title: Cognitive and emotional impairments in adults with attention-deficit/hyperactivity disorder and cocaine use.
abstract: Attention-deficit/hyperactivity disorder (ADHD) is an important modulator of cognitive and social functioning in cocaine addiction but it is unclear whether ADHD symptoms and cocaine use display mutually aggravating interaction effects on cognition, social functioning, and depressive symptoms. Therefore, we investigated the interaction of cocaine use and adult ADHD on social and non-social cognition and depressive symptoms.
  
  
  
  Twenty-four cocaine users with (CU+ADHD) and 30 without ADHD (CU-ADHD), 29 cocaine-naïve ADHD patients, and 40 cocaine-naïve healthy controls underwent comprehensive neuropsychological testing including assessment of social cognition (cognitive/emotional empathy and Theory-of-Mind). Additionally, depressive symptoms were measured with the Beck Depression Inventory.
  
  
  
  The effect size of global cognitive impairment was largest in CU+ADHD (d=1.22 vs. controls) followed by CU-ADHD (d=0.74), and cocaine-naïve ADHD patients (d=0.33). A similar pattern appeared regarding depressive symptoms (CU+ADHD: d=1.47; CU-ADHD: d=0.49, ADHD: d=0.34). In the measures of Theory-of-Mind (CU+ADHD: d=0.76; CU-ADHD: d=0.06, ADHD: d=0.01) and cognitive empathy (CU+ADHD: d=0.80; CU-ADHD: d=0.39, ADHD: d=-0.11) only CU+ADHD showed moderate to large impairments. Moreover, two-way analyses of covariance revealed a significant interaction effect of the factors ADHD and cocaine use on depressive symptoms (p<0.05) and Theory-of-Mind (p<0.05) but not on global cognitive performance (p=0.64).
  
  
  
  When occurring together, cognitive impairments associated with both ADHD and cocaine use are largely additive, whereas both factors seem to mutually potentiate one another with respect to mood and mental perspective-taking disturbances. Given the high comorbidity between ADHD and cocaine use, longitudinal studies are needed to investigate the origin of these potentiated impairments.
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wunderli
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Vonmoos
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Stefania M
authors.initials: SM
authors.lastname: Niedecker
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Lea M
authors.initials: LM
authors.lastname: Hulka
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Katrin H
authors.initials: KH
authors.lastname: Preller
authors.affiliation: Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Kurvenstrasse 17, 8006 Zurich, Switzerland.
authors.forename: Markus R
authors.initials: MR
authors.lastname: Baumgartner
authors.affiliation: Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Kurvenstrasse 17, 8006 Zurich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kraemer
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
authors.forename: Erich
authors.initials: E
authors.lastname: Seifritz
authors.affiliation: Swiss Research Institute for Public Health and Addiction, Associated Institute at the University of Zurich and WHO Collaborating Centre, Konradstrasse 32, 8031 Zurich, Switzerland.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Schaub
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Dominique
authors.initials: D
authors.lastname: Eich-Höchli
authors.affiliation: Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland. Electronic address: quednow@bli.uzh.ch.
authors.forename: Boris B
authors.initials: BB
authors.lastname: Quednow
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000523:psychology*; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D021641:Recognition, Psychology; D012919:Social Behavior; D055815:Young Adult
keywords: Affective disorder; Chronic use; Depression; Emotion recognition; Mentalizing; Stimulants