ADHD: Gaps Between Patients With Alcohol-dependence and Impact on Relapse

Study Overview
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Brief Summary
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Some recent studies have found that adult attention deficit - hyperactivity disorder (ADHD) was frequent among patients with alcohol-dependence. However, no investigation has ever addressed whether ADHD may impact the drinking outcome. Moreover, most of the different aforementioned studies assessed ADHD using the ADHD self-report scale (ASRS). The ASRS is a screening questionnaire that is of limited diagnostic value, and the overrepresentation of high-score ASRS among patients with alcohol-dependence could be in part due to differential diagnoses such as antisocial or borderline personality disorders, executive function impairments, or isolated impulsiveness. The study aims to evaluate ADHD: Gaps between patients with Alcohol Dependence and Impact on early Relapse (AGADIR). In AGADIR, subjects with alcohol-dependence are recruited at the end of a residential detoxification program. They are assessed for ADHD using the ASRS, but also with a standardized diagnostic tool, i.e., the Diagnostic Interview for ADHD in adults (DIVA 2.0). Potential differential diagnoses are screened during the baseline visit. The patients are followed-up during the 12 first post-detox weeks, through a standardized psychosocial treatment. ASRS is re-performed at the end of the follow-up.

Official Title
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Impact of Attention Deficit/Hyperactivity Disorder on the Post-detoxification Alcohol Relapse Rate

Conditions
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Alcoholism, Attention Deficit Disorder With Hyperactivity

Intervention / Treatment
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* Behavioral: cognitive and psychiatric assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: current DSM-IV-Tr criteria for alcohol-dependence current residential alcohol detoxification program Non-inclusion Criteria: concurrent alcohol withdrawal symptoms, i.e., CIWA-Ar ≥ 10 benzodiazepine diazepam-equivalent dose > 30 mg medical history of neurological impairment (excluding alcohol-induced cognitive disorders) guardianship or loss of liberty pregnant or lactating woman

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Post-Detox Cohort<br>All the patients included should meet Diagnostic and Statistical Manual 4th edition revised (DSM-IV-Tr) criteria for Alcohol Dependance. They are all recruited at the end of an inpatient alcohol detoxification process (see inclusion criteria). The initial screening is performed just before the end of hospitalization. The subsequent follow-up is 12 weeks-long. There is no drug for abstinence maintenance during the study. The psychosocial intervention is based on the BRENDA model. | Behavioral: cognitive and psychiatric assessment<br>* Administered at baseline: Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) hyperactivity : Adult ADHD Self-Report Scale (ASRS), Wenders-Utah Rating Scale (WURS), Diagnostic Interview for Adult ADHD 2nd edition (DIVA 2.0) psychiatric history : Mini International Neuropsychiatric Interview 5th edition (MINI 5.0), Personality Disorder Questionnaire for the DSM-IV (PDQ-4) cognitive functions : Frontal Assessment Battery (FAB), Montreal Cognitive Assessment (MoCA) impulsivity : Barratt's Impulsiveness scale 11th edition (BIS-11) alcohol consumption: alcohol - timeline follow-back (A-TLFB) ,administered at baseline (month before hospitalization), week 4 visit, week 6 visit, and week 12 visit. administered at week 12: ASRS<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulated rate of alcohol relapse | Cumulated rate of alcohol relapse during the 12 weeks following the detoxification program | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychometric properties of the ASRS | Psychometric properties of the ASRS by comparison with the DIVA 2.0 and the screening of differential diagnoses | 12 weeks | 
| Multivariate analysis of the alcohol relapse | Multivariate analysis of the cumulated rate of alcohol relapse during the 12 weeks following the detoxification program | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Attention Deficit Disorder with Hyperactivity, Alcohol Dependence, Adults, Treatment outcome, Mental Health