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Jong A, Odoi CM, Lau J, J.Hollocks M. Loneliness in Young People with ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2024; 28:1063-1081. [PMID: 38400533 PMCID: PMC11016212 DOI: 10.1177/10870547241229096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Many studies focus on problematic peer functioning in attention deficit/hyperactivity disorder (ADHD) but loneliness has been studied less. This paper examined (1) The loneliness level differences between young people (below 25 years old) with ADHD and those without ADHD, and (2) The association between loneliness and mental health difficulties in young people with ADHD. Six electronic databases were searched and 20 studies were included. A random effects meta-analysis was carried out in RStudio using the metafor package for the first question, while a narrative synthesis summarized the findings for the second question. The meta-analysis (n = 15) found that young people with ADHD reported significantly higher loneliness than those without ADHD, with a small-to-medium weighted pool effect (Hedges' g = 0.41) and high heterogeneity (I2 = 75.1%). For the second question (n = 8), associations between loneliness and mental health difficulties in ADHD was found (r = 0.05-0.68). Targeted research and interventions on loneliness in young people with ADHD is needed.
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Affiliation(s)
- Angelina Jong
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Clarissa Mary Odoi
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Jennifer Lau
- Queen Mary University of London Wolfson Institute of Population Health, London, UK
| | - Matthew J.Hollocks
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
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2
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Farhat LC, Blakey R, Smith GD, Fujita A, Shephard E, Stergiakouli E, Eley TC, Thapar A, Polanczyk GV. Networks of Neurodevelopmental Traits, Socioenvironmental Factors, Emotional Dysregulation in Childhood, and Depressive Symptoms Across Development in Two U.K. Cohorts. Am J Psychiatry 2023; 180:755-765. [PMID: 37583326 PMCID: PMC7615665 DOI: 10.1176/appi.ajp.20220868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Previous population-based studies have identified associations between childhood neurodevelopmental traits and depression in childhood, adolescence, and young adulthood. However, neurodevelopmental traits are highly correlated with each other, which could confound associations when traits are examined in isolation. The authors sought to identify unique associations between multiple neurodevelopmental traits in childhood and depressive symptoms across development, while taking into account co-occurring difficulties, in multivariate analyses. METHODS Data from two U.K. population-based cohorts, the Twins Early Development Study (TEDS) (N=4,407 independent twins) and the Avon Longitudinal Study of Parents and Children (ALSPAC) (N=10,351), were independently analyzed. Bayesian Gaussian graphical models were estimated to investigate pairwise conditional associations between neurodevelopmental traits (autism and ADHD symptoms and general cognitive, learning, and communication abilities), socioenvironmental stressors (academic performance and peer relations), and emotional dysregulation in childhood (ages 7-11) and depressive symptoms across development (ages 12, 16, and 21). RESULTS In both cohorts, bivariate correlations indicated several associations between neurodevelopmental traits and depressive symptoms across development. However, based on replicated findings across cohorts, these pairs of variables were mostly conditionally independent, and none were conditionally associated, after accounting for socioenvironmental stressors and emotional dysregulation. In turn, socioenvironmental stressors and emotional dysregulation were conditionally associated with both neurodevelopmental traits and depressive symptoms. Based on replicated findings across cohorts, neurodevelopmental traits in childhood could be associated only indirectly with depressive symptoms across development. CONCLUSIONS This study indicates that associations between childhood neurodevelopmental traits and depressive symptoms across development could be explained by socioenvironmental stressors and emotional dysregulation. The present findings could inform future research aimed at the prevention of depression in youths with neurodevelopmental disorders.
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Affiliation(s)
- Luis C. Farhat
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BR
| | - Rachel Blakey
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - André Fujita
- Departamento de Ciência da Computação, Instituto de Matemática e Estatística, Universidade de São Paulo, São Paulo, BR
| | - Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BR
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Thalia C. Eley
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Anita Thapar
- Wolfson Centre for Young People’s Mental Health Cardiff University School of Medicine, Cardiff, UK
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Guilherme V. Polanczyk
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BR
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3
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Liang X, Qiu H, Sit CHP. The mediating role of resilience in the association between MVPA and psychological ill-being in children with ADHD. Scand J Med Sci Sports 2023; 33:485-494. [PMID: 36514869 DOI: 10.1111/sms.14282] [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: 03/22/2022] [Revised: 11/07/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE This study investigated the mediating role of resilience in the association between moderate-to-vigorous physical activity (MVPA) and psychological ill-being, as well as the moderating role of age in the direct and indirect relationship between MVPA and psychological ill-being in children with attention-deficit/hyperactivity disorder (ADHD). METHODS Eighty-five children aged 6-12 years (Mage = 8.41 ± 1.44 years) diagnosed with ADHD were recruited. Participants wore an accelerometer on their non-dominant wrist for seven consecutive days to record MVPA. Resilience and psychological ill-being were assessed using self-reported questionnaires. RESULTS MVPA was positively associated with resilience but negatively related to depression and stress. Resilience was negatively correlated with depression and stress. Using the bootstrapping method, the indirect effect of resilience was found between MVPA and depression (-0.006%, 95% confidence interval [CI] = [-0.060, -0.020]) in children with ADHD, supporting partial mediation. Moderated mediation analysis further demonstrated that the indirect effect of MVPA on depression via resilience was stronger in older children (-0.008, 95% CI = [-0.023, -0.001]) than in younger children with ADHD. CONCLUSION The findings may inform future empirical studies on designing exercise interventions with MVPA levels that help to improve resilience and depression in children with ADHD.
