الفهرس 
The effect of attention deficit hyperactivity disorder on executive functions in patients with opioid dependence
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Abstract
ADHD is one of the most important comorbid diagnoses seen with opioid use disorder (OUD). When adding ADHD to OUD, this leads to worsening of clinical presentation, prognosis, and treatment outcome. This could be explained by the defect both do in the executive functions.
Aim: to detect the presence of ADHD among patients with opioid dependence and to assess the executive functions and the association between the severity of addiction and executive functions in those patients.
Method: it was a cross-sectional study, conducted on 110 male patients with OUD who were recruited from Psychiatry and Addiction Medicine Hospital, Faculty of Medicine, Cairo University. All subjects were assessed by adult ADHD self-reporting scale (ASRS), whose part A results divided the sample into ADHD group and non-ADHD group. MINI plus 5 was administered to exclude comorbid psychiatric diagnoses. Then the addiction severity and executive functions were assisted in both groups by using Addiction Severity Index (ASI), Frontal Assessment Battery (FAB), Verbal Fluency Test (VFT), Trail Making Test (TMT), digit span and paired associates tests.
Results: 24 patients (21.8%) had ADHD. There was statistically significant difference between both groups in educational level (P= 0.022), employment, legal status and family history domains of ASI (P= 0.008, P= 0.002, P=0.028), the distribution of ADHD group and non-ADHD group according to the total result of FAB, CFT and digit span test (P=0.002, P=0.017, P<0.001) and the score achieved by ADHD group and non-ADHD group according to the total result of FAB, TMT part A&B, digit span test (P=0.022, P=0.006, P=0.030, P=0.002). There was significant association between ADHD severity and digit span test results.
Conclusion: Adult ADHD often presents as an impairing underlying yet underdiagnosed and untreated condition, it worsen the executive functions which is already impaired by substance use and this affects the severity of addiction and impairment of functionality leading to ineffective treatment and higher costs of psychiatric illness.