title: Cognition and impulsivity in adults with attention deficit hyperactivity disorder with and without cocaine and/or crack dependence.
abstract: BACKGROUND
  Substance use disorder (SUD) is a common comorbidity in adults with attention deficit-hyperactivity disorder (ADHD). However,there have been few studies on cognitive profiles of these patients. Impulsivity is also commonly increased in both disorders. The central aim of this study was to compare cognition and impulsivity in subjects who had ADHD and cocaine dependence (ADHD+COC group) to those with ADHD only (ADHD-noSUD group). We hypothesized that the ADHD+COC group would show more marked cognitive dysfunction and greater impulsivity than their counterparts with ADHD only.
  
  
  METHODS
  A total of 70 adult patients diagnosed with ADHD according to (DSM-IV-TR) criteria were enrolled; 36 with ADHD+COC and 34 with ADHD-noSUD. All study participants were evaluated with a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; the Adult ADHD Self-Report Scale; the Addiction Severity Index; the Alcohol, Smoking and Substance Involvement Screening Test; the Barratt Impulsiveness Scale; and a comprehensive neurocognitive battery.
  
  
  RESULTS
  Compared to individuals with ADHD-noSUD, ADHD+COC individuals had significantly lower mean IQ and higher motor impulsivity. On average, the ADHD+COC group also performed more poorly on tasks assessing verbal skills, vigilance, implicit learning during decision making, and ADHD-noSUD performed more poorly on selective attention, information processing, and visual search.
  
  
  CONCLUSIONS
  Our results support the integrative theory of ADHD based on the cognitive and affective neuroscience model, and suggests that ADHD-noSUD patients have impairments in cognitive regulation, while ADHD+COC patients have impairments in both cognitive and affective regulation.
authors: Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil. Electronic address: carmen1sil@yahoo.com.br.
authors: Carmen S
authors: CS
authors: Miguel
authors: Program for Early Evaluation and Treatment of Psychosis, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
authors: Paula A
authors: PA
authors: Martins
authors: Mackenzie Presbyterian University, Rua da Consolação, 930, 01302-907 São Paulo, SP, Brazil.
authors: Nathalya
authors: N
authors: Moleda
authors: Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
authors: Margarete
authors: M
authors: Klein
authors: (LIM-21, Laboratory for Medical Research 21), specializing in Neuroimaging, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785, 05403-010 São Paulo, SP, Brazil.
authors: Tiffany
authors: T
authors: Chaim-Avancini
authors: Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
authors: Maria A
authors: MA
authors: Gobbo
authors: Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
authors: Tania M
authors: TM
authors: Alves
authors: Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
authors: Maria A
authors: MA
authors: Silva
authors: Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil; Program for Early Evaluation and Treatment of Psychosis, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
authors: Mario R
authors: MR
authors: Louzã
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D019970:Cocaine-Related Disorders / Q000523:psychology*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D011795:Surveys and Questionnaires
keywords: Attention Deficit Disorder with Hyperactivity; Cocaine; Cognition; Decision making; Impulsivity