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Turjeman-Levi Y, Itzchakov G, Engel-Yeger B. Executive function deficits mediate the relationship between employees' ADHD and job burnout. AIMS Public Health 2024; 11:294-314. [PMID: 38617412 PMCID: PMC11007411 DOI: 10.3934/publichealth.2024015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 04/16/2024] Open
Abstract
Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) often face significant deficits in executive function and adverse work-related outcomes. This study aimed to explore the role of executive function deficits in job burnout of employees with ADHD. We hypothesized that employees with ADHD, relative to employees without ADHD, will experience higher levels of job burnout and deficits in executive function. We also hypothesized that the ADHD-job burnout relationship would be mediated through executive function deficits, specifically by self-management to time and self-organization/problem-solving. A field study with 171 employees provided support for the research hypotheses and mediation model in which the employees' ADHD-job burnout relationship was mediated through executive function deficits. Additional mediation analyses indicated that the specific executive function of self-management to time and self-organization/problem-solving mediated the effect of ADHD on job burnout and its facets. Specifically, for physical fatigue, the mediation was realized through self-management to time, and for emotional exhaustion and cognitive weariness, the mediation was significant through self-organization/problem-solving. The present findings shed light on the relevance of referring ADHD among employees, their vulnerability to job burnout, and the role of executive function deficits in job burnout of employees with ADHD.
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Affiliation(s)
- Yaara Turjeman-Levi
- Faculty of Social Welfare and Health Sciences, Department of Human Services, University of Haifa, 199 Aba Hushi Ave. Mount Carmel, Haifa, 3498838, Israel
| | - Guy Itzchakov
- Faculty of Social Welfare and Health Sciences, Department of Human Services, University of Haifa, 199 Aba Hushi Ave. Mount Carmel, Haifa, 3498838, Israel
| | - Batya Engel-Yeger
- Faculty of Social Welfare and Health Sciences, Department of Occupational Therapy, University of Haifa, 199 Aba Hushi Ave. Mount Carmel, Haifa, 3498838, Israel
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Patkar P, Shah H, Sahu S. A mixed-methods study of Indian mothers assessing the effect of the lockdown on the understanding of ADHD in their child and the burden experienced. Ind Psychiatry J 2023; 32:S243-S249. [PMID: 38370930 PMCID: PMC10871433 DOI: 10.4103/ipj.ipj_216_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 07/11/2023] [Accepted: 08/28/2023] [Indexed: 02/20/2024] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed developmental disorders and is common among referrals to child guidance clinics. Aim This study aimed to study the impact of the lockdown during the coronavirus disease 2019 (COVID-19) pandemic on the mother's understanding of ADHD and the burden faced by her. Materials and Methods A mixed-methods design with a combination of a qualitative and quantitative approach was adopted. An in-depth in-person semi-structured interview with the participant's mother was conducted. The qualitative and quantitative part of the study consisted of burden assessment by the Zarit Caregiver Burden Scale. The responses were transcribed, and themes were identified. Results As far as understanding the disorder was concerned, the major themes identified were "Knew about the child's problems from teachers but online schooling made me see the child's issues in person" and "Knew about the illness but more time led to bonding and understanding the child." When questioned about the burden faced, the major themes that evolved were "Increased exhaustion taking care of a child 24/7" and "Increased burden as one felt angry and irritated with the child, the school, and the family." The Zarit caregiver questionnaire revealed a statistically significant difference in the burden of care before and after the pandemic, with a greater number of mothers falling in the mild to moderate and severe categories of burden. Conclusion The COVID-19 pandemic increased the caregiver burden for mothers of children with ADHD. Their understanding of their child's disorder increased significantly as they could spend more time and devise different ways and means of helping their child in academics and other areas.
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Affiliation(s)
- Prajakta Patkar
- Department of Psychiatry, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Henal Shah
- Department of Psychiatry, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Samiksha Sahu
- Department of Psychiatry, Gandhi Medical College, Bhopal, Madhya Pradesh, India
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Adamis D, Kasianenko D, Usman M, Saleem F, Wrigley M, Gavin B, McNicholas F. Prevalence of Personality Disorders in Adults With Attention Deficit Hyperactivity Disorder (ADHD). J Atten Disord 2023; 27:658-668. [PMID: 36927130 DOI: 10.1177/10870547231161531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To estimate the prevalence of PDs according to Millon's evolution-based model among adult ADHD outpatients. METHOD Cross-sectional study of consecutive patients referred to an adult ADHD clinic. PDs were evaluated with Millon Clinical Multiaxial Inventory-III (MCMI-III). RESULTS One-hundred-eighty-one participants had valid MCMI-III, of whom147 were diagnosed with ADHD. Mean age: 32.97, SD:11.56, females: 74 (50.3%). Among the 147 participants with ADHD, 29 (19.7%) did not meet criteria for any PD, 43 (29.3%) met the criteria for one PD, 34 (23.1%) for two PDs and the rest three or more. Most common PD was Dependent (n = 58) followed by Depressive (n = 45). Inattentive sub-type was associated with dependent PD, while combined type with antisocial, negativistic (passive/aggressive) and sadistic PD. CONCLUSION Particular personality profiles were more common with different ADHD subtypes. Given the developmental origins of PD, further research may help identify possible links with childhood difficulties.
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Affiliation(s)
| | | | | | | | - Margo Wrigley
- National Clinical Programme for Adult ADHD, Dublin, Ireland
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Cortese S, Sabé M, Chen C, Perroud N, Solmi M. Half a century of research on Attention-Deficit/Hyperactivity Disorder: a scientometric study. Neurosci Biobehav Rev 2022; 140:104769. [DOI: 10.1016/j.neubiorev.2022.104769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 10/17/2022]
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Doğru H, Esin İS. Counsellors’ position in the child–teacher-parent axis in attention-deficit/hyperactivity disorder and learning disorders. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2022. [DOI: 10.1080/03069885.2022.2089631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Hicran Doğru
- Department of Child and Adolescent Psychiatry, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - İbrahim Selçuk Esin
- Department of Child and Adolescent Psychiatry, Ataturk University Faculty of Medicine, Erzurum, Turkey
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Pham C, Vryer R, O’Hely M, Mansell T, Burgner D, Collier F, Symeonides C, Tang MLK, Vuillermin P, Gray L, Saffery R, Ponsonby AL. Shortened Infant Telomere Length Is Associated with Attention Deficit/Hyperactivity Disorder Symptoms in Children at Age Two Years: A Birth Cohort Study. Int J Mol Sci 2022; 23:ijms23094601. [PMID: 35562991 PMCID: PMC9104809 DOI: 10.3390/ijms23094601] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 12/13/2022] Open
Abstract
Environmental factors can accelerate telomere length (TL) attrition. Shortened TL is linked to attention deficit/hyperactivity disorder (ADHD) symptoms in school-aged children. The onset of ADHD occurs as early as preschool-age, but the TL-ADHD association in younger children is unknown. We investigated associations between infant TL and ADHD symptoms in children and assessed environmental factors as potential confounders and/or mediators of this association. Relative TL was measured by quantitative polymerase chain reaction in cord and 12-month blood in the birth cohort study, the Barwon Infant Study. Early life environmental factors collected antenatally to two years were used to measure confounding. ADHD symptoms at age two years were evaluated by the Child Behavior Checklist Attention Problems (AP) and the Attention Deficit/Hyperactivity Problems (ADHP). Associations between early life environmental factors on TL or ADHD symptoms were assessed using multivariable regression models adjusted for relevant factors. Telomere length at 12 months (TL12), but not at birth, was inversely associated with AP (β = −0.56; 95% CI (−1.13, 0.006); p = 0.05) and ADHP (β = −0.66; 95% CI (−1.11, −0.21); p = 0.004). Infant secondhand smoke exposure at one month was independently associated with shorter TL12 and also higher ADHD symptoms. Further work is needed to elucidate the mechanisms that influence TL attrition and early neurodevelopment.
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Affiliation(s)
- Cindy Pham
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
| | - Regan Vryer
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Martin O’Hely
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Toby Mansell
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Fiona Collier
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Christos Symeonides
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Mimi L. K. Tang
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Peter Vuillermin
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Lawrence Gray
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Richard Saffery
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Correspondence:
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Coetzee C, Truter I, Meyer A. Differences in alcohol and cannabis use amongst substance use disorder patients with and without comorbid attention-deficit/hyperactivity disorder. S Afr J Psychiatr 2022; 28:1786. [PMID: 35547103 PMCID: PMC9082225 DOI: 10.4102/sajpsychiatry.v28i0.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background Substance use disorders (SUDs) continue to be a public health problem. Attention-deficit/hyperactivity disorder (ADHD) is seen as a risk factor for SUD. Prevalence of alcohol and cannabis use amongst adults with SUD and comorbid ADHD impacts both disorders cognitively and behaviourally. Aim Our study aimed to compare alcohol and cannabis use between treatment-seeking SUD patients with ADHD and SUD patients without ADHD symptomatology. Setting Various rehabilitation centres, including the South African National Council on Alcoholism and Drug Dependence (SANCA) Centres, and Private and Provincial Government Substance Abuse Treatment Centres. Methods A cross-sectional study of adults on drug rehabilitation was conducted. Data on socio-demographic information and alcohol and cannabis use from 185 post-detox inpatients were collected. Diagnoses were based on DSM-IV criteria. Attention-deficit/hyperactivity disorder diagnosis was confirmed by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). SUD+ADHD (n = 52) and SUD-ADHD (n = 128) groups were compared on alcohol and cannabis use as a function of gender. Results No significant differences in the use of alcohol between the SUD+ADHD and SUD-ADHD groups were found. However, the SUD+ADHD group showed increased cannabis consumption. Especially, the SUD+ADHD females showed an earlier age of onset of cannabis use than the SUD-ADHD females and revealed that they use cannabis for a longer period compared with the SUD-ADHD females and SUD+ADHD and SUD-ADHD males. Conclusion The results revealed the relationship between ADHD and cannabis use, especially amongst females with ADHD and reinforce the need to consider ADHD in cannabis use SUD in clinical interventions.
