features. According to the high prevalence of childhood trauma among inmates, we assessed whether exposition to childhood trauma can be related to the presence of ADHD symptoms. Methods: A total of 159 male prisoners admitted to Monza prison between January 2020 and June 2021 were included. Both Wender Utah ADHD rating scale and adult ADHD self-report scale were administered to assess ADHD symptoms. Moreover, inmates completed the childhood trauma questionnaire. Results: Data were available for 108 inmates. Thirty-five prisoners (32.4%) were found on screening to meet the criteria for symptoms of ADHD. Cocaine use disorder, prescription of mood stabilizers and a history of emotional abuse significantly increased the likelihood of having clinically significant ADHD symptoms. Furthermore, patients who experienced physical neglect resulted in meeting the criteria for ADHD symptoms. Conclusions: ADHD symptoms are widespread among inmates and are associated with specific risk factors. Screening for ADHD should be done to provide appropriate intervention strategies.
... In other words, we confirmed the idea that the use of cocaine may work as self-medication behavior in subjects who feel less interest in pleasurable feelings and reward than non-CUD individuals who have ADHD. In a psychiatric setting, A-ADHD has correlated to the use of cocaine-alcohol and cannabinoids, and the use of heroin is sporadic [31,32]. In the present study, in a drug addiction unit, the use of heroin seems to be predominant. ...
... Two patterns of substance use were identified: The first (type 1) was distinguished by stimulants/alcohol, and the second (type 2) using cannabinoids (THC). Type 1 users were significantly younger and had more legal problems, but the two patterns were similar in terms of ADHD-specific symptomatology and severity at treatment entry [31,32]. Dual disorder A-ADHD patients seem to use less cocaine and alcohol when HUD characterizes dual disorder. ...
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The role of opioids and opioid medications in ADHD symptoms is still largely understudied. We tested the hypothesis that, in Heroin Use Disorder (HUD), when patients are treated with Agonist Opioid medications (AOT), treatment outcome is associated with the presence of Adult Attention-Deficit/Hyperactive Disorder (A-ADHD) symptomatology. A retrospective cohort study of 130 HUD patients in Castelfranco Veneto, Italy, covering 30 years, was divided into two groups according to the Adult ADHD Self-Report Scale (ASRS) score and compared them using demographic, clinical and pharmacological factors. Survival in treatment was studied by utilizing the available data for leaving treatment and relapsing into addictive behavior and for mortality during treatment as poor primary outcomes. Thirty-five HUD subjects (26.9%) were unlikely to have A-ADHD symptomatology, and 95 (73.1%) were likely to have it. Only current age and co-substance use at treatment entry differed significantly between groups. Censored patients were 29 (82.9%) for HUD patients and 70 (73.9%) for A-ADHD/HUD patients (Mantel-Cox test = 0.66 p = 0.415). There were no significant linear trends indicative of a poorer outcome with the presence of A-ADHD after adjustment for demographic, clinical and pharmacological factors. Conclusions: ADHD symptomatology does not seem to exert any influence on the retention in AOT of HUD patients.
Chapter
Substance Use Disorders (SUDs) are often associated with Attention-Deficit Hyperactivity Disorder (ADHD) in adult populations due to multiple neurobiological, genetic, and psychosocial risk factors. This chapter provides a picture of the clinical aspects of adults with both ADHD and SUDs at treatment entry into a Dual Disorder Unit introducing the concept of different types of craving that may lead to substance use and abuse. At treatment entry, the presence of different comorbid SUD clusters, characterized by either stimulants/alcohol or by the use of cannabinoids, has not been shown to influence ADHD-specific symptomatology or severity, despite being crucial for the identification of a specific type of craving. We identified four clinical presentations of adult ADHD: Emotional Dysregulation, Substance Use, Core-ADHD Symptoms, and Positive Emotionality variants, that offer a practical guide in diagnosing and managing adult ADHD patients. Although the evidence of an effective medical treatment for Cocaine Use Disorder is insufficient, in our experience, toxicomanic behavior during stimulant treatment is sharply reduced in ADHD patients with cocaine addiction. Moreover, caffeinated compounds in military soldiers with ADHD may help reduce ADHD symptoms, making caffeine a potential pharmacological tool worth further investigation. Finally, substance use comorbidity does not influence treatment retention rate.