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Affiliation(s)
- Xiao Liang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China.,Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hui Qiu
- Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong, China
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
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Capps RE, Wilson ED, Evans SW, Allan DM, Langberg JM. Impairment's Role in the Pathway From Externalizing Psychopathology to Depressive Symptoms in Adolescents With ADHD. J Atten Disord 2023; 27:887-898. [PMID: 36915046 DOI: 10.1177/10870547231159911] [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: 03/16/2023]
Abstract
OBJECTIVE This study examined the role of academic, social, and family impairment in the pathway from externalizing psychopathology to depression among young adolescents with ADHD in a multiple mediation model. METHOD The sample included adolescents with ADHD enrolled in an intervention trial. Parent ratings of externalizing psychopathology were measured at eligibility assessment, adolescent self-reported depressive symptoms were measured at eligibility and at the end of treatment, and parent-rated impairment was measured in the middle of treatment. A multiple mediation model was used to examine mediating effects of impairment types in the pathway from externalizing psychopathology to depression. RESULTS Parent-reported family impairment significantly mediated the association between externalizing psychopathology and depressive symptoms. CONCLUSIONS Results suggest family impairment mediates the association between externalizing psychopathology and depressive symptoms beyond academic and social impairment for youth with ADHD. Findings implicate the importance of targeting family functioning during early adolescence to prevent depression.
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Pedersen GA, Lam C, Hoffmann M, Zajkowska Z, Walsh A, Kieling C, Mondelli V, Fisher HL, Gautam K, Kohrt BA. Psychological and contextual risk factors for first-onset depression among adolescents and young people around the globe: A systematic review and meta-analysis. Early Interv Psychiatry 2023; 17:5-20. [PMID: 35388612 PMCID: PMC10084304 DOI: 10.1111/eip.13300] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/28/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
AIM Identifying predictors for future onset of depression is crucial to effectively developing preventive interventions. We conducted a systematic review and meta-analysis to identify risk factors for first-onset depression among adolescents and young people. METHODS We searched MEDLINE (Ovid), PsycINFO, Cochrane Database, Web of Science, Lilacs, African Journals Online and Global Health (July 2009 to December 2020) for longitudinal studies assessing risk factors for first-onset depression among adolescents and young people aged 10-25 years. Meta-analyses generated summary odds ratio (OR) estimates. REGISTRATION PROSPERO CRD42018103973. RESULTS Nineteen studies representing 21 unique populations were included in the meta-analysis. Among studies reporting race/ethnicity, 79% of participants were of White/European descent. Seventeen studies were from high-income countries, with only two from an upper-middle-income country (China). Odds for first-onset depression were significantly greater for girls compared to boys (n = 13; OR = 1.78 [1.78, 2.28], p < 0.001) and for youth with other mental health problems at baseline (n = 4; OR = 3.20 [1.95, 5.23], p < 0.001). There were non-significant associations for negative family environment (n = 8; OR = 1.60 [0.82, 3.10], p = 0.16) and parental depression (n = 3; OR = 2.30 [0.73, 7.24], p = 0.16). CONCLUSIONS Most longitudinal studies do not report risk factors specifically for first-onset depression. Moreover, predictive data are limited to predominantly White populations in high-income countries. Future research must be more ethnically and geographically representative. Recommendations are provided for consistent and comprehensive reporting of study designs and analyses of risk factors for first-onset depression.