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Affiliation(s)
- Corné Coetzee
- Drug Utilization Research Unit (DURU), Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
- Department of Pharmacy, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - Anneke Meyer
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
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Cherkasova MV, Roy A, Molina BSG, Scott G, Weiss G, Barkley RA, Biederman J, Uchida M, Hinshaw SP, Owens EB, Hechtman L. Review: Adult Outcome as Seen Through Controlled Prospective Follow-up Studies of Children With Attention-Deficit/Hyperactivity Disorder Followed Into Adulthood. J Am Acad Child Adolesc Psychiatry 2022; 61:378-391. [PMID: 34116167 DOI: 10.1016/j.jaac.2021.05.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/28/2021] [Accepted: 06/01/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe adult outcome of people with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and its several key predictors via a review of 7 North American controlled prospective follow-up studies: Montreal, New York, Milwaukee, Pittsburgh, Massachusetts General Hospital (MGH), Berkeley, and 7-site Multimodal Treatment Study of Children With ADHD (MTA). METHOD All studies were prospective and followed children with a diagnosis of ADHD and an age- and gender-matched control group at regular intervals from childhood (6-12 years of age) through adolescence into adulthood (20-40 years of age), evaluating symptom and syndrome persistence, functional outcomes, and predictors of these outcomes. RESULTS The rates of ADHD syndrome persistence ranged from 5.7% to 77%, likely owing to varying diagnostic criteria and the source of information (self-report vs informant report) across the studies. However, all studies observed high rates of symptomatic persistence ranging from 60% to 86%. The 7 studies were largely consistent in finding that relative to control groups, research participants with childhood-diagnosed ADHD had significant impairments in the areas of educational functioning, occupational functioning, mental health, and physical health as well as higher rates of substance misuse, antisocial behavior, and unsafe driving. The most consistently observed predictors of functional outcomes included ADHD persistence and comorbidity, especially with disruptive behavior disorders. CONCLUSION Childhood ADHD has high rates of symptomatic persistence, which is associated with negative functional outcomes. Characteristics that predict these negative outcomes, such as comorbid disruptive behavior disorders, may be important targets for intervention.
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Affiliation(s)
| | | | | | | | - Gabrielle Weiss
- McGill University, Montreal, and the University of British Columbia, Vancouver, Canada
| | | | | | - Mai Uchida
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Stephen P Hinshaw
- University of California Berkeley and the University of California San Francisco, California
| | | | - Lily Hechtman
- McGill University Health Center, Montreal, Quebec, Canada; Division of Child Psychiatry, McGill University, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
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Harstad EB, Katusic S, Sideridis G, Weaver AL, Voigt RG, Barbaresi WJ. Children With ADHD Are at Risk for a Broad Array of Adverse Adult Outcomes That Cross Functional Domains: Results From a Population-Based Birth Cohort Study. J Atten Disord 2022; 26:3-14. [PMID: 33090057 DOI: 10.1177/1087054720964578] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To identify patterns ("classes") of outcomes for adults with and without childhood ADHD. METHOD Subjects were 232 childhood ADHD cases and 335 non-ADHD referents from a 1976 to 1982 birth cohort. We used latent class analyses to identify classes based on a broad array of adult psychosocial outcomes and determined the proportion of subjects with childhood ADHD within each class. RESULTS A three class solution provided optimal model fit; classes were termed "good," "intermediate," and "poor" functioning. Subjects with childhood ADHD comprised 62.8% of the "poor," 53.5% of the "intermediate," and 24.9% of the "good" functioning class. The "poor" functioning class was distinguished by increased likelihood of legal trouble and substance use disorders and included more individuals with childhood ADHD and psychiatric disorder than the "intermediate" class (45.5% vs. 30.6%). CONCLUSION Children with ADHD are at risk for adverse adult outcomes in multiple domains and co-morbid childhood psychiatric disorders increase risk.
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Dou A, Oram R, Rogers M, DuPaul G. The effects of ADHD symptomatology and academic enabling behaviours on undergraduate academic achievement. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Angela Dou
- School of Psychology University of Ottawa Ottawa Ontario Canada
| | - Rylee Oram
- School of Psychology University of Ottawa Ottawa Ontario Canada
| | - Maria Rogers
- Department of Psychology Carleton University Ottawa Ontario Canada
| | - George DuPaul
- Department of Education and Human Services Lehigh University Bethlehem Pennsylvania USA
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Children and adolescents with ADHD followed up to adulthood: a systematic review of long-term outcomes. Acta Neuropsychiatr 2021; 33:283-298. [PMID: 34384511 DOI: 10.1017/neu.2021.23] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective is to highlight the clinical and social outcomes among adults who suffered from Attention-Deficit Hyperactivity Disorder (ADHD) in their childhood/adolescence. PubMed, PsycINFO, and Scopus databases were searched for prospective studies published during the last 5 years addressing patients with ADHD in childhood/adolescence followed-up to adulthood. We also included studies published before 2015 reported in other reviews with similar outcomes. Thousand four-hundred and eighty-five studies were identified, but only 39 were included for qualitative analysis and 27 for quantitative analysis. Overall, we found that ADHD persisted into adulthood with a mean rate of 43% and was mainly associated with both substance/alcohol use disorders and antisocial behavior and, less frequently, with anxiety and depressive disorders. The prevalence of persistent ADHD in adulthood reported by studies published after 2011 (55%) was higher than that reported by studies published previously from 1985 to 2011 (34%), suggesting a greater focus on ADHD in recent years. Our results highlight that ADHD can be considered not only a neurodevelopmental disorder, but also a persistent and complex condition, with detrimental consequences for quality of life in adulthood.
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Adult-Attention Deficit Hyperactive Disorder Symptoms Seem Not to Influence the Outcome of an Enhanced Agonist Opioid Treatment: A 30-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010997. [PMID: 34682744 PMCID: PMC8535915 DOI: 10.3390/ijerph182010997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/13/2021] [Accepted: 10/16/2021] [Indexed: 11/24/2022]
Abstract
The role of opioids and opioid medications in ADHD symptoms is still largely understudied. We tested the hypothesis that, in Heroin Use Disorder (HUD), when patients are treated with Agonist Opioid medications (AOT), treatment outcome is associated with the presence of Adult Attention-Deficit/Hyperactive Disorder (A-ADHD) symptomatology. A retrospective cohort study of 130 HUD patients in Castelfranco Veneto, Italy, covering 30 years, was divided into two groups according to the Adult ADHD Self-Report Scale (ASRS) score and compared them using demographic, clinical and pharmacological factors. Survival in treatment was studied by utilizing the available data for leaving treatment and relapsing into addictive behavior and for mortality during treatment as poor primary outcomes. Thirty-five HUD subjects (26.9%) were unlikely to have A-ADHD symptomatology, and 95 (73.1%) were likely to have it. Only current age and co-substance use at treatment entry differed significantly between groups. Censored patients were 29 (82.9%) for HUD patients and 70 (73.9%) for A-ADHD/HUD patients (Mantel-Cox test = 0.66 p = 0.415). There were no significant linear trends indicative of a poorer outcome with the presence of A-ADHD after adjustment for demographic, clinical and pharmacological factors. Conclusions: ADHD symptomatology does not seem to exert any influence on the retention in AOT of HUD patients.
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DSM-5 Adult Attention-Deficit/Hyperactivity Disorder: Sex Differences in EEG Activity. Appl Psychophysiol Biofeedback 2021; 46:377-388. [PMID: 34529233 DOI: 10.1007/s10484-021-09522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
This study examined sex differences in the EEG of adults diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD) according to DSM-5 criteria. Sixteen females and 16 males with AD/HD, and age- and sex-matched control groups, had an eyes-closed resting EEG recorded from 19 electrode sites. EEGs were Fast Fourier transformed and estimates for total power, absolute and relative power in the delta, theta, alpha, beta and gamma bands, and the theta/beta ratio, were analysed across nine cortical regions. Males with AD/HD, compared with male controls, had globally reduced absolute beta, globally elevated relative theta, and a larger theta/beta ratio. In contrast, no global effects emerged between females with and without AD/HD. Significant group interactions indicated that globally elevated relative theta and elevated frontal-midline theta/beta ratio noted in males with AD/HD differed significantly from results in females. There are statistically significant EEG differences in relative theta and the theta/beta ratio between males and females with and without AD/HD. These results indicate that AD/HD affects the EEG activity of males and females differently. This study helps confirm the need for further independent examination of AD/HD within female populations.
