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## COUMAR Lucie

Addictions et Trouble du Déficit de l'Attention avec ou sans Hyperactivité (TDAH) : étude expérimentale en cas unique

Addictions and Attention Deficit Hyperactivity Disorder (ADHD): single case experimental design

Thèse d'exercice. Médecine. Diplôme d'Études Spécialisées de Psychiatrie. Amiens : 2024

## RÉSUMÉ

**Introduction** Le trouble du déficit de l'attention avec ou sans hyperactivité est associé à un risque accru de développer une addiction avec ou sans substances. L'objectif principal était d'évaluer l'impact d'une prise en charge intégrée du TDAH sur le retentissement fonctionnel et les conduites addictives chez des patients comorbidés. Le protocole comprenait un traitement pharmacologique et un programme d'éducation thérapeutique.

**Matériel et Méthodes** L'étude a été menée au sein du centre d'addictologie Sésame de l'EPSM de la Somme en utilisant la méthodologie expérimentale en cas unique (SCED). 2 séries indépendantes de 3 patients ont été incluses. Les patients ont été évalués sur deux phases (A : baseline, B : intervention) en effectuant des mesures hebdomadaires sur le retentissement fonctionnel du TDAH, les comportements addictifs, l'humeur et l'anxiété. L'analyse des résultats comprenait une analyse visuelle et une analyse statistique.

**Résultats** On retrouve une tendance majoritaire à l'amélioration des symptômes du TDAH et des conduites addictives.

**Conclusion** Cette étude souligne l'importance d'une approche intégrée pour traiter simultanément le TDAH et les addictions. Elle suggère l'efficacité d'une prise en soins combinée pour une meilleure gestion des comorbidités et un impact positif sur la qualité de vie des patients.

## ABSTRACT

**Introduction** Attention deficit hyperactivity disorder is associated with an increased risk for addiction, substance-related or not. The main objective was to evaluate the impact of integrative treatment for adult ADHD on functional impairment and addictive behaviors in comorbid patients. The protocol included pharmacological treatment and a therapeutic education program.

**Materials and Methods** The study has been conducted in Sesame addiction center of EPSM de la Somme using the single case experimental design (SCED). 2 independent series of 3 patients were included. Patients were evaluated weekly on phase A (baseline) and on phase B (intervention) to take measures of the functional impairment, addictive behaviors, mood and anxiety. The analysis of results included a visual and statistical analysis.

**Results** ADHD symptoms and addictive behaviors tend to be improved.

**Conclusion** This study highlights the value of an integrated approach to treat concurrently ADHD and addiction. It suggests the effectiveness of combined treatment on handling comorbidities and thus, a better life.

**Mots-clés** : Trouble déficitaire de l'attention avec hyperactivité, Troubles liés à la consommation de substances psycho-actives, Médecine de l'addiction

**Keywords** : attention deficit hyperactivity disorder, substance use disorders, ADHD, Medicine, Addiction