Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

Lugoboni, Fabio; Bertoldi, Anna; Casari, Rebecca; Mantovani, Elisa; Morbioli, Laura; Tamburin, Stefano

doi:10.1159/000507852

Cited by 8 publications

(12 citation statements)

References 52 publications

(99 reference statements)

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“…Adult ADHD symptoms were overrepresented in highdose BZD/Z-drug users, in that 39.4% of our sample was positive to adult ADHD screening with the ASRS v1.1 Symptoms Checklist Part A. This finding is in keeping with our previous report (Lugoboni et al 2020b), and in accordance with studies in other SUD patients (van de Glind et al 2013;Katzman et al 2017), where the prevalence of adult ADHD symptoms was reported up to 8 times higher than the general population (Volkow and Swanson, 2013). At variance with the general population (Chung et al 2019), demographic variables did not differ between ADHD + and ADHD− groups, probably because of the limited age range of our sample.…”

Section: Adult Adhdsupporting

confidence: 92%

“…In keeping with previous studies, all SF-36 dimensions were worse in high-dose BZD/Z-drug users than the general population (Tamburin et al 2017b), and worse in ADHD+ than ADHD− groups (Lugoboni et al 2020b). GHQ-12 scores did not differ according to the positivity to adult ADHD screening that is in contrast to a previous report from our group (Tamburin et al 2017b).…”

Section: The Influence Of Adult Adhd and Cognition On Qolsupporting

confidence: 90%

“…Adult ADHD, neuropsychological Z-scores, and variables (i.e., sex, age, education, BZD/Z-drug active principle, and DDDE) that we found to significantly influence QoL in highdose BZD/Z-drug users in previous studies (Tamburin et al 2017b;Lugoboni et al 2020b) were entered as covariates in the multivariate analysis with QoL measures as dependent variables.…”

Section: Multivariate Analysismentioning

confidence: 99%

“…A validated screening tool for adult ADHD with good accuracy and short application time might be used in the clinical setting (van de Glind et al 2013). We have previously documented that a screening test for adult ADHD may be positive in approximately one-third of high-dose BZD and Z-drug users (Tamburin et al 2017c), and that adult ADHD is associated with worse QoL in this population (Lugoboni et al 2020b).…”

Section: Introductionmentioning

confidence: 98%

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Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug

et al. 2020

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High-dose use of benzodiazepines (BZDs) and Z-drugs was found to be associated with adult attention deficit/hyperactivity disorder (ADHD) and multidomain cognitive deficits, but the interplay between these factors and its effect on quality of life (QoL) is unclear. We explored (a) whether cognitive dysfunction differs in high-dose BZD/Z-drug users with and without adult ADHD and (b) the impact of cognitive deficits and adult ADHD on QoL in this substance-use disorder (SUD). From January 2015 to December 2019, we recruited 207 high-dose BZD/Z-drug users seeking treatment. We assessed the presence of adult ADHD with a screening tool, which was validated in SUD patients, and collected demographic, clinical and QoL data from the 76 included patients. A neuropsychological battery explored five cognitive domains. We found that: (a) screening for adult ADHD was frequently positive; (b) Short Form-36 (SF-36), a self-administered QoL questionnaire, was worse than the general population and worse in patients positive (ADHD+) vs. those negative (ADHD−) to ADHD screening tool; (c) executive function was significantly worse in ADHD+ than ADHD− patients; (d) some SF-36 dimensions were negatively influenced by executive dysfunction; (e) multivariate analysis showed an interplay between adult ADHD and cognitive dysfunction in worsening QoL. We documented a complex interplay between adult ADHD, cognitive dysfunction and QoL in high-dose BZD/Z-drug users. Assessing adult ADHD, neuropsychological measures and QoL may offer a full scenario of these patients, who are frequently impaired in everyday activities. Future research should explore whether pharmacological treatment might improve cognitive dysfunction and QoL in this SUD.

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Section: Adult Adhdsupporting

confidence: 92%

Section: The Influence Of Adult Adhd and Cognition On Qolsupporting

confidence: 90%

Section: Multivariate Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug

et al. 2020

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“…2,6 Lastly, regarding zolpidem's hazardousness, we would like to report the fact that zolpidem was significantly preferred by addicts with a positive ADHD test result. 5 These data should be kept in mind by institutions and services that study and handle neurodevelopmental issues.…”

mentioning

confidence: 99%

Zolpidem: A masked hero. A reply to ZORRO study

Lugoboni

Casari

Fusina

et al. 2021

Brit J Clinical Pharma

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Benzodiazepine high‐doses: The need for an accurate definition

Cloos¹,

Cow²,

Bocquet

2021

Int J Methods Psych Res

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Objectives A clear definition of what we understand of high‐dose misuse or of a ‘markedly increased dose’ (as stated by the DSM‐5) is important and past definitions may be inadequate. The aim of this review is to describe the different definitions used and to test these definitions for their accuracy. Methods A narrative PubMed literature review was conducted based on articles published between 1 January 1990 and 31 December 2020 describing benzodiazepines (in MeSH Terms or MeSH Major Topic) and high‐dose (or high‐dosage). Specific definitions were applied to a population sample to show how definitions affect high‐dose benzodiazepine prevalence. Results Multiples of an equivalent‐diazepam dose or of the World Health Organization ‘defined daily dosage’ were used more frequently than the overstep of the recommended maximum therapeutic dosage as a cut‐off point. Conclusion High‐dose use is rare but the prevalence in the general population varies among studies, mainly due to different definitions, making both clinical and epidemiological comparisons between studies difficult. Defining a high‐dose user as a person who takes at least a higher dose than the maximum usual therapeutic dose over a defined period of time therefore appears to be clinically more consistent.

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Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

Cited by 8 publications

References 52 publications

Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug

Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug

Zolpidem: A masked hero. A reply to ZORRO study

Benzodiazepine high‐doses: The need for an accurate definition

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