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Di Lonardo Burr SM, LeFevre JA. The subject matters: relations among types of anxiety, ADHD symptoms, math performance, and literacy performance. Cogn Emot 2021; 35:1334-1349. [PMID: 34253140 DOI: 10.1080/02699931.2021.1955243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In this study, we extended a model of the relations among ADHD symptoms, anxiety, and academic performance. Undergraduates (N = 515) completed self-report measures of anxiety (i.e. trait, test, math, and literacy) and ADHD symptoms. During the study, they completed math and literacy measures and reported their current (i.e. state) anxiety three times. There were significant correlations among ADHD symptoms and all measures of anxiety. However, neither ADHD symptoms nor trait anxiety were correlated with math or literacy performance. Test-anxious students reported increasing state anxiety as the study progressed. In contrast, math-anxious students reported increased state anxiety following the math tasks but not the literacy tasks and literacy-anxious students reported increased state anxiety following the literacy tasks but not the math tasks. With respect to performance, math-anxious students had worse math performance and literacy-anxious students had worse literacy performance whereas test anxiety was not directly related to performance on either math or literacy tasks. Patterns of relations did not differ for men and women, but, except for literacy anxiety, women reported higher levels of all types of anxiety. These results could help educators understand how affective responses are related to university students' academic performance.
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Affiliation(s)
| | - Jo-Anne LeFevre
- Department of Cognitive Science, Carleton University, Ottawa, Canada.,Department of Psychology, Carleton University, Ottawa, Canada
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Zhang J, Li W, Zhang H, Wilson A, Shuai L, Xia W, Wang Z, Qiu M, Wang Y. Callous-unemotional traits in Chinese preschool children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2021; 15:35. [PMID: 34246300 PMCID: PMC8272896 DOI: 10.1186/s13034-021-00388-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD. METHODS A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4-5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child's sex, conduct problems, and oppositional defiant symptoms. RESULTS The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = - 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24-0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable. CONCLUSIONS The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.
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Affiliation(s)
- Jinsong Zhang
- Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China. .,Ministry of Education and Shanghai Key Laboratory of Children's Environment Health, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Wei Li
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ,Ministry of Education and Shanghai Key Laboratory of Children’s Environment Health, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Huifeng Zhang
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ,Ministry of Education and Shanghai Key Laboratory of Children’s Environment Health, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Amanda Wilson
- grid.48815.300000 0001 2153 2936Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lan Shuai
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Weiping Xia
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Zhouye Wang
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Meihui Qiu
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
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16
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Lyhne CN, Pedersen P, Nielsen CV, Bjerrum MB. Needs for occupational assistance among young adults with ADHD to deal with executive impairments and promote occupational participation - a qualitative study. Nord J Psychiatry 2021; 75:362-369. [PMID: 33380255 DOI: 10.1080/08039488.2020.1862911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine perceived aspects of importance among young adults with ADHD to participate and engage in occupational activities, and to explain how support from occupational specialists can assist them to deal with executive impairments. MATERIALS AND METHODS Individual interviews with eight young adults with attention-deficit/hyperactivity disorder. The interview guide was based on assumptions derived from the literature regarding executive functioning and issues related to participation in occupational activities, alongside the needs for social support. Interview transcripts were analysed using qualitative content analysis. RESULTS Four categories emerged from the analysed interviews: (1) Being involved in an occupational environment fulfils a need for social contact, (2) Occupational activities must be clear and within interest (3) Self-confidence and daily routines are prerequisites for occupational participation (4) Having a lifeline providing continuous support is important. CONCLUSIONS Routines, interest and structure in everyday life are important to engage in occupational activities. There is a need for continuous support from a trusted person to establish and maintain healthy daily routines. Occupational specialists can be a vital resource, as they possess specific knowledge on the possibilities for occupation, and additionally, they can fulfil the young adults' needs for continuous support. There is a need for studies questioning how some young adults with ADHD fulfil their work role despite executive impairments. Focusing on executive functioning can be a valuable supplement to the focus on specific diagnoses in research and practice.
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Affiliation(s)
- Cecilie N Lyhne
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Social Medicine and Rehabilitation, Regional Hospital West Jutland, Central Denmark Region, Herning, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Aarhus University, Aarhus, Denmark.,The Centre of Clinical Guidelines - Danish National Clearing House, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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17
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Christiansen MS, Labriola M, Kirkeskov L, Lund T. The impact of childhood diagnosed ADHD versus controls without ADHD diagnoses on later labour market attachment-a systematic review of longitudinal studies. Child Adolesc Psychiatry Ment Health 2021; 15:34. [PMID: 34162422 PMCID: PMC8220843 DOI: 10.1186/s13034-021-00386-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Previous studies have suggested that Attention Deficit Hyperactive Disorder (ADHD) affect individuals across their lifespan, especially in relation to employment. The purpose of this review was to synthesize the results from studies examining the prospective association of ADHD diagnosis in childhood and later education, earnings and employment, compared to children without an ADHD diagnosis. A review protocol was prospectively registered with PROSPERO (ID = CRD42019131634). The findings were reported according to the PRISMA guidelines. The systematic review is based on a structured and preplanned analysis of original prospective longitudinal studies. A total of 2505 potential records were identified, two through backward search. Six papers met the inclusion criteria. One paper was assessed as good, four as fair and one as poor quality. The studies indicated that ADHD diagnosis affected the nature of the individual's attachment to the labour market across different labour market attachment outcomes. Adults with persisting symptoms, had significantly more problems at work. Even if ADHD symptoms desist in adulthood, the negative impact of earlier ADHD symptoms can still be seen on occupational outcomes. Significantly fewer probands had a Bachelor's degree compared to controls. Based on one good quality study and four fair quality studies, it is indicated that patients with childhood diagnosed ADHD, generally experience employment of lower quality compared with peers, in relation to income, education and occupational attainment. The overall level of evidence is rated as poor.
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Affiliation(s)
| | - Merete Labriola
- grid.509009.5NORCE, Norwegian Research Centre AS, Bergen, Norway
| | - Lilli Kirkeskov
- grid.411702.10000 0000 9350 8874Center for Social Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Thomas Lund
- grid.411702.10000 0000 9350 8874Center for Social Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark
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18
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Attention deficit hyperactivity disorder (ADHD) symptoms, comorbid psychopathology, behaviour problems and gastrointestinal symptoms in children and adolescents with autism spectrum disorder. Ir J Psychol Med 2021; 39:240-250. [PMID: 33973506 DOI: 10.1017/ipm.2020.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The study aims to investigate attention deficit hyperactivity disorder (ADHD) symptoms, gastrointestinal (GI) symptoms, comorbid psychopathology and behaviour problems in children and adolescents with autism spectrum disorder (ASD). METHODS Parents of 147 children and adolescents with ASD aged 6-18 years completed the Conners 3 Parent-Short Form, Gastrointestinal Symptom Inventory, Behavior Problems Inventory-Short Form and Autism Spectrum Disorder-Comorbid for Children. RESULTS Fifty-six per cent of children and adolescents had a comorbid diagnosis of ADHD, yet over 70% presented with clinically significant ADHD symptoms. Forty per cent of participants received a diagnosis of ADHD before ASD and 25.6% received a diagnosis of ASD first. Relationships were found between ADHD symptoms and comorbid psychopathology, GI symptoms, and behaviour problems. CONCLUSIONS The outcomes suggest that ADHD is being underestimated as a comorbid disorder of ASD. This may have implications on treatment and interventions for children and adolescents who have a diagnosis of both ASD and ADHD.
