The assessment of adolescents with substance use disorder in terms of executive functions, childhood traumas and peer bullying

Objective: Substance use disorders (USDs) are defined as recurrent diseases that affect a large number of people, with costly consequences. Comorbidity of Attention Deficit Hyperactivity Disorder (ADHD) and psychoactive substance use disorder is known to be high. In our study, the 14-19 age group patients with the diagnosis of substance use disorder, Attention Deficit and Hyperactivity Disorder and the patients with comorbid substance use disorder and ADHD were evaluated in terms of executive functions, childhood trauma and peer bullying, and all three groups were compared with each other and with healthy controls. Methods: Adolescents, aged 14-19 years, who were admitted to the Ege University Children's Psychiatry outpatient clinic and diagnosed with ADHD (n = 30), ADHD and ADHD comorbid SUD (n = 31) and SUD (n=30) and control adolescents of the same age group (n = 33) were included to the study. Sociodemographic data form was given, K-SADS was applied for accompanying symptoms, and cases without additional psychiatric diagnosis were included in the study. Informed consent was obtained from all the subjects indicating that they volunteered to enroll into the study. To all cases, WCST, SKIP, BRIEF-PF, CTQ, PVS, PBS were applied. Results: The mean and standard deviation values of the Executive Function Indicator scores in the YİDÖÖ-ABF are as follows: SUD = 128.5 ± 25.9, SUD + ADHD = 163.5 ± 23.8, ADHD = 146 ± 26.1, Control = 99 ± 15.2. In the further analysis made on the score of executive function indicator; there was a statistically significant difference between Control / SUD (p = 0.004), Control / ADHD (p = 0.000), Control / SUD + ADHD (p = 0.000), and SUD / SUD + ADHD (p = 0.000) groups. The results of the groups in SKIP that evaluate impulsivity were similar. When WCST results were examined, it was found that substance abuse groups (SUD, SUD+ ADHD) had more distruption and were similar among themselves; ADHD and control groups were also similar. Compared to the groups in terms of the CTQ, the scale score was higher in the substance use groups and statistically significant difference was found between the groups (p = 0.000). Considering the cases of victims of peer bullying, all patient groups (SUD, SUD + ADHD, ADHD) were significantly higher than the control group. It was seen that the highest score in the patient groups was in the SUD + ADHD group. In terms of peer bullying, substance use groups (SUD, SUD + ADHD) were found to have higher scores, on the other hand ADHD and control groups were similar. Subjects with conduct disorder were not included into the study. It has been found that substance abuse can be a factor to increase peer bullying irrespective of conduct disorder. Conclusion: Deterioration of executive functions was found in cases with SUD. It has been determined that ADHD has more impairment in SUD comorbid ADHD cases. Childhood trauma was found to be more frequent in substance use cases, and ADHD comorbidity did not make a difference. In terms of behaviors of peer bullying and being a victim of bullying, there was no statistically significant difference between ADHD and ADHD+SUD groups, although higher scores were determined in the SUD + ADHD cases. ADHD did not effect bullying but substance use increased both the risk of bullying and being bullied. Substance use increases the likelihood of peer bullying regardless of behavioral disorder. Substance use and peer bullying are factors that make adolescents' life difficult. This conclusion should be taken into account when implementing conservation programs.