TY - JOUR
T1 - Differential Diagnosis in Patients with Substance Use Disorder and/or Attention-Deficit/Hyperactivity Disorder Using Continuous Performance Test
AU - Slobodin, Ortal
AU - Blankers, Matthijs
AU - Kapitány-Fövény, Máté
AU - Kaye, Sharlene
AU - Berger, Itai
AU - Johnson, Brian
AU - Demetrovics, Zsolt
AU - Van Den Brink, Wim
AU - Van De Glind, Geurt
N1 - Funding Information:
The authors acknowledge the support by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences.
Funding Information:
For data collection, the ICASA Foundation (www.adhdandsub-stanceabuse.org) received a nonrestricted research grant from Neurotech (the company who developed the MOXO test). This funding was used to compensate researchers and their institutes for the time involved in collecting the data. For data sampling purposes, the authors/researchers used the database and e-CRFs as used in the IASP study. For the IASP study, funding was provided by the following pharmaceutical companies: Janssen Cilag, Eli Lilly and Company, Shire. Since the ICASA Network is a formal foundation (September 2010), it operates independent from pharmaceutical funding. Thus, funding was obtained via the following sources: Participating institutes; The Noaber Foundation, The Waterloo Foundation, The Augeo Foundation [5].
Publisher Copyright:
© 2020 S. Karger AG, Basel. Copyright: All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Background: Although substance use disorders (SUD) and attention-deficit/hyperactivity disorder (ADHD) show significant symptomatic overlap, ADHD is often overlooked in SUD patients. Objective: The aim of the present study was to characterize aspects of attention and inhibition (as assessed by a continuous performance test [CPT]) in SUD patients with and without a comorbid diagnosis of ADHD and in healthy controls, expecting the most severe deficits in patients with a combined diagnosis. Methods: The MOXO-CPT version, which incorporates visual and auditory environmental distractors, was administered to 486 adults, including healthy controls (n = 172), ADHD (n = 56), SUD (n = 150), and combined SUD and ADHD (n = 108). Results: CPT performance of healthy controls was better than that of individuals in each of the 3 clinical groups. The only exception was that the healthy control group did not differ from the ADHD group on the Timing index. The 3 clinical groups differed from each other in 2 indices: (a) patients with ADHD (with or without SUD) showed increased hyperactivity compared to patients with SUD only and (b) patients with ADHD showed more responses on correct timing as compared with the SUD groups (with or without ADHD). Conclusion: The CPT is sensitive to ADHD-related deficits, such as disinhibition, poor timing, and inattention, and is able to consistently differentiate healthy controls from patients with ADHD, SUD, or both. Our results are in line with previous research associating both ADHD and SUD with multiple disruptions across a broad set of cognitive domains such as planning, working memory, decision-making, inhibition control, and attention. The lack of consistent differences in cognitive performance between the 3 diagnostic groups might be attributed to various methodological aspects (e.g., heterogeneity in severity, type, and duration of substances use). Our results support the view that motor activity should be considered a significant marker of ADHD.
AB - Background: Although substance use disorders (SUD) and attention-deficit/hyperactivity disorder (ADHD) show significant symptomatic overlap, ADHD is often overlooked in SUD patients. Objective: The aim of the present study was to characterize aspects of attention and inhibition (as assessed by a continuous performance test [CPT]) in SUD patients with and without a comorbid diagnosis of ADHD and in healthy controls, expecting the most severe deficits in patients with a combined diagnosis. Methods: The MOXO-CPT version, which incorporates visual and auditory environmental distractors, was administered to 486 adults, including healthy controls (n = 172), ADHD (n = 56), SUD (n = 150), and combined SUD and ADHD (n = 108). Results: CPT performance of healthy controls was better than that of individuals in each of the 3 clinical groups. The only exception was that the healthy control group did not differ from the ADHD group on the Timing index. The 3 clinical groups differed from each other in 2 indices: (a) patients with ADHD (with or without SUD) showed increased hyperactivity compared to patients with SUD only and (b) patients with ADHD showed more responses on correct timing as compared with the SUD groups (with or without ADHD). Conclusion: The CPT is sensitive to ADHD-related deficits, such as disinhibition, poor timing, and inattention, and is able to consistently differentiate healthy controls from patients with ADHD, SUD, or both. Our results are in line with previous research associating both ADHD and SUD with multiple disruptions across a broad set of cognitive domains such as planning, working memory, decision-making, inhibition control, and attention. The lack of consistent differences in cognitive performance between the 3 diagnostic groups might be attributed to various methodological aspects (e.g., heterogeneity in severity, type, and duration of substances use). Our results support the view that motor activity should be considered a significant marker of ADHD.
KW - Attention
KW - Attention-deficit/hyperactivity disorder
KW - Continuous performance test
KW - Inhibition
KW - Substance use disorders
UR - http://www.scopus.com/inward/record.url?scp=85081403714&partnerID=8YFLogxK
U2 - 10.1159/000506334
DO - 10.1159/000506334
M3 - Article
C2 - 32074617
AN - SCOPUS:85081403714
SN - 1022-6877
VL - 26
SP - 151
EP - 162
JO - European Addiction Research
JF - European Addiction Research
IS - 3
ER -