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19
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Ito M, Kinjo T, Seki T, Horie J, Suzuki T. The long-term prognosis of hippocampal neurogenesis and behavioral changes of offspring from rats exposed to valproic acid during pregnancy. Neuropsychopharmacol Rep 2021; 41:260-264. [PMID: 33949804 PMCID: PMC8340817 DOI: 10.1002/npr2.12181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/01/2021] [Accepted: 04/08/2021] [Indexed: 01/30/2023] Open
Abstract
Aim In pregnant women with epilepsy, it is essential to balance maternal safety and the potential teratogenicity of anticonvulsants. Recently, growing evidence has indicated that valproic acid (VPA) can produce postnatal congenital malformations and impair cognitive function. However, the mechanisms underlying cognitive dysfunction in long‐term prognoses remain unclear. Methods Pregnant Wistar rats received daily intraperitoneal injections of VPA (200 mg/kg/day) from embryonic day 12.5 until birth. On postnatal day (PD) 149, the rats received an injection of bromodeoxyuridine (BrdU). On PD 150, the rats were subjected to the open field (OF), elevated plus‐maze (EPM), and Y‐maze tests. After behavioral testing, perfusion fixation was performed and the brain was dissected for immunohistochemistry. Results A significant marked decrease was seen in the number of BrdU‐positive cells in the dentate gyrus of offspring of VPA‐treated dams compared to those of control. However, no significant differences in hyperactivity were found based on the results of the OF test among the offspring on PD 150 of 200 VPA‐treated dams. In addition, no significant differences were seen in the EPM test. Conclusion The behavioral abnormality observed in young offspring of VPA‐treated dams was not significantly different from that of controls in adult offspring on PD 150. However, compared with controls, the number of BrdU‐positive cells in VPA‐treated rats was halved. The findings suggest that the behavioral abnormality seems to improve as they grow, even if some structural abnormalities may remain in the central nervous system. Pregnant Wistar rats received daily intraperitoneal injections of VPA (200 mg/kg/d) from embryonic day 12.5 until birth. On postnatal day (PD) 149, the rats received an injection of bromodeoxyuridine (BrdU). A significant marked decrease was seen in the number of BrdU‐positive cells in the dentate gyrus of offspring of VPA‐treated dams compared to those of control.![]()
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Affiliation(s)
- Masanobu Ito
- Department of Psychiatry, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Tomoya Kinjo
- Department of Psychiatry, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Tatsunori Seki
- Department of Histology and Neuroanatomy, Tokyo Medical University, Tokyo, Japan
| | - Junko Horie
- Department of Psychiatry & Behavioral Science, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Toshihito Suzuki
- Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan
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20
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Hanley C, Saleem F, Graffeo I, McCarthy G, Gavin B, McNicholas F, Adamis D. Association of Wender Utah Rating Scale (WURS)-61 items with clinical psychiatric diagnosis in adulthood. Ir J Med Sci 2021; 191:327-335. [PMID: 33665779 DOI: 10.1007/s11845-021-02574-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Wender Utah Rating Scale (WURS) is a widely used retrospective scale in adults presenting for ADHD evaluations which features items relating to childhood symptoms. AIMS The aim of this study is to establish if certain childhood symptoms (including ADHD) as identified by the WURS-61 are associated with specific mental health disorders in adulthood. METHODS Case-control study of N=630 attending Adult Mental Health Services (AMHS) and a control group without mental disorders (N=96). RESULTS The mean age of the participants was 39.81 (SD 12.94) of which 387 (53.3%) were females. There were no significant differences between cases and controls in terms of age (t= 1.829, df 724, p=.068) and gender (x2=1.123, df 1, p=.289). Exploratory factor analysis of WURS-61 reveals 5 factors. Using factor scores and after cross-tabulation, we found that: The presence of childhood impulsivity, emotional lability and distress in addition to inattention/disorganisation were significantly associated with adult ADHD diagnosis (F90). WURS items which suggests childhood conduct problems were associated with a number of adult diagnoses, when present either on its own (psychoactive substance use, or when present in combination with childhood impulsivity, emotional lability and distress (personality disorders). CONCLUSION There is an association between certain childhood behaviours and risk for later development of personality disorders, and psychoactive substance use. There is overlap of childhood symptoms to those who later diagnosed in adulthood with ADHD, personality disorders, and substance abuse.
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Affiliation(s)
- Cliodhna Hanley
- Sligo Mental Health Services, Clarion Rd, Sligo, Ireland.,University College Dublin, Dublin, Ireland
| | - Faisal Saleem
- Sligo Mental Health Services, Clarion Rd, Sligo, Ireland
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21
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Schiweck C, Arteaga-Henriquez G, Aichholzer M, Edwin Thanarajah S, Vargas-Cáceres S, Matura S, Grimm O, Haavik J, Kittel-Schneider S, Ramos-Quiroga JA, Faraone SV, Reif A. Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 124:100-123. [PMID: 33515607 DOI: 10.1016/j.neubiorev.2021.01.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 12/17/2022]
Abstract
Attention-deficit / hyperactivity disorder (ADHD) and Bipolar Disorder (BD) are common mental disorders with a high degree of comorbidity. However, no systematic review with meta-analysis has aimed to quantify the degree of comorbidity between both disorders. To this end we performed a systematic search of the literature in October 2020. In a meta-analysis of 71 studies with 646,766 participants from 18 countries, it was found that about one in thirteen adults with ADHD was also diagnosed with BD (7.95 %; 95 % CI: 5.31-11.06), and nearly one in six adults with BD had ADHD (17.11 %; 95 % CI: 13.05-21.59 %). Substantial heterogeneity of comorbidity rates was present, highlighting the importance of contextual factors: Heterogeneity could partially be explained by diagnostic system, sample size and geographical location. Age of BD onset occurred earlier in patients with comorbid ADHD (3.96 years; 95 % CI: 2.65-5.26, p < 0.001). Cultural and methodological differences deserve attention for evaluating diagnostic criteria and clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide optimal care for both disorders.
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Affiliation(s)
- Carmen Schiweck
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany.
| | - Gara Arteaga-Henriquez
- Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Mareike Aichholzer
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| | - Sharmili Edwin Thanarajah
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany; Max-Planck-Institute for Metabolism Research, Cologne, Germany
| | - Sebastian Vargas-Cáceres
- Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Silke Matura
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| | - Oliver Grimm
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway; Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital, University of Würzburg, Würzburg, Germany
| | - Josep Antoni Ramos-Quiroga
- Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Andreas Reif
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
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22
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Baraskewich J, Climie EA. The relation between symptoms of ADHD and symptoms of eating disorders in university students. The Journal of General Psychology 2021; 149:405-419. [PMID: 33480309 DOI: 10.1080/00221309.2021.1874862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There is evidence to suggest an association between Attention-Deficit/Hyperactivity Disorder (ADHD) and eating disorders (EDs). As those with subclinical symptoms of ADHD or ED often experience impairment, this cross-sectional study examined the relationship between ADHD symptoms and ED symptoms in a predominately subclinical undergraduate population. Students (n = 133; 80% female) completed questionnaires measuring ADHD and ED symptomatology. The relation between overall ADHD symptoms and ED symptoms was examined using linear regression; findings indicated that higher ADHD symptoms significantly predicted higher ED symptoms. When symptoms of both disorders were further delineated, inattentive ADHD symptoms consistently predicted higher ED symptoms (bulimia, body dissatisfaction, and drive for thinness). A number of mechanisms may explain the association between ADHD and ED symptoms, including shared executive function deficits, poor emotion regulation, and mood challenges. These mechanisms may have clinical relevance in ADHD and ED treatment and prevention efforts.
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23
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Childress AC. Novel Formulations of ADHD Medications: Stimulant Selection and Management. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:31-38. [PMID: 34483764 PMCID: PMC8412159 DOI: 10.1176/appi.focus.20200032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric disorder in children and adolescents in the United States. In 2016, approximately 3.8 million U.S. children ages 2 to 17 years with ADHD were being treated with medication. There are approximately 30 different amphetamine (AMPH) and methylphenidate (MPH) formulations on the market. These include immediate-release and extended-release compounds. The extended-release formulations contain various ratios of immediate-release and extended-release components, which determine the pharmacokinetic (PK) profile. For stimulants, the PK and pharmacodynamic (PD) profiles are tightly linked, and the immediate-release and extended-release percentages influence onset and duration of drug effects. Choosing the right stimulant medication for a patient depends on an understanding of the PK/PD profile, the time of day that symptoms are most impairing, the need for morning and evening symptom control and individual patient preferences.
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Affiliation(s)
- Ann C Childress
- Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas
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24
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Wang T, Wang F, Li Y, Shi X, Duan H, Zhou K, Hua Y. Clinical Characteristics of Personality and Conduct Disorders in Child Patients With Vasovagal Syncope: A Clinical Case-Control Study. Front Pediatr 2021; 9:778605. [PMID: 34900878 PMCID: PMC8662341 DOI: 10.3389/fped.2021.778605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To analyze the clinical characteristics of abnormal personality and conduct disorders (CDs) in pediatric patients with vasovagal syncope (VVS). Methods: In this study, we recruited patients diagnosed with VVS at Children's Heart Center from January 2018 to December 2020. Healthy children were recruited as controls. The Eysenck Personality Questionnaire-Child edition (EPQ-C) and Achenbach Child Behavior Checklist (CBCL) were used for the assessment. Results: One hundred and fifty-one VVS patients and 151 healthy controls were included in this study. Compared with the control group, patients in the VVS group had a higher incidence of abnormal personality and were more prone to suffer from CDs. Moreover, pediatric patients with VVS suffered more events of syncope recurrence if they had CDs. Conclusion: Abnormal personality and CDs are common clinical characteristics in pediatric patients with VVS.
