dc.contributor.advisor | Eisemann, Martin | |
dc.contributor.author | Flores-García, Lizbett | |
dc.date.accessioned | 2020-05-11T08:29:55Z | |
dc.date.available | 2020-05-11T08:29:55Z | |
dc.date.issued | 2020-05-22 | |
dc.description.abstract | <p><i>Background.</i> About 15% of adults seeking substance use disorder (SUD) treatment also have Attention Deficit Hyperactivity Disorder (ADHD). SUD+ADHD patients often present more severe substance use (SU) and may be more difficult to treat. Research on SUD+ADHD has mostly focused on the reduction of ADHD and SUD symptoms and less on other relevant factors in the context of SUD treatment.
<p><i>Aims.</i> To compare SUD+ADHD vs SUD-ADHD patients on personality, SU-related aspects (i.e., readiness to change SU, positive and negative aspects of SU, and treatment goals) and quality of life (QoL).
<p><i>Materials and Methods.</i> Patients consecutively entering SUD treatment between 2010 and 2012 were assessed at baseline and followed-up 12 months after SUD treatment. Personality was measured by self-report questionnaires. SU-related aspects were investigated by self-report questionnaires and qualitative interviews. QoL was measured by self-report questionnaires and compared with a Norwegian population sample (NPS). Substance use was measured by self-report questionnaires.
<p><i>Results.</i> The study sample consisted of 16 SUD+ADHD and 87 SUD-ADHD patients with a mean age of 43.3 ± 11.1. Concerning personality SUD+ADHD patients reported lower fear of uncertainty, higher eagerness to effort, ambition and self-forgetfulness, compared to SUD-ADHD patients. Regarding SU-related aspects, SUD+ADHD patients reported lower readiness to change than SUD+ADHD patients. Additionally, SUD+ADHD patients more commonly perceived SU as positive, had more variable treatment goals than SUD-ADHD patients. Both SUD groups reported low QoL at baseline compared to the NPS. At follow-up, only SUD+ADHD patients reported an improved QoL, however not significantly different compared to SUD-ADHD patients or the NPS.
<p><i>Conclusions.</i> SUD+ADHD patients differed from SUD-ADHD patients on personality, SU-related aspects and QoL. More studies are needed to confirm our findings and investigate what might contribute to a better QoL in SUD+/- ADHD patients. SUD+ADHD and SUD-ADHD patients may benefit from individualized treatment strategies. | en_US |
dc.description.abstract | <p><i>Bakgrunn.</i> Omtrent 15% av voksne personer med rusmiddelavhengighet (eng. SUD) som søker rusbehandling har også ADHD. SUD+ADHD pasienter viser ofte en alvorligere rusmiddelavhengighet enn SUD-ADHD pasienter, og kan være vanskeligere å behandle. Forskning på SUD+ADHD har stort sett fokusert på reduksjon av ADHD og SUD symptomer, mens det er begrenset forskning i forhold til andre faktorer som kan være relevante i en rusbehandlingssammenheng.
<p><i>Hensikten</i> med denne studien var å sammenligne SUD+ADHD pasienter med SUD-ADHD pasienter i forhold til faktorer som personlighet, rusmiddelbruksrelaterte aspekter som endringsvilje, positive og negative aspekter ved rusmiddelbruk og behandlingsmål, samt livskvalitet.
<p><i>Materialer og metoder.</i> SUD pasienter med og uten ADHD-diagnose som fortløpende startet opp i rusbehandling mellom 2010 og 2012 ble kartlagt ved baseline og fulgt opp 12 måneder etter rusbehandling. Personlighet ble undersøkt med spørreskjemaer. Rusmiddelbruksrelaterte aspekter ble undersøkt med spørreskjemaer og kvalitative intervjuer. Livskvalitet ble undersøkt med spørreskjema og sammenlignet med livskvalitetsdata fra et norsk populasjonsutvalg (NPS).
