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We explored (a) whether cognitive dysfunction differs in high-dose BZD\/Z-drug users with and without adult ADHD and (b) the impact of cognitive deficits and adult ADHD on QoL in this substance-use disorder (SUD). From January 2015 to December 2019, we recruited 207 high-dose BZD\/Z-drug users seeking treatment. We assessed the presence of adult ADHD with a screening tool, which was validated in SUD patients, and collected demographic, clinical and QoL data from the 76 included patients. A neuropsychological battery explored five cognitive domains. We found that: (a) screening for adult ADHD was frequently positive; (b) Short Form-36 (SF-36), a self-administered QoL questionnaire, was worse than the general population and worse in patients positive (ADHD+) vs. those negative (ADHD\u2212) to ADHD screening tool; (c) executive function was significantly worse in ADHD+\u2009than ADHD\u2212 patients; (d) some SF-36 dimensions were negatively influenced by executive dysfunction; (e) multivariate analysis showed an interplay between adult ADHD and cognitive dysfunction in worsening QoL. We documented a complex interplay between adult ADHD, cognitive dysfunction and QoL in high-dose BZD\/Z-drug users. Assessing adult ADHD, neuropsychological measures and QoL may offer a full scenario of these patients, who are frequently impaired in everyday activities. Future research should explore whether pharmacological treatment might improve cognitive dysfunction and QoL in this SUD.<\/jats:p>","DOI":"10.1007\/s00702-020-02285-w","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T07:02:55Z","timestamp":1608188575000},"page":"1109-1119","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Adult attention-deficit\/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug"],"prefix":"10.1007","volume":"128","author":[{"given":"Angela","family":"Federico","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Mantovani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Casari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Bertoldi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Lugoboni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1561-2187","authenticated-orcid":false,"given":"Stefano","family":"Tamburin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"2285_CR1","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s12888-018-1803-y","volume":"18","author":"E Ahnemark","year":"2018","unstructured":"Ahnemark E, Di Schiena M, Fredman AC, Medin E, S\u00f6derling JK, Ginsberg Y (2018) Health-related quality of life and burden of illness in adults with newly diagnosed attention-deficit\/hyperactivity disorder in Sweden. 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