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Affiliation(s)
- Tao Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
| | - Fang Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
| | - Yifei Li
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
| | - Xiaoqing Shi
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
| | - Hongyu Duan
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
| | - Kaiyu Zhou
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
| | - Yimin Hua
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu, China
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25
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Peltier MR, Fassett MJ, Chiu VY, Getahun D. Maternal Hypothyroidism Increases the Risk of Attention-Deficit Hyperactivity Disorder in the Offspring. Am J Perinatol 2021; 38:191-201. [PMID: 33086392 DOI: 10.1055/s-0040-1717073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to determine if hypothyroidism prior to, or during, pregnancy increases the risk of attention-deficit hyperactivity disorder (ADHD) in the child and how the association may be modified by preterm birth, sex of the child, and race-ethnicity. STUDY DESIGN Data were abstracted from linked maternal-child medical records. Incidence rate differences (IRDs), adjusted hazard ratios (aHRs), and their 95% confidence intervals (CIs) were estimated to evaluate the association of maternal hypothyroidism with childhood ADHD risk. Stratified analyses were used to evaluate whether the association is affected by timing of first diagnosis, gestational age at birth (term vs. preterm), sex, and race-ethnicity. RESULTS Hypothyroidism diagnosed prior to (IRD = 1.30), or during (IRD = 0.59) pregnancy increases the risk of ADHD in the children (aHR = 1.27; 95% CI: 1.15, 1.41, and 1.17; 95% CI: 1.00, 1.38). The association was strongest when diagnosed during the first trimester (IRD = 0.97 and aHR = 1.28; 95% CI: 1.04, 1.58). For children born preterm, there was significantly increased risk of ADHD if their mothers were diagnosed prior to (IRD = 3.06 and aHR = 1.43; 95% CI: 1.09, 1.88), but not during pregnancy. The effect of maternal hypothyroidism on increased risk of ADHD was stronger for boys (IRD = 1.84 and aHR = 1.26; 95% CI: 1.14, 1.40) than it was for girls (IRD = 0.48 and aHR = 1.19; 95% CI: 1.01, 1.40) and for Hispanic children (IRD = 1.60 and aHR = 1.45; 95% CI: 1.25, 1.68) compared with other race ethnicities. CONCLUSION Exposure to maternal hypothyroidism during the periconceptual period significantly increases the risk of ADHD and that the association varies with gestational age at delivery, child sex, and race-ethnicity. KEY POINTS · Maternal hypothyroidism increases the risk of ADHD diagnosis in the offspring.. · The association of maternal hypothyroidism with childhood ADHD was influenced by timing of diagnosis.. · Strength of the association was strongest in preterm born infants, boys, and Hispanic children..
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Affiliation(s)
- Morgan R Peltier
- Department of Foundations of Medicine, NYU-Long Island School of Medicine, Mineola, New York.,Department of Obstetrics and Gynecology, NYU-Winthrop Hospital, Mineola, New York
| | - Michael J Fassett
- Department of Obstetrics and Gynecology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, California
| | - Vicki Y Chiu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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26
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Triece PA, Oddo LE, Hill RM, Pettit JW, Meinzer MC. Investigation of the interpersonal theory of suicide in the context of attention-deficit/hyperactivity disorder symptomatology and suicide ideation. Suicide Life Threat Behav 2020; 50:1198-1204. [PMID: 32770790 DOI: 10.1111/sltb.12683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/05/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self-reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression. METHOD Participants were 217 college students with elevated depressive symptoms (Mage = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well-being. The sample was predominantly female (77.9% female) and Hispanic (72.7%). RESULTS In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self-reported ADHD symptoms and suicide ideation. CONCLUSION Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.
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Affiliation(s)
| | - Lauren E Oddo
- University of Maryland at College Park, College Park, MD, USA
| | - Ryan M Hill
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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Attention-Deficit/Hyperactivity Disorder (ADHD), antisociality and delinquent behavior over the lifespan. Neurosci Biobehav Rev 2020; 120:236-248. [PMID: 33271164 DOI: 10.1016/j.neubiorev.2020.11.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/28/2020] [Accepted: 11/26/2020] [Indexed: 12/24/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is closely linked to the development of conduct problems during socialization in early life and to an increased risk for antisocial activities and delinquency over the lifespan. The interaction between ADHD and common comorbid disorders like substance use disorders as well as changing environmental conditions could mediate the course of antisocial and delinquent behavior with increasing age. However, this complex interaction is only partially understood so far. This review presents current knowledge about the association of ADHD with antisociality and the development of delinquent behavior. Thereby, the relationships between ADHD, conduct disorder and antisocial personality disorder in offenders are discussed, as well as the impact of comorbid psychiatric disorders and psychosocial conditions on offending behavior. Also, treatment studies in offender populations with ADHD are presented. Although our understanding of the role of ADHD in the development of criminal behavior has substantially improved during the last two decades, more research is needed to further elucidate the mechanisms generating unfavorable outcomes and to engender adequate treatment strategies for this population at risk. Moreover, more attention is needed on children with conduct problems in order to avoid antisocial or delinquent behaviors over the lifespan.
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Abstract
Objective: This research aimed to provide explanations for the inconsistent findings regarding creativity in ADHD. Method: In Study 1, we assessed real-world creative achievements and intrinsic motivation during idea generation in adults with ADHD and compared these with controls. In Study 2, we manipulated competition during idea generation to investigate effects on idea originality in adults with ADHD versus controls, and assessed creativity in specific domains. Results: Adults with ADHD reported more real-world creative achievements. We did not observe differences in intrinsic motivation during idea generation between groups, but adults with ADHD generated more original ideas when competing for a bonus. Moreover, adults with ADHD rated themselves as more creative in specific creative domains. Conclusion: Our findings suggest that goal-directed motivation may drive the enhanced real-world creative achievements of people with ADHD. Moreover, people with ADHD may selectively engage and excel in creative domains that fit their skills and preferences.
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Jeong MY, Lee YJ, Kim JH, Park SY. The Moderating Effect of Working Memory on the Relationship between Inattention and Aggressive Behavior in Attention-Deficit/Hyperactivity Disorder. Soa Chongsonyon Chongsin Uihak 2020; 31:207-213. [PMID: 33110358 PMCID: PMC7584283 DOI: 10.5765/jkacap.200023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/23/2020] [Accepted: 07/02/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives Although aggressive behavior in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) has previously shown correlations with hyperactivity/impulsivity, few studies have examined its association with inattention or the effect of working memory on aggressive behavior. This study aimed to assess the relationship between inattention and aggressive behavior and the effect of working memory on the relationship between inattention and aggressive behavior in children and adolescents with ADHD. Methods Thirty-one children and 26 adolescents with ADHD were retrospectively investigated. The subjects completed the Korean Wechsler Intelligence Scale for Children-Fourth Edition (KWISC-IV), the Korean Child Behavior Checklist (K-CBCL), and the Korean Children’s Depression Inventory (CDI). Results Inattention was positively correlated with aggressive behavior in children and adolescents with ADHD and working memory showed an insignificant correlation. However, working memory had a significant moderating effect on aggressive behavior by interacting with inattention. The moderating effect of working memory manifested when the working memory index score on the K-WISC-IV was 73.5 points or higher, and it had a significant effect on aggressive behavior. Conclusion This study shows that the severity of inattention and hyperactivity/impulsivity should be addressed to provide appropriate treatment to children and adolescents with ADHD who exhibit aggressive behavior.
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Affiliation(s)
- Mi Young Jeong
- Michuhol-gu Community Mental Health Welfare Center, Incheon, Korea
| | - Yeon Jung Lee
- Department of Psychiatry, Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Jung Ho Kim
- Department of Nursing, Masan University, Changwon, Korea
| | - Seo Young Park
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
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Erdogan Bakar E, Karakaş S. Spontaneous age-related changes of attention in unmedicated boys with attention deficit hyperactivity disorder. Clin Neuropsychol 2020; 36:664-698. [PMID: 32954923 DOI: 10.1080/13854046.2020.1801846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Neuropsychological, neuroanatomical, and electrophysiological studies have reported a steady increase in the different attention types until the age of 10 years. Moreover, differences between healthy control (HC) boys and those with attention deficit hyperactivity disorder (ADHD) become nonsignificant in late childhood. This cross-sectional study aimed to perform a comparative analysis of attentional processing in boys with ADHD and HC in the 6:00-10:11 years age range. Methods: Age-related changes in attentional processing were compared between Caucasian Turkic boys (72-131 months of age) with ADHD (n = 144) and HC (n = 112). Selective, focused, and inhibitory attention were measured using the Stroop Test (5 scores); sustained attention was measured using the Cancellation Test (3 scores); and attention span was measured using the Visual Aural Digit Span Test-Revised (6 scores). Results: At the age of 6 years, the ADHD group had a significantly lower performance for all attention types. By the age of 10 years, there were no significant between-group differences. However, the component structure of the neuropsychological test scores in the ADHD group differed from that in the HC group and previous studies. Conclusions: Attentional processing in boys with ADHD changes within the age-range of 6:00-10:00 years where it finally becomes similar to that in HC boys. This delayed maturation is consistent with the maturational lag model of ADHD. However, there was a between-group difference in the component structure of attentional processing, which is consistent with the maturational deviance model of ADHD.