<p><i>Resultater.</i> Utvalget bestod av 16 SUD+ADHD og 87 SUD-ADHD pasienter (gjennomsnittsalder 43.3 ± 11.1). I forhold til personlighet viste pasienter med SUD+ADHD lavere engstelse for det ukjente, høyere iver etter innsats, ambisjon og selvforglemmelse (eng. self-forgetfulness), sammenlignet med pasienter med SUD-ADHD. I forhold til rusmiddelbruksrelaterte aspekter, viste pasienter med SUD+ADHD lavere endringsvilje, oppfattet sitt rusmiddelbruk oftere som positivt og hadde mer varierende rusrelaterte behandlingsmål sammenlignet med SUD-ADHD pasienter. Begge gruppene rapporterte om lav livskvalitet ved baseline sammenlignet med en NPS. Tolv måneder etter rusmiddelbehandling var det kun SUD+ADHD pasienter som rapporterte forbedret livskvalitet, men ingen signifikant forskjell sammenlignet med SUD-ADHD pasienter eller NPS.
<p><i>Konklusjon.</i> Resultatene illustrerer at SUD+ADHD og SUD-ADHD pasienter har ulike personlighetsstiler. De ser ut til å forholde seg ulikt til sitt rusmiddelbruk og rapporterer forskjellig på livskvalitet. Det er behov for flere studier for å bekrefte funnene og undersøke videre hva kan bidra til en forbedret livskvalitet hos pasienter med SUD+/- ADHD. Pasientene med SUD+ADHD og SUD-ADHD kan dra nytte av individualiserte behandlingstiltak. | en_US |
dc.description.abstract | <p><i>Marco teórico.</i> Aproximadamente el 15% de adultos que buscan tratamiento para el trastorno por abuso de sustancias (SUD, inglés) presenta trastorno por déficit de atención con hiperactividad (ADHD, inglés). Los pacientes con SUD+ADHD son más difíciles de tratar. Estudios sobre SUD+ADHD se han centrado en la reducción de síntomas y menos en otros factores relevantes en el contexto del tratamiento de SUD.
<p><i>Objetivos.</i> Comparar pacientes con SUD+ADHD vs SUD-ADHD en cuanto a personalidad, aspectos relacionados con uso de sustancias (USUS) (preparación para el cambio, aspectos positivos y negativos de USUS y metas de tratamiento) y calidad de vida (CdV).
<p><i>Materiales y métodos.</i> Los pacientes que ingresaron consecutivamente al tratamiento para SUD entre 2010 y 2012 fueron evaluados y se les dio seguimiento 12 meses después del tratamiento. La personalidad se midió mediante escalas de auto informe. Los aspectos relacionados con USUS fueron investigados mediante escalas de auto informe y entrevistas cualitativas. La CdV se midió mediante escalas de auto informe y se comparó CdV de una muestra poblacional noruega (NPS).
<p><i>Resultados.</i> Participaron 16 pacientes con SUD+ADHD y 87 con SUD-ADHD (edad 43.3 ± 11.1). Con respecto a la personalidad, los pacientes con SUD+ADHD reportaron menor temor a la incertidumbre, mayor afán de esforzarse, ambición y olvido de sí mismos que aquellos con SUD-ADHD. En los aspectos relacionados con el USUS, auquellos con SUD+ADHD reportaron menor preparación al cambio, más aspectos positivos sobre su USUS y objetivos de tratamiento más variables que aquellos con SUD-ADHD. Inicialmente, ambos grupos reportaron una CdV baja comparados con NPS. Doce meses después, sólo aquellos con SUD+ADHD reportaron mejor CdV aunque sin diferir significativamente con respecto a SUD-ADHD o NPS.