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Affiliation(s)
- Gloria A Pedersen
- Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Crystal Lam
- Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Megan Hoffmann
- Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Zuzanna Zajkowska
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Annabel Walsh
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christian Kieling
- Child & Adolescent Psychiatry Division, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Kamal Gautam
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Kathmandu, Nepal
| | - Brandon A Kohrt
- Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA
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Thapar A, Livingston LA, Eyre O, Riglin L. Practitioner Review: Attention-deficit hyperactivity disorder and autism spectrum disorder - the importance of depression. J Child Psychol Psychiatry 2023; 64:4-15. [PMID: 35972029 PMCID: PMC10087979 DOI: 10.1111/jcpp.13678] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
Young people with neurodevelopmental disorders, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), show high rates of mental health problems, of which depression is one of the most common. Given that depression in ASD and ADHD is linked with a range of poor outcomes, knowledge of how clinicians should assess, identify and treat depression in the context of these neurodevelopmental disorders is much needed. Here, we give an overview of the latest research on depression in young people with ADHD and ASD, including possible mechanisms underlying the link between ADHD/ASD and depression, as well as the presentation, assessment and treatment of depression in these neurodevelopmental disorders. We discuss the implications for clinicians and make recommendations for critical future research in this area.
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Affiliation(s)
- Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy A Livingston
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olga Eyre
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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7
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Suzuki T, Wada K, Nakazato M, Ohtani T, Yamazaki M, Ikeda S. Associations Between Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Traits and Sociodemographic Characteristics in Japanese Workers. Neuropsychiatr Dis Treat 2023; 19:759-773. [PMID: 37041858 PMCID: PMC10083016 DOI: 10.2147/ndt.s398478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/23/2023] [Indexed: 04/13/2023] Open
Abstract
Purpose Most previous studies that described associations between adult attention-deficit/hyperactivity disorder (ADHD) and sociodemographic characteristics were focused on individuals diagnosed with ADHD, and few studies investigated ADHD traits in the general population. Additionally, some workers, who experienced no problems while at university and successfully graduated from university, developed ADHD traits after finding employment. This study described associations between ADHD traits and sociodemographic characteristics among Japanese workers who were university graduates. Patients and Methods Participants were randomly selected workers (n=1240) from across Japan who completed a self-administered online survey. ADHD traits were measured using an adult ADHD Self-report Scale, with scoring rules applied to reflect the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Information was collected on sociodemographic characteristics including sex, age, socioeconomic status, working time, and health-related behaviors. We performed partial correlation analysis to estimate trend associations and used analysis of covariance to compare adjusted averages. This model was adjusted for all variables. Results Males had higher levels of ADHD traits than females (p = 0.001), and younger age was associated with higher levels of ADHD traits (p < 0.001). Workers with low incomes had higher levels of ADHD traits than workers with high incomes (p = 0.009). More frequent consumption of midnight meals was associated with higher levels of ADHD traits (p < 0.001), although there were no differences for breakfast, lunch, and dinner. Those who did not get enough rest from sleep had higher levels of ADHD traits (p = 0.007). Conclusion Results for high levels of ADHD traits among workers were consistent with previous studies for adults diagnosed with ADHD, even though all participants had successfully graduated from university. Assessment of these ADHD traits may support prevention of health deterioration related to these ADHD traits.
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Affiliation(s)
- Tomoko Suzuki
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
- Correspondence: Tomoko Suzuki, Department of Public Health, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, 286-8686, Japan, Tel +81-476-20-7701, Fax +81-476- 28-1188, Email ;
| | - Koji Wada
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita, Japan
| | | | - Michiko Yamazaki
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
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Sadeghian Nadooshan MR, Shahrivar Z, Mahmoudi Gharaie J, Salehi L. ADHD in adults with major depressive or bipolar disorder: does it affect clinical features, comorbidity, quality of life, and global functioning? BMC Psychiatry 2022; 22:707. [PMID: 36380307 PMCID: PMC9667673 DOI: 10.1186/s12888-022-04273-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study compared clinical characteristics, concurrent disorders, level of function, and quality of life in adults with bipolar (BD) or major depressive disorder (MDD) in those with/without adult attention defici1t hyperactivity disorder (AADHD). METHODS The participants were recruited among adult inpatients and outpatients with MDD or BD in their current partial remission in a psychiatric hospital. They were evaluated using the interview for adults with ADHD (DIVA-5), Conners' Adult ADHD Rating Scales-Self-Report-Screening Version (CAARS-SR-SV), Structured Clinical Interview for DSM-V (SCID-5), Beck Depression Inventory-II and Young Mania Rating Scale, Global Assessment of Functioning (GAF) and World Health Organization Quality of Life Scale-Brief (WHOQoL-BREF). RESULTS In those with MDD (n = 105) and BD (n = 103), AADHD was detected as 13.3% and 16.5%, respectively. The inattentive presentation was the most prevalent type among patients with AADHD. Compared to the patients without AADHD, the results regarding the prevalence of comorbidities, suicidal attempts, severity of affective episodes, the early emergence of the affective disorders, and level of quality of life and global functioning were poorer in the group with AADHD (p < 0.05). LIMITATIONS The participants were individuals with major depressive or bipolar type I disorder with a mostly manic episode, chosen among the referrals to a tertiary psychiatric hospital with high comorbidity and more severe psychopathology. This may limit the generalizability of the findings. CONCLUSION ADHD was common in adults with MDD and BD, along with high psychiatric comorbidity and negative consequences. Clinicians are suggested to screen adults with mood disorders for the symptoms of ADHD for a more precise and comprehensive diagnosis and to provide a more appropriate therapeutic intervention.