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Affiliation(s)
| | - Sirel Karakaş
- Department of Psychology, Doğuş University, İstanbul, Turkey.,Neurometrika Medical Technologies Research and Development Limited Liability Company, Ankara, Turkey
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31
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Methylphenidate treatment of adult ADHD patients improves the degree of ADHD severity under routine conditions. J Neural Transm (Vienna) 2020; 127:1427-1434. [PMID: 32880706 PMCID: PMC7497302 DOI: 10.1007/s00702-020-02226-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/11/2020] [Indexed: 12/02/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is associated with substantial personal and social impairments. Besides psychosocial interventions, current guidelines recommend a therapy with methylphenidate (MPH). This prospective, non-interventional study aims to investigate the efficacy and tolerability of MPH treatment of adult ADHD patients in a real-world setting. 468 adult patients with newly diagnosed ADHD were observed for 12–14 weeks. Primary efficacy endpoint was the clinical global impression (CGI) by the physician. Secondary endpoints comprise patient evaluation (Wender–Reimherr self-report, WR-SR), safety, tolerability, and dosage of MPH. With a mean daily dose of 35.8 (±17.0) mg MPH, the population of patients being severely/most extremely ill or markedly ill decreased by 64% and 61%, respectively. According to physicians’ assessment (CGI), 74.5% of patients were identified as treatment responders. The total score of patient-based assessment (WR-SR) improved by 23.5% (50.1 ± 40.3 points) with the most profound improvement in attention deficit (−30.0%), disorganization (−26.6%), and hyperactivity / unrest (−23.3%). Self-evaluation revealed a responder rate of 35.4%. In summary, MPH treatment improves the degree of ADHD severity under routine conditions. In addition, activities of daily living were facilitated when taking MPH. The rather poor responder rates determined by patient assessment as well as the comparatively low applied mean daily dose of 35.8 mg (median 40 mg) indicate sub-optimal dosing under routine conditions, not exploiting the full beneficial therapeutic potential of MPH.
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Notzon DP, Pavlicova M, Glass A, Mariani JJ, Mahony AL, Brooks DJ, Levin FR. ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders. J Atten Disord 2020; 24:1487-1492. [PMID: 27033880 PMCID: PMC5568505 DOI: 10.1177/1087054716640109] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To estimate the prevalence of ADHD and determine an effective screening test for ADHD in a population-seeking treatment for cannabis use disorders. Method: The Conners Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; CAADID) was used to generate sensitivity and specificity data for ADHD screening tests, which were then administered to 99 participants seeking treatment for cannabis use disorders to estimate ADHD prevalence. Results: The prevalence estimated from the Wender Utah Rating Scale (WURS) was 45% (sensitivity = 0.88, sensitivity of 0.75), from the Conners Adult ADHD Rating Scale (CAARS) 34% (sensitivity = 0.80, specificity = 0.91), from the WURS + CAARS 36% (sensitivity = 0.71, specificity = 0.95), and from the Adult ADHD Self-Report Scale (ASRS) 46% (sensitivity = 0.61, specificity = 0.86). Conclusion: The prevalence of ADHD in adults seeking treatment for cannabis use disorders is estimated to be between 34% and 46%. The WURS paired with the CAARS provides excellent sensitivity and specificity for the diagnosis of ADHD in this population.
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Affiliation(s)
- Daniel P. Notzon
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| | | | | | - John J. Mariani
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| | | | | | - Frances R. Levin
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
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Pehlivanidis A, Papanikolaou K, Mantas V, Kalantzi E, Korobili K, Xenaki LA, Vassiliou G, Papageorgiou C. Lifetime co-occurring psychiatric disorders in newly diagnosed adults with attention deficit hyperactivity disorder (ADHD) or/and autism spectrum disorder (ASD). BMC Psychiatry 2020; 20:423. [PMID: 32847520 PMCID: PMC7449076 DOI: 10.1186/s12888-020-02828-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. METHODS The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. RESULTS At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). CONCLUSIONS Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
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Affiliation(s)
- Artemios Pehlivanidis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital, 72-74 Vas. Sofias Ave, 11528, Athens, Greece.
| | - Katerina Papanikolaou
- Department of Child Psychiatry, National and Kapodistrian University of Athens, Medical School, “Agia Sophia” Children’s Hospital, 11527 Athens, Greece
| | - Vasilios Mantas
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Eva Kalantzi
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Kalliopi Korobili
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Lida-Alkisti Xenaki
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Georgia Vassiliou
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Charalambos Papageorgiou
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
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Farrington DP, Ahonen L. Rolf Loeber's Research and Life-Course Persistent Offenders. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2020; 30:153-158. [PMID: 32696573 DOI: 10.1002/cbm.2151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/09/2020] [Indexed: 06/11/2023]
Affiliation(s)
| | - Lia Ahonen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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35
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Gin K, Stewart C, Jolley S. A systematic literature review of childhood externalizing psychopathology and later psychotic symptoms. Clin Psychol Psychother 2020; 28:56-78. [DOI: 10.1002/cpp.2493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Kimberley Gin
- King's College London, Department of Psychology Institute of Psychiatry Psychology and Neuroscience London UK
| | - Catherine Stewart
- South London and Maudsley NHS Foundation Trust United Kingdom of Great Britain and Northern Ireland London UK
| | - Suzanne Jolley
- King's College London, Department of Psychology Institute of Psychiatry Psychology and Neuroscience London UK
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Buitelaar NJL, Posthumus JA, Buitelaar JK. ADHD in Childhood and/or Adulthood as a Risk Factor for Domestic Violence or Intimate Partner Violence: A Systematic Review. J Atten Disord 2020; 24:1203-1214. [PMID: 25995243 DOI: 10.1177/1087054715587099] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To date, treatment programs for adult domestic violence (DV) or intimate partner violence (IPV) have had minimal impact. To make treatment more effective, programs should be adjusted to psychopathology of the offender. As emotional lability and poor emotional self-regulation and self-control are common features of ADHD, it may play a pivotal role as a predictor for adult DV/IPV. Method: This systematic review synthesizes the available evidence for childhood and/or adult ADHD being a risk factor for DV/IPV. Results: Four case control studies and three cohort studies were included in the review. Although three case control studies showed positive associations between childhood and/or adult ADHD and adult DV/IPV, two did insufficiently control for the presence of comorbid Conduct Disorder (CD) or Antisocial Personality Disorder (ASPD). Conclusion: Cohort studies identified hyperactive, impulsive, and inattention symptoms as risk factors for adult IPV. CD and ASPD were regarded as mediators in three studies.
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Affiliation(s)
- Nannet J L Buitelaar
- De Forensische Zorgspecialisten, Utrecht, The Netherlands.,Radboud University Nijmegen, The Netherlands
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37
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Sônego M, Meller M, Massuti R, Campani F, Amaro J, Barbosa C, Rohde LA. Exploring the association between attention-deficit/hyperactivity disorder and entrepreneurship. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:174-180. [PMID: 32555982 PMCID: PMC8023171 DOI: 10.1590/1516-4446-2020-0898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/23/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and entrepreneurial profiles and the effects of entrepreneurial characteristics in individuals who screen positive for ADHD and self-identify as entrepreneurs. METHODS We sent 4,341 questionnaires by e-mail to applicants for a career development course for entrepreneurs. We used the propensity score covariate adjustment to balance differences between included and excluded individuals. ADHD symptoms were evaluated with the Adult ADHD Self-Report Scale. The Individual Entrepreneurial Orientation scale was used to assess the entrepreneurial profile of the participants. Impairment from ADHD symptoms was assessed with the Barkley Functional Impairment Scale. RESULTS Those who screened positive for ADHD had higher risk-taking scores (p-value = 0.016) and lower proactivity (p-value = 0.001) than those who screened negative. Higher inattention scores were related to lower proactivity (p-value < 0.001), while higher hyperactive symptom scores were related to a more generalized entrepreneurial profile (p-value = 0.033). Among ADHD-positive participants, entrepreneurial profile scores were not significantly associated with company profits or impairment. CONCLUSIONS Inattention symptoms were related to less proactivity, whereas hyperactive symptoms were positively associated with a general entrepreneurial orientation. ADHD-positive individuals had a higher risk-taking profile, and these characteristics did not negatively impact their lives.
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Affiliation(s)
- Márcio Sônego
- Programa de Transtornos de Déficit de Atenção/Hiperatividade, Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Martin Meller
- Programa de Transtornos de Déficit de Atenção/Hiperatividade, Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafael Massuti
- Programa de Transtornos de Déficit de Atenção/Hiperatividade, Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fausto Campani
- Programa de Transtornos de Déficit de Atenção/Hiperatividade, Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Julia Amaro
- Programa de Transtornos de Déficit de Atenção/Hiperatividade, Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Luis A Rohde
- Programa de Transtornos de Déficit de Atenção/Hiperatividade, Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
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The Transition of Youth with ADHD into the Workforce: Review and Future Directions. Clin Child Fam Psychol Rev 2020; 22:316-347. [PMID: 30725305 DOI: 10.1007/s10567-019-00274-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Previous research suggests that a majority of children with attention-deficit/hyperactivity disorder (ADHD) continue to experience increased impairment across multiple life domains into adulthood. A systematic review of the occupational impairments, and associated educational and financial difficulties, faced by individuals with childhood ADHD was conducted. Systematic searches from PsycINFO and PubMed databases and other sources (i.e., books and consultants with experts) yielded 35 relevant articles that described 19 longitudinal studies on adults with a history of ADHD or related symptoms. Multiple studies indicated that those with a history of ADHD had more educational impairment and were less likely to graduate from high school and college than their peers without a history of ADHD. Subsequently, they faced lower occupational attainment, had more job instability, and demonstrated more impaired job performance, and these outcomes were largely consistent regardless of sex, medication history, or symptom persistence. Similar results were found in clinical and representative national studies in both U.S. and abroad, although older studies tended to indicate less occupational impairment. In addition, ADHD was associated with a number of financial challenges, including lower annual income, more reliance on public aid, and increased risk for homelessness. Future research should use more varied informant sources and utilize innovative measures of occupational impairment at both a macro- and micro-level of analyses. In addition, studies of effective supports and interventions in occupational settings for individuals with ADHD are needed.
