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Objective: This study aimed to investigate ADHD in adult outpatients seeking treatment for a behavioral addiction and to identify the specificity of psychopathological features if the behavioral addiction cooccurs with adult ADHD. Method: Sixty-five outpatients consulting for a behavioral addiction were assessed for ADHD (DIVA-5), addictive disorder (alcohol, tobacco, cannabis, gambling, gaming, food, and sex), impulsivity (UPPS-P), and emotion dysregulation (DERS-36). Results: In our sample of outpatients seeking treatment for a behavioral addiction, adult ADHD was independently associated with higher compulsive sexual behavior disorder severity, “sensation seeking,” “positive urgency,” difficulties in “goal-directed behavior,” “impulse control,” and use of “emotion regulation strategies” in the context of intense emotions. A 29% of the sample was diagnosed for adult ADHD. Conclusion: The association of adult ADHD with specific dimensions of impulsivity and emotion dysregulation, pave the way for future clinical and research perspectives.

Objective: Increasing number of studies show an association between adult ADHD (a-ADHD) and posttraumatic stress disorder (PTSD). We explored this association in alcohol use disorder (AUD) inpatients. Method: In total, 551 inpatients cross-sectionally completed self-administered questionnaires regarding sociodemographics, lifetime trauma exposure, PTSD Checklist for DSM-5, Adult ADHD Self-Report Scale (ASRS), and Wender Utah Rating Scale (WURS). We considered self-reported a-ADHD when ASRS and WURS had significant scores. Results: Prevalence for a-ADHD was 20%. PTSD prevalence was higher in a-ADHD patients (84% vs. 40%; p < .001). They also were younger ( p < .001) and women ( p = .015). Adult ADHD was associated with more traumatic events, and symptoms were correlated with PTSD severity. After adjusting for age, gender and marital status, PTSD severity was associated with a-ADHD. Conclusion: Our study confirms that a-ADHD is associated with PTSD in AUD inpatients, and thus, may represent a specific subpopulation. Future studies should explore implication of this dual diagnosis on AUD and treatment outcome.

Post-traumatic stress disorder (PTSD) is highly prevalent among patients hospitalized for an alcohol use disorder (AUD). Hospitalization can improve PTSD and AUD outcomes in some but not all patients, but we lack data on the baseline predictors of PTSD non-remission. This study aimed to determine the baseline risk factors for non-remitted PTSD in patients hospitalized for an AUD. Of 298 AUD inpatients recruited in a rehabilitation center (Le Courbat, France), we included 91 AUD inpatients with a co-occurring PTSD and a longitudinal assessment at baseline (T1) and before discharge (T2: 8 weeks later). Patients were assessed for PTSD diagnosis/severity (PCL-5=PTSD Checklist for DSM-5), different types of trauma including childhood trauma (LEC-5=Life Events Checklist for DSM-5/CTQ-SF=Childhood Trauma Questionnaire, Short-Form), and AUD diagnosis/severity (clinical interview/AUDIT=Alcohol Use Disorders Identification Test). Rate of PTSD remission between T1 and T2 was 74.1%. Non-remitted PTSD at T2 was associated with a history of childhood trauma (physical, emotional or sexual abuse, physical negligence), but not with other types of trauma experienced, nor baseline PTSD or AUD severity. Among patients hospitalized for an AUD with co-occurring PTSD, PTSD remission was more strongly related to the existence of childhood trauma than to AUD or PTSD severity at admission. These patients should be systematically screened for childhood trauma in order to tailor evidence-based interventions.