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Affiliation(s)
| | - Zahra Shahrivar
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Javad Mahmoudi Gharaie
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leyla Salehi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Wu SCJ, Hsu JW, Huang KL, Bai YM, Tu PC, Chen MH. Functional dysconnectivity of cerebellum and attention networks in emotional dysregulation shared between attention deficit hyperactivity disorder and major depressive disorder: a multimodal imaging study. CNS Spectr 2022; 28:1-8. [PMID: 35761511 DOI: 10.1017/s1092852922000876] [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: 11/06/2022]
Abstract
BACKGROUND Emotional dysregulation (ED) is a common characteristic of both attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD), especially in adolescents. However, whether ADHD and MDD may share the specific ED-related neural networks remains unknown. METHODS In total, 43 adolescents with clinical ED (22 adolescents with ADHD and 21 with MDD) were recruited; in addition, 29 sex- and age-matched healthy controls (HCs) were included. Resting-state functional connectivity (RSFC) analysis, voxel-based morphometry, and diffusion tensor imaging analysis were performed for each patient. In addition, we determined the significant regions of interest in patients with ED due to ADHD and MDD as compared with HCs and tested their correlations with clinical rating scale scores. RESULTS Compared with HCs, patients with ED had greater RSFC in the cerebellum and supramarginal gyrus (SMG), especially between vermis VI and the SMG in the attention networks, and lower RSFC between the right supplementary motor area and right lateral parietal area. Lower gray matter (GM) volume in the SMG was also found. RSFC was significantly correlated with clinical rating scale scores for all patients with ED due to ADHD or MDD. GM change was correlated with ED and MDD rating scale scores. DISCUSSION The cerebellum and attention networks might play major roles in ED pathophysiology in adolescents with ADHD and MDD. Increased connectivity of the vermis to the SMG serves as a possible underlying neural network.
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Affiliation(s)
- Shun-Chin J Wu
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Graduate School of Neural and Behavioral Sciences, University of Tübingen, Tübingen, Germany
- Graduate Training Centre of Neuroscience, University of Tübingen, Tübingen, Germany
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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10
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LaCount PA, Hartung CM, Vasko JM, Serrano JW, Wright HA, Smith DT. Acute Effects of Physical Exercise on Cognitive and Psychological Functioning in College Students with Attention-Deficit/Hyperactivity Disorder. Ment Health Phys Act 2022; 22:100443. [PMID: 35449602 PMCID: PMC9017792 DOI: 10.1016/j.mhpa.2022.100443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We sought to elucidate the acute effects of high-intensity interval training (HIIT) among college students with and without attention-deficit/hyperactivity disorder (ADHD). Participants were age- and sex-matched across ADHD (n = 18) and non-ADHD groups (n = 18) and both groups completed baseline (non-HIIT) and experimental sessions (HIIT). We examined within- and between-subject effects on a continuous performance task (CPT) and self-reported ADHD and internalizing symptomatology. We found that the degree of improvement on ADHD and depressive symptomatology, as well as processing speed and response variability following HIIT was significantly greater for the ADHD group than the comparison group. Further investigations such as randomized controlled trials focusing on the chronic effects of sustained HIIT interventions are needed to substantiate the potential feasibility and efficacy of HIIT as an intervention. HIIT may be a useful adjunct to psychosocial and/or pharmacological treatments for college students with ADHD because it: (a) yields immediate, acute improvements in executive functioning, ADHD, and mood; (b) promotes improved physical and mental health; (c) poses a relatively low risk of deleterious effects in apparently healthy college students. Even with the need for additional research, current data suggest a single, brief, high-intensity bout of aerobic exercise can yield immediate significant short-term improvements. These improvements may enhance functioning and improve outcomes for college students with ADHD.