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Sobanski E, Brüggemann D, Alm B, Kern S, Philipsen A, Schmalzried H, Heßlinger B, Waschkowski H, Rietschel M. Subtype differences in adults with attention-deficit/hyperactivity disorder (ADHD) with regard to ADHD-symptoms, psychiatric comorbidity and psychosocial adjustment. Eur Psychiatry 2020; 23:142-9. [DOI: 10.1016/j.eurpsy.2007.09.007] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2007] [Revised: 09/26/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022] Open
Abstract
AbstractBackgroundTo date, nearly all research of subtype differences in ADHD has been performed in children and only two studies, with conflicting results, have covered this subject in adults with ADHD.ObjectiveThis study examined subtype differences in the clinical presentation of ADHD-symptoms, related psychopathological features, psychosocial functioning and comorbid psychiatric disorders in adults with ADHD.MethodOne hundred and eighteen adults with ADHD, diagnosed according to DSM-IV criteria, and a population based control group underwent diagnostic evaluations with clinical interviews for ADHD, DSM-IV disorders and demographic features. Comparisons were made between ADHD combined type (n = 64), predominantly inattentive type (n = 30) and predominantly inattentive type, anamnestically combined type (n = 24), relative to each other and to a community control group (n = 70).ResultsThe four groups did not differ in age and gender composition. All ADHD groups had significantly less education, were significantly more often unemployed and reported significantly more lifetime psychiatric comorbidity than controls. In comparison to each other, the three ADHD groups differed mainly in core symptoms and the pattern of comorbid psychiatric disorders, whereas no prominent differences in associated psychopathological features and most of the assessed psychosocial functions could be found. Patients with ADHD combined type and inattentive, anamnestically combined type both presented with significantly more hyperactive symptoms and also showed more impulsive symptoms than those with the predominantly inattentive type. With a similar overall lifetime psychiatric comorbidity in the three groups, patients with ADHD combined type and inattentive, anamnestically combined type suffered significantly more from lifetime substance use disorders than patients with predominantly inattentive type.ConclusionOur results clearly show impaired psychosocial adjustment and elevated risk for additional psychiatric disorders in adults with all subtypes of ADHD, compared to healthy controls. They provide preliminary evidence that in adult ADHD there might be a subgroup of patients, which is classified as predominantly inattentive subtype according to current diagnostic criteria, but which in its clinical presentation is in between ADHD combined and inattentive type. Further studies are needed to evaluate this finding and to gain a clear picture of its validity.
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The effect of serotonin transporter gene promoter polymorphism on adolescent and adult ADHD symptoms and educational attainment: A longitudinal study. Eur Psychiatry 2020; 28:372-8. [DOI: 10.1016/j.eurpsy.2012.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 04/25/2012] [Accepted: 04/26/2012] [Indexed: 02/02/2023] Open
Abstract
AbstractIntroduction:The purpose of this longitudinal study was to investigate the relationship between the 5-HTTLPR genotype, symptoms of ADHD in adolescence and adulthood, and educational attainment in a population representative sample. Neuroticism, depressive symptoms and general mental abilities were controlled for as possible confounding factors.Methods:ADHD symptoms were reported at age 15 and 18 by teachers using the Hyperactivity Scale of af Klinteberg and SNAP-IV, and self-reported at age 25 using the ASRS. Data about education were reported at age 25.Results:At age 15, subjects with the l/l genotype had more concentration difficulties compared to s-allele carriers, and they also had more inattention symptoms according to SNAP-IV at age 18. These results were not altered by taking neuroticism or depressive symptoms into account. No 5-HTTLPR genotype effect on self-reported ADHD symptoms at age 25 was found. Inattention symptoms in adolescence were associated with lower education in young adulthood. The proportion of subjects with higher education at age 25 was significantly larger among s/s genotype compared to the l/l or s/l genotype.Conclusions:The l/l genotype of the 5-HTTLPR is associated with inattentive symptoms during adolescence in the general population, and increases the likelihood of inferior educational level in young adulthood.
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Cairncross M, Miller CJ. The Effectiveness of Mindfulness-Based Therapies for ADHD: A Meta-Analytic Review. J Atten Disord 2020; 24:627-643. [PMID: 26838555 DOI: 10.1177/1087054715625301] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: Mindfulness-based therapies (MBTs) have been shown to be efficacious in treating internally focused psychological disorders (e.g., depression); however, it is still unclear whether MBTs provide improved functioning and symptom relief for individuals with externalizing disorders, including ADHD. To clarify the literature on the effectiveness of MBTs in treating ADHD and to guide future research, an effect-size analysis was conducted. Method: A systematic review of studies published in PsycINFO, PubMed, and Google Scholar was completed from the earliest available date until December 2014. Results: A total of 10 studies were included in the analysis of inattention and the overall effect size was d = -.66. A total of nine studies were included in the analysis of hyperactivity/impulsivity and the overall effect was calculated at d = -.53. Conclusion: Results of this study highlight the possible benefits of MBTs in reducing symptoms of ADHD.
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DuPaul GJ, Eckert TL. The Effects of School-based Interventions for Attention Deficit Hyperactivity Disorder: A Meta-Analysis. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.1997.12085845] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Price A, Newlove-Delgado T, Eke H, Paul M, Young S, Ford T, Janssens A. In transition with ADHD: the role of information, in facilitating or impeding young people's transition into adult services. BMC Psychiatry 2019; 19:404. [PMID: 31847827 PMCID: PMC6918680 DOI: 10.1186/s12888-019-2284-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Many national and regional clinical guidelines emphasise the need for good communication of information to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates only a minority of young people in need of transition for Attention Deficit Hyperactivity Disorder (ADHD) experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative study explored the role that information plays in experiences of transition from the perspectives of parent/carers and young people. METHODS Participants were recruited from 10 National Health Service Trusts, located across England, with varying service configurations. Ninety two qualitative interviews were conducted: 64 with young people with ADHD at different stages relative to transition, and 28 with parent/carers. Thematic analysis of data was completed using the Framework Method. RESULTS Interviewees reported a range of experiences; however reliance on parent/carers to gather and translate key information, and negative experiences associated with poor communication of information, were universal. Three themes emerged: Navigating information with help from parents; Information on ADHD into adulthood; Information about the transition process. The first revealed the essential role of parent in the translation and application of information, the other two explored distinct types of information necessary for a smooth transition. Interviewees made recommendations for clinical practice similar to UK (United Kingdom) National Institute for Health and Care Excellence (NICE) guidelines, with an additional emphasis on providing nuanced information on ADHD as a potentially long term condition. It was important to interviewees that General Practitioners had a basic understanding of adult ADHD and also had access to information about service provision. CONCLUSIONS Our findings illustrate that the availability and communication of information to young people and their parent/carers is an essential component of the transition process between child and adult ADHD services. How and when it is provided may support or impede transition. This study constitutes a substantial contribution to the evidence base, drawing on interviews from a range of participants across England and from Trusts offering different types of services.
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Affiliation(s)
- Anna Price
- University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | | | - Helen Eke
- University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Moli Paul
- Stratford CAMHS, Coventry and Warwickshire Partnership Trust, Stratford Healthcare, Stratford upon Avon, CV37 6NQ UK
- Honorary Associate Clinical Professor of Psychiatry, University of Warwick, Coventry, CV4 7AL UK
| | | | - Tamsin Ford
- University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Astrid Janssens
- University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
- Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, DK-5000 Odense, Denmark
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Hadianfard H, Kiani B, Weiss MD. Psychometric Properties of the Persian Version of the Weiss Functional Impairment Rating Scale-Self-Report Form in Iranian Adolescents. J Atten Disord 2019; 23:1600-1609. [PMID: 29099238 DOI: 10.1177/1087054717738084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The Weiss Functional Impairment Rating Scale-Self-Report Form (WFIRS-S) was developed as a measure of functional impairment in adolescents and adults with ADHD. This study reports the psychometric properties of the Persian version of the WFIRS-S in a sample of normal Iranian adolescents. METHOD Internal consistency and factor structure of the WFIRS-S were tested on a sample of 386 students (Grades 7-12). The test-retest reliability and the convergent validity of the WFIRS-S were evaluated by using two different subsamples including 50 and 100 students, respectively. RESULTS The Cronbach's alpha values were between .72 and .94 for the WFIRS-S subdomains and total scale. The test-retest reliability was .80 for the total scale. The WFIRS-S subdomains had moderate to high significant correlations with the Pediatric Quality of Life total scale. CONCLUSION The Persian version of the WFIRS-S has acceptable psychometric properties and could be used as a functional impairment assessment for adolescents.