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Background: In police officers, posttraumatic stress disorder (PTSD) is associated with alcohol use disorder (AUD), but we lack data on the association between PTSD and other substance-related and addictive disorders. Objectives: We assessed whether PTSD could be a risk factor for different substance-related and addictive disorders in police officers, including alcohol, tobacco, cannabis, and gambling. Method: This cross-sectional study included all police officers admitted consecutively for alcohol to an inpatient ward dedicated to police officers (Le Courbat rehabilitation center, France; n= 133). Each patient completed self-administered questionnaires that assessed lifetime exposure to potentially traumatic events (Life Event Checklist for DSM-5), PTSD severity and diagnosis (PTSD Checklist for DSM-5), AUD severity (Alcohol Use Disorder Identification Test [AUDIT]), tobacco dependence (Fagerström test for Nicotine Dependence), cannabis dependence (Cannabis Abuse Screening test), and gambling disorder (Canadian Problem Gambling Index). Results: Mean AUDIT score was 23.7 ± 8.0; 66.2% had an AUDIT score ≥20. Our sample comprised a high prevalence for PTSD (38.3%) and for substance-related and addictive disorders: tobacco dependence (68.4%), cannabis dependence (3.8%), and pathological gambling (3%). Patients with PTSD experienced higher lifetime exposure to traumatic experiences: physical assault, severe human suffering, sudden accidental death of another person, and other types of stressful events/experiences. In multiple linear regressions adjusted for age, sex, and marital status, PTSD was a significant predictor of the severity of AUD and tobacco use disorder, but not of the severity of cannabis use disorder nor gambling disorder. Conclusions: PTSD is common in police officers hospitalized for alcohol and associated with a higher severity of some addictive disorders (alcohol/tobacco). PTSD and its comorbid addictive disorders should be systematically screened and treated in this population.

Resume Le concept d’addiction a l’alimentation fait l’hypothese qu’il est possible de developper une addiction vis-a-vis de certains aliments (i.e., aliments riches en sucre, en graisse ou en sel, notamment les aliments industriels), avec des symptomes similaires aux autres addictions : craving et perte de controle vis-a-vis de ces aliments, existence de dommages et poursuite du comportement malgre les dommages. L’objectif de cet article etait de presenter une revue du concept d’addiction a l’alimentation : pertinence du modele addictif pour certaines formes de compulsions alimentaires, origines, modalites de mesure (questionnaires « Yale Food Addiction Scale original » et « Yale Food Addiction Scale 2.0 », bases sur l’extrapolation des criteres DSM-IV-TR et DSM-5 de troubles addictifs au domaine de l’alimentation) et presentation d’implications pour certains patients dont les patients en transplantation hepatique, en chirurgie bariatrique et ceux souffrant d’un TDAH (Trouble Deficit de l’Attention avec ou sans Hyperactivite) associe a une obesite.

Introduction La chirurgie bariatrique (BS) est un traitement de choix dans l’obesite morbide. Le tabagisme est un enjeu de sante publique majeur et est associe avec un poids plus faible en population generale et chez des candidats a la BS. Le risque peri-operatoire chez les patients fumeurs est bien documente mais aucune etude n’a etudie le lien entre l’histoire ponderale chez ces patients en fonction du statut tabagique. Notre objectif etait de comparer [1] l’histoire ponderale et [2] les traits de personnalite entre les patients fumeurs et non fumeurs. Materiels et Methodes Le statut tabagique a ete determine par la consommation quotidienne d’au moins une cigarette. Ont egalement ete recueillis les donnees socio-demographiques, l’histoire ponderale (poids, indice de masse corporelle (IMC) actuel et maximal, âge de debut de l’obesite et duree de l’obesite), les traits de personnalite par la Big Five inventory, l’impulsivite par la Barratt Impulsiveness Scale, et l’alexithymie par la Toronto Alexithymia Scale chez 329 candidats a la BS ayant consulte au Centre specialise de l’obesite du CHRU de Tours. Resultats La prevalence du tabagisme etait de 25.2 %. Les patients fumeurs consultaient plus jeunes, avaient une duree d’evolution de l’obesite plus courte mais il n’y avait pas difference en terme d’IMC actuel ou d’IMC maximal. Ils avaient un caractere consciencieux plus faible et un nevrosisme, une impulsivite et une alexithymie plus elevee. Discussion Les patients fumeurs candidats a la BS ont une evolution plus rapide vers l’obesite et des traits de personnalite similaires aux patients souffrant d’autres troubles addictifs. Il y a un interet au sevrage tabagique avant la BS et d’integrer la prise en charge du tabagisme dans une approche psychopathologique commune plutot qu’une approche par produit.

