Abstract

Research Article

A forensic treatment-monitoring study of an adult with attention-deficit disorder with hyperactivity and substance use disorder

Niels Peter Nielsen and Elisabeth H Wiig*

Published: 27 June, 2019 | Volume 3 - Issue 1 | Pages: 001-008

Background: The patient in this study experienced a childhood marked by conflicts within the family, physical abuse, frequent changes of school settings, truancy, and unspecified learning disabilities. After leaving school at age 17, she was chronically depressed, had anger attacks, lacked motivation, refused psychological assistance, and had problems finding work. At age 30, this culminated in an aggravated assault of a female in an urban public space, after which she was referred to the criminal courts. She was granted probation and hospitalized for psychiatric evaluation with follow-up, outpatient psychiatric treatment.

Aim: To present outcomes of longitudinal monitoring of methylphenidate effects on cognition and self-regulation during treatment of attention-deficit disorder with hyperactivity and substance use.

Methods: During more than a year of treatment, psychiatric interviews and norm-referenced assessments of processing-speed and cognitive overhead monitored changes in cognition and substance use.

Results: At baseline, processing-speed measures of reactive and active attention were within the average-normal range, whereas cognitive overhead/shift cost was in the atypically high range, suggestive of ADHD symptomatology. The patient engaged in daily excessive use of cannabis, amphetamines, and other illegal substances. At the end of treatment, cognitive speed was increased and cognitive overhead normalized. With reductions in ADHD symptomatology, the patient used small amounts of cannabis during weekends and showed improved self-regulation, and legal restrictions were discontinued.

Read Full Article HTML DOI: 10.29328/journal.jatr.1001009 Cite this Article Read Full Article PDF

Keywords:

Attention deficit disorder with hyperactivity; Substance use; Pharmacological treatment; Cognition

References

  1. Wiig EH, Nielsen NP, Minthon L, Warkentin S. A Quick Test of Cognitive Speed (AQT): Assessment of parietal function. San Antonio. Psychological Corporation. 2002.
  2. Wiig, EH, Nielsen NP, Minthon L, Warkentin S. A quick test of cognitive speed (AQT). Et kort manual. Swedish. Harcourt/Psych Corp. 2005.
  3. Wiig EH, Nielsen NP, Jacobson J. A quick test of cognitive speed: group patterns of aging from 15 to 85. Percept Mot Skills. 2007; 104: 1067-1075. Ref.: https://tinyurl.com/y2gxt6w4
  4. Nielsen NP, Wiig EH. An additive model for relations between AQT single- and dual-dimension naming speeds. Percept Mot Skills. 2011; 11: 499-508. Ref.: https://tinyurl.com/y5fmf8yn
  5. Nielsen NP, Wiig EH. Validation of the AQT color-form additive model for screening and monitoring pharmacological treatment of ADHD. J Atten Dis. 2011; 17: 187-193. Ref.: https://tinyurl.com/y38ghbs6
  6. Nielsen NP, Wiig EH. AQT cognitive speed and processing efficiency differentiate adults with and without ADHD: A preliminary study. Int J Psychiatry Clin Pract. 2011; 15: 219-227. Ref.: https://tinyurl.com/y6ywodjq
  7. Wiig EH, Nielsen NP. A Quick Test of Cognitive Speed for comparing processing speed and efficiency to differentiate adolescent and adult psychiatric referrals with and without attention-deficit/hyperactivity disorders. Prim Care Companion CNS Dis. 2012; 14. Ref.: https://tinyurl.com/y3ruzhl5
  8. Nielsen NP, Wiig EH, Bäck S, Gustafsson J. Processing-speed can monitor stimulant medication effects in adults with Attention Deficit Disorder with Hyperactivity. Nordic J Psychiatry. 2017; 71: 296-303. Ref.: https://tinyurl.com/yy9oenjv
  9. Magell G, Gustafsson J, Wiig EH, Nielsen NP. Monitoring methylphenidate dose effects in adults with attention deficit disorder with hyperactivity: A validation study. J Neuorsci Neuropsychol. 2018; 2: 104.
  10. Nielsen NP, Wig EH. Review of screening and monitoring treatment of ADHD in adults with processing-speed. 2019.
  11. Volkov ND, Fowler JS, Wang GJ, Swanson JM, Telang F. Dopamine in drug abuse and addiction, Arch Neurol. 2007; 64: 1575-1579. Ref.: https://tinyurl.com/yxvghfzo
  12. Konstenius M, Jayaram-Lindström N, Guterstam J, Beck O, Phillips B, Franck J. Methylphenidate for ADHD and drug relapse in criminal offenders with substance dependence: A 24-week randomized placebo-controlled trial. Addiction. 2014; 109: 440-449. Ref.: https://tinyurl.com/y35nf6x5
  13. Skoglund C, Brandt L, D’Onofrio B, Larsson H., Franck J. Methylphenidate doses in Attention Deficit/Hyperactivity Disorder and comorbid substance use disorders. Eur Neuropsychopharmacol. 2017; 27: 1144-1152. Ref.: https://tinyurl.com/y63eccoz
  14. Arvidsson M, Dahl ML, Franck J, Wiig EH, Nielsen NP. Methylphenidate effects on processing speed in a clinical sample of adults with ADHD and substance use disorder: a pilot study. Nordic J Psychiatry. 2019; 73: 118-124. Ref.: https://tinyurl.com/y4xqw2qv

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