<p><i>Conclusiones.</i> Los pacientes SUD+ADHD difirieron de los pacientes SUD-ADHD en cuanto a personalidad, aspectos relacionados con USUS y CdV. Más estudios son necesarios para confirmar nuestros resultados e inverstigar factores contribuyentes a la CdV en pacientes con ADHD +/- ADHD. Los pacientes con SUD+ADHD y SUD-ADHD podrían beneficiarse de estrategias de tratamiento individualizadas. | en_US |
dc.description.doctoraltype | ph.d. | en_US |
dc.description.popularabstract | About 15% of substance use disorder (SUD) patients also have attention deficit hyperactivity disorder (ADHD). SUD+ADHD patients may be more difficult to treat due to higher substance use (SU) severity. Research on SUD+ADHD has mostly focused on ADHD and SUD symptom reduction and less on other relevant factors in the context of SUD treatment. Between 2010 and 2012, SUD+ADHD vs SUD-ADHD patients completed self-report questionnaires and interviews on personality, SU- related aspects and quality of life (QoL). They were followed-up 12 months after SUD treatment. SUD+ADHD patients were less fearful, more eager to effort, ambitious and self-forgetful than SUD-ADHD patients. Additionally, SUD+ADHD patients reported lower readiness to change, more positive SU perceptions and more variable treatment goals. At baseline, both SUD groups reported low QoL. At follow-up, only SUD+ADHD patients reported an improved QoL. SUD+ADHD and SUD-ADHD patients may benefit from individualized treatment strategies. | en_US |
dc.description.sponsorship | Helse Nord RHF
3925/RUS983-10. | en_US |
dc.identifier.isbn | 978-82-7589-670-2 | |
dc.identifier.uri | https://hdl.handle.net/10037/18252 | |
dc.language.iso | eng | en_US |
dc.publisher | UiT The Arctic University of Norway | en_US |
dc.publisher | UiT Norges arktiske universitet | en_US |
dc.relation.haspart | <p>Paper I: Flores-Garcia, L., Ytterstad, E., Lensing, M.B. & Eisemann, M. (2016). Exploring Personality and Readiness to Change in Patients With Substance Use Disorders With and Without ADHD. <i>Journal of Attention Disorders</i>. Also available at <a href=https://doi.org/10.1177/1087054716677819>https://doi.org/10.1177/1087054716677819</a>. Accepted manuscript version available in Munin at <a href=https://hdl.handle.net/10037/14162>https://hdl.handle.net/10037/14162</a>.
<p>Paper II: Flores-García, L., Lensing, M.B., Bjerke, T.N., Kvalnes, M. & Eisemann, M. (2019). Positive and negative aspects of substance use and treatment goals among substance use disorder patients with and without attention deficit hyperactivity disorder: A qualitative study. <i>Cogent Psychology, 6</i>(1), 1682765. Also available in Munin at <a href=https://hdl.handle.net/10037/16869>https://hdl.handle.net/10037/16869</a>.
<p>Paper III: Flores-García, L., Lensing, M.B., Ytterstad, E.Y. & Eisemann, M. (2019). Quality of life in substance use disorder patients with and without attention deficit hyperactivity disorder 12 months after treatment: a naturalistic follow-up study. <i>ADHD Attention Deficit and Hyperactivity Disorders 11</i>(3), 299-310. Also available at <a href=https://doi.org/10.1007/s12402-019-00297-5>https://doi.org/10.1007/s12402-019-00297-5</a>. Accepted manuscript version available in Munin at <a href=https://hdl.handle.net/10037/16868>https://hdl.handle.net/10037/16868</a>. | en_US |
dc.relation.isbasedon | Samlet inn egne data. | en_US |
dc.rights.accessRights | openAccess | en_US |
dc.rights.holder | Copyright 2020 The Author(s) | |
dc.subject.courseID | DOKTOR-003 | |
dc.subject | VDP::Samfunnsvitenskap: 200::Psykologi: 260 | en_US |
dc.subject | VDP::Social science: 200::Psychology: 260 | en_US |
dc.subject | VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Psykiatri, barnepsykiatri: 757 | en_US |
dc.subject | VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Psychiatry, child psychiatry: 757 | en_US |
dc.title | Substance Use Disorder patients with and without Attention Deficit Hyperactivity Disorder: Exploring differences in personality, substance use-related aspects and quality of life in a naturalistic follow-up study | en_US |
dc.type | Doctoral thesis | en_US |
dc.type | Doktorgradsavhandling | en_US |