Summary Introduction Women's addiction to alcohol remains a taboo subject, whereas one third of alcohol-dependent people are female. Social representations concerning them are very unfavorable. Their alcoholism is usually accompanied by strong feelings of guilt, depreciation and lowered self-esteem. There is little existing work about self-esteem in women who have become abstinent. This study's goal is to compare the self-esteem of women who are alcohol-dependent and the self-esteem of women who have become abstinent in various domains (social, familial, professional). Methods The sample contained 71 women divided into three groups: 31 alcohol-dependent women (average age of 44.9); 20 alcohol-dependent women who had become abstinent for at least two months (average age of 44.7) and 20 women who formed the control group (average age of 44.4). The material was put together from the Self-Esteem Inventory (SEI, adult version of Coopersmith 1981). It includes 58 items divided into four sub-categories (general self-esteem, social, familial and professional) and a scale for falsehoods. The SEI was self-administered. The statistics were produced entirely with non-parametric tests: Mann-Whitley U Test for the comparison of two independent samples and Kruskal-Wallis Anova for the comparison of three independent samples. Results A significant difference was found for general self-esteem ( P = 0.001), familial ( P = 0.01) and professional ( P = 0.03) between the three groups of women (alcohol-dependent, alcohol-dependent who had become abstinent and women from the control group). There was no statistical difference for social self-esteem or the lying scale. There was a difference between alcohol-dependent women and the control group in general self-esteem ( P = 0.0001), familial self-esteem ( P = 0.01) and professional self-esteem ( P = 0.002), as well as between women who had become abstinent and women from the control group in general self-esteem ( P = 0.02), familial self-esteem ( P = 0.005) and professional self-esteem ( P = 0.07; ns). No difference was found between alcohol-dependent women and women who had become abstinent. Conclusion This study has shown evidence that general, familial and professional self-esteem drops in alcohol-dependent women and in women who had become abstinent compared to a general population. There was no proof of any difference of self-esteem in women who had become abstinent and alcohol-dependent women, although abstinent women seemed to have better general and professional self-esteem while their familial self-esteem seemed to be lower. This study begs the question about self-esteem in women who have become abstinent suggests that self-esteem should be integrated into their treatment.

Women's addiction to alcohol remains a taboo subject, whereas one third of alcohol-dependent people are female. Social representations concerning them are very unfavorable. Their alcoholism is usually accompanied by strong feelings of guilt, depreciation and lowered self-esteem. There is little existing work about self-esteem in women who have become abstinent. This study's goal is to compare the self-esteem of women who are alcohol-dependent and the self-esteem of women who have become abstinent in various domains (social, familial, professional).The sample contained 71 women divided into three groups: 31 alcohol-dependent women (average age of 44.9); 20 alcohol-dependent women who had become abstinent for at least two months (average age of 44.7) and 20 women who formed the control group (average age of 44.4). The material was put together from the Self-Esteem Inventory (SEI, adult version of Coopersmith 1981). It includes 58 items divided into four sub-categories (general self-esteem, social, familial and professional) and a scale for falsehoods. The SEI was self-administered. The statistics were produced entirely with non-parametric tests: Mann-Whitley U Test for the comparison of two independent samples and Kruskal-Wallis Anova for the comparison of three independent samples.A significant difference was found for general self-esteem (P=0.001), familial (P=0.01) and professional (P=0.03) between the three groups of women (alcohol-dependent, alcohol-dependent who had become abstinent and women from the control group). There was no statistical difference for social self-esteem or the lying scale. There was a difference between alcohol-dependent women and the control group in general self-esteem (P=0.0001), familial self-esteem (P=0.01) and professional self-esteem (P=0.002), as well as between women who had become abstinent and women from the control group in general self-esteem (P=0.02), familial self-esteem (P=0.005) and professional self-esteem (P=0.07; ns). No difference was found between alcohol-dependent women and women who had become abstinent.This study has shown evidence that general, familial and professional self-esteem drops in alcohol-dependent women and in women who had become abstinent compared to a general population. There was no proof of any difference of self-esteem in women who had become abstinent and alcohol-dependent women, although abstinent women seemed to have better general and professional self-esteem while their familial self-esteem seemed to be lower. This study begs the question about self-esteem in women who have become abstinent suggests that self-esteem should be integrated into their treatment.

International audience