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Impulsivity and Salivary Cortisol Level in Patients With Substance Dependence

Dessoki, Hani H., MBBCH, MSc, MD*; Refaat, Osama, MBBCH, MSc, MD; Salah, Hisham, MBBCH, MSc, MD*; Tahoun, Taghrid, MBBCH, Msc, MRCPsych*; Emadeldin, Maha, MBBCH, MSc, MD*; Khalil, Mohamed A., MBBCH, MSc, MD

Addictive Disorders & Their Treatment: March 2019 - Volume 18 - Issue 1 - p 1–9
doi: 10.1097/ADT.0000000000000142
Original Articles

Objectives: The aim of this work was to study the association between different dimensions of impulsive behavior from one side and addiction-related problems and diurnal salivary cortisol levels from the other side.

Methods: A cross sectional case/control study with 50 subjects consisting 2 equal groups. Subjects were recruited consecutively from Kasr Al-Ainy Psychiatry and Addiction Hospital, Cairo University and were matched for age, sex, and socioeconomic status. Both groups were subjected to Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), Arabic version; UPPS Impulsive Behavior Scale. Patients with substance dependence completed the Addiction Severity Index, Arabic version. Diurnal salivary cortisol level was measured in both groups to reflect baseline activity of the hypothalamo-pituitary-adrenal (HPA) axis.

Results: Patients with substance dependence had statistically significant higher scores on urgency (P=0.000), lack of premeditation (P=0.006), and lack of perseverance (P=0.018) subscales. About 76% had no problem, (20%) had mild problems and (4%) had severe alcohol use problems. Difference between the 2 groups in terms of salivary cortisol levels was not statistically significant (P=0.806).

Conclusions: Substance-dependent subjects scored significantly higher than control subjects on lack of premeditation, urgency, and lack of perseverance traits. There was no relation between diurnal salivary cortisol levels and impulsivity.

*Faculty of Medicine, Beni-Suef University

Faculty of Medicine, Cairo University, Egypt

The authors declare no conflict of interest.

Reprints: Mohamed A. Khalil, MBBCH, MSc, MD, Faculty of Medicine, Cairo University, 8 Mohi El-Deen Abo El-Ezz street, P.O. Box 12311, Dokki, Giza, Egypt (e-mails:;

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