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Affiliation(s)
| | | | - Margaret D Weiss
- 2 University of Arkansas for Medical Sciences, Little Rock, USA.,3 University of British Columbia, Vancouver, Canada
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Johnstone JM, Leung B, Gracious B, Perez L, Tost G, Savoy A, Hatsu I, Hughes A, Bruton A, Arnold LE. Rationale and design of an international randomized placebo-controlled trial of a 36-ingredient micronutrient supplement for children with ADHD and irritable mood: The Micronutrients for ADHD in Youth (MADDY) study. Contemp Clin Trials Commun 2019; 16:100478. [PMID: 31763491 PMCID: PMC6859218 DOI: 10.1016/j.conctc.2019.100478] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/21/2019] [Accepted: 10/24/2019] [Indexed: 12/31/2022] Open
Abstract
Background Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental disorder affecting up to 9% of children and substantial numbers of adults. Existing pharmacologic treatments often improve symptoms, but concerns exist over side effects, stigma, potential long-term health effects, and residual irritability, often treated with adjunctive antipsychotics. To address public and clinician demand for non-pharmacologic evidence-based treatments, this study will examine efficacy of a 36-ingredient micronutrient (vitamin/mineral) supplement as treatment for children with ADHD and irritability. Methods An international team of experts in ADHD, mood dysregulation, nutrition, epidemiology, and clinical trials conferred to develop/refine a protocol powered to detect a medium effect. The study will employ a fully-blind randomized controlled trial (RCT) design, comparing the micronutrient supplement to matched placebo in 135 children aged 6-12 with ADHD symptoms and irritability, based on the parent-rated Child and Adolescent Symptom Inventory-5 (CASI-5). Irritability will be measured by at least one symptom of oppositional defiant disorder (ODD) or disruptive mood dysregulation disorder (DMDD). Based on research suggesting an irritable ADHD subtype, the primary outcome will be a composite score comprised of the CASI-5 subscales: ADHD, ODD, DMDD, and the Peer Conflict Scale, which assesses anger and aggression perpetrated towards peers. Participants will provide biological samples (blood, urine, saliva, hair and stool) to explore the micronutrients' mechanisms of action. Discussion This study is the first adequately powered RCT in North America to examine both behavioral responses to, and biological mechanisms of, micronutrients for ADHD and irritability in children. If found efficacious, broad-spectrum micronutrients, given at therapeutic doses, may provide an evidence-based alternative to prescription medications for ADHD and associated irritability. Trial registration NCT03252522. Registered 26 July 2017.
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Affiliation(s)
- Jeanette M Johnstone
- National University of Natural Medicine, Helfgott Research Institute, Portland, OR, USA.,Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Brenda Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Barbara Gracious
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, USA.,Orange Park Medical Center, Orange Park, FL, USA
| | - Leanna Perez
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Gabriella Tost
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Andrew Savoy
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Irene Hatsu
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Andrew Hughes
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Alisha Bruton
- National University of Natural Medicine, Helfgott Research Institute, Portland, OR, USA.,Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - L Eugene Arnold
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, USA
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Fruchter E, Marom-Harel H, Fenchel D, Kapra O, Ginat K, Portuguese S, Weiser M. Functioning of Young Adults With ADHD in the Military. J Atten Disord 2019; 23:1470-1474. [PMID: 27269006 DOI: 10.1177/1087054716652478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To assess the functioning of young adults with ADHD in a military setting. Method: In all, 14,655 young adults with ADHD (mean age at first examination 17.8 ± 0.7) attending mandatory service in the Israeli military were compared with matched controls on several functioning domains. Results: Young adults with ADHD had more sessions with mental health care professionals, physician appointments, sick days, and disqualifications of professions than controls (p < .001). Young adults with ADHD were also less medically fit for combat service (odds ratio [OR] = 0.75, 95% confidence interval [CI] = [0.72, 0.79]), more medically unfit for military service in general (OR = 1.26, 95% CI = [1.13, 1.40]), and had higher rates of overweight and obesity (p < .001). In addition, they were more likely to be diagnosed with a personality disorder (OR = 1.29, 95% CI = [1.07, 1.53]) or with minor affective and anxiety disorders (OR = 1.33, 95% CI = [1.06, 1.67]) than matched controls. Conclusion: These results support a negative effect of ADHD on the functioning of young adults in a military setting.
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Affiliation(s)
- Eyal Fruchter
- 1 IDF Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | | | | | - Ori Kapra
- 2 Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Keren Ginat
- 1 IDF Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | | | - Mark Weiser
- 2 Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.,3 Tel Aviv University, Tel Aviv-Yafo, Israel
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Koyuncu A, Çelebi F, Ertekin E, Kök BE, Tükel R. Clinical Effects of ADHD Subtypes in Patients With Social Anxiety Disorder. J Atten Disord 2019; 23:1464-1469. [PMID: 26637843 DOI: 10.1177/1087054715617533] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Our aim in this study is to evaluate the impacts of inattentive and combined types of childhood ADHD (ADHD-I, ADHD-C) in patients with social anxiety disorder (SAD). Methods: A total of 142 adult outpatients with a primary diagnosis of SAD were included. All patients were assessed by using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), ADHD module and a clinical and sociodemographic data form and scales were filled out. Results: Childhood ADHD comorbidity rates was found to be 88 (62%) in patients with SAD, and 63 of these patients had the diagnosis of ADHD-I. ADHD-I group had higher scores of social anxiety and avoidance and had earlier onset of SAD than the ADHD-C group. Conclusion: The inattentive subtype of ADHD may have a more specific relationship with SAD than ADHD-C.
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Affiliation(s)
| | - Fahri Çelebi
- 2 Zonguldak Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Zonguldak, Turkey
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Theule J, Hurl KE, Cheung K, Ward M, Henrikson B. Exploring the Relationships Between Problem Gambling and ADHD: A Meta-Analysis. J Atten Disord 2019; 23:1427-1437. [PMID: 26832122 DOI: 10.1177/1087054715626512] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: At present, there are inconsistencies in the literature pertaining to the association between ADHD and problem gambling. This study utilized meta-analytic techniques to clarify the association between symptoms of problem gambling and symptoms of ADHD. Method: Several meta-analyses were conducted using a random effects model. PsycINFO, PubMed, ProQuest Dissertations & Theses, and Google Scholar were searched for relevant studies. Results: The weighted mean correlation between ADHD symptomology and gambling severity was r = .17, 95% confidence interval (CI) = [0.12, 0.22], p < .001. Mean age of the sample was the only moderator to approach significance, with greater age being linked to a stronger relationship between symptoms of ADHD and gambling severity. Conclusion: Clinicians needs to be cognizant of the greater risk of ADHD symptoms when working with problem gamblers and vice versa.
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Huh SY, Kim SG, Lee JS, Jung WY, Choi BS, Kim JH. A study on the school violence experience of children with attention-deficit hyperactivity disorder in the context of bullying. Asia Pac Psychiatry 2019; 11:e12353. [PMID: 30941893 DOI: 10.1111/appy.12353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 02/21/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION School violence causes harmful effects to victims. Harmful effects are likely to persist into adulthood. There are many studies about the relationship between attention-deficit hyperactivity disorder (ADHD) and school violence. But, there are few comparative studies dividing groups by the context of bullying and by the school grade. Therefore, this study will identify the differences between general students and patients with ADHD under treatment, creating two groups (one with experience of the perpetration of violence and one with victimization). METHODS This study was conducted by questionnaires that dealt with experiences of being a bully and being bulled at school in the past year as six items each. A 5-point Likert scale was used. The ADHD group was 49, and the general students group was 245. The data were compared using the chi-squared test. Statistical analysis was performed using SPSS version 24, with statistical significance at P < 0.05. RESULTS The ADHD group was significantly high who reported severely beating other people than the general group. Likewise, ADHD group who reported threatening other people was significantly higher than in the general group. However, for the remaining items, there was no significant difference between the ADHD group and the general student group. DISCUSSION Previous studies suggested that ADHD symptoms are major causes of both bullying and being the victim of bullying. However, in this study, ADHD patients have more being the victim of bullying experiences than general students. Further, a well-designed study will be needed to accurately evaluate the relationship between school violence and ADHD.
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Affiliation(s)
- Sung-Young Huh
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Sung-Gon Kim
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Psychiatry, School of Medicine, Pusan National University, Yangsan, South Korea
| | - Jin-Sung Lee
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Woo-Young Jung
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Bum-Sung Choi
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ji-Hoon Kim
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Psychiatry, School of Medicine, Pusan National University, Yangsan, South Korea
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Adenosine A2A receptor as potential therapeutic target in neuropsychiatric disorders. Pharmacol Res 2019; 147:104338. [DOI: 10.1016/j.phrs.2019.104338] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 01/20/2023]
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