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Affiliation(s)
- Patrick A. LaCount
- University of Wyoming, Department of Psychology, 1000 E University Ave, Laramie, WY 82071
| | - Cynthia M. Hartung
- University of Wyoming, Department of Psychology, 1000 E University Ave, Laramie, WY 82071
| | - John M. Vasko
- University of Wyoming, Department of Psychology, 1000 E University Ave, Laramie, WY 82071
| | - Judah W. Serrano
- University of Wyoming, Department of Psychology, 1000 E University Ave, Laramie, WY 82071
| | - Halle A. Wright
- University of Wyoming, Department of Psychology, 1000 E University Ave, Laramie, WY 82071
| | - Derek T. Smith
- University of Wyoming, Department of Kinesiology, 1000 E University Ave, Laramie, WY 82071
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Meinzer MC, T. G. Schwartz K, Triece P, Raye Horn S, Chronis-Tuscano A. From the Clinic to Schools: Iterative Development of a Depression Prevention Program for Adolescents With ADHD Within an Urban School System. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Mayer JS, Brandt GA, Medda J, Basten U, Grimm O, Reif A, Freitag CM. Depressive symptoms in youth with ADHD: the role of impairments in cognitive emotion regulation. Eur Arch Psychiatry Clin Neurosci 2022; 272:793-806. [PMID: 35107603 PMCID: PMC9279209 DOI: 10.1007/s00406-022-01382-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/14/2022] [Indexed: 12/21/2022]
Abstract
Youth with attention-deficit/hyperactivity disorder (ADHD) are at increased risk to develop co-morbid depression. Identifying factors that contribute to depression risk may allow early intervention and prevention. Poor emotion regulation, which is common in adolescents, is a candidate risk factor. Impaired cognitive emotion regulation is a fundamental characteristic of depression and depression risk in the general population. However, little is known about cognitive emotion regulation in youth with ADHD and its link to depression and depression risk. Using explicit and implicit measures, this study assessed cognitive emotion regulation in youth with ADHD (N = 40) compared to demographically matched healthy controls (N = 40) and determined the association with depressive symptomatology. As explicit measure, we assessed the use of cognitive emotion regulation strategies via self-report. As implicit measure, performance in an ambiguous cue-conditioning task was assessed as indicator of affective bias in the processing of information. Compared to controls, patients reported more frequent use of maladaptive (i.e., self-blame, catastrophizing, and rumination) and less frequent use of adaptive (i.e., positive reappraisal) emotion regulation strategies. This pattern was associated with the severity of current depressive symptoms in patients. In the implicit measure of cognitive bias, there was no significant difference in response of patients and controls and no association with depression. Our findings point to depression-related alterations in the use of cognitive emotion regulation strategies in youth with ADHD. The study suggests those alterations as a candidate risk factor for ADHD-depression comorbidity that may be used for risk assessment and prevention strategies.
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Affiliation(s)
- Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany.
| | - Geva A Brandt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany
| | - Juliane Medda
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany
| | - Ulrike Basten
- Department of Psychology, University of Koblenz-Landau, Fortstraße 7, 76829, Landau in der Pfalz, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany
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13
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Mössinger H, Kostev K. Age effects on treatment patterns in 138,097 patients with unipolar depression followed in general practices in Germany. J Psychiatr Res 2021; 144:208-216. [PMID: 34700208 DOI: 10.1016/j.jpsychires.2021.10.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Risk factors and comorbidities associated with depression vary with age and must be considered when selecting appropriate anti-depressant medication for patients. Studies are lacking which focus both on treatments prescribed and include a broad age spectrum. The goal of this study was to investigate whether age of patients at diagnosis impact the type of antidepressant drug class prescribed. METHODS This retrospective cohort study based on the Disease Analyzer database (IQVIA) included 138,097 patients with depression followed in 1188 general practices from date of first depression diagnosis given between 2015 and 2018 (index date). Patients aged 18-30, 31-65 and > 65 were compared in homogeneous groups based on gender and insurance type. Odds ratios adjusted by gender, insurance type, treatment site and Charlson-Comorbidity-Index were used to assess the difference in probability of receiving prescription for antidepressant drug classes as well as individual treatment drugs by age group. RESULTS The cohort included 13,553 (9.8%), 82,524 (59.8%) and 42,020 (30.4%) patients aged 18-30 years (young), 31-65 years (middle-aged) and >65 years (older). Less than half of patients received anti-depressant medication, with 4717 (34.8%) aged 18-30, 35,014 (42.4%) aged 31-65, and 20,294 (48.3%) aged 65 or older receiving at least one anti-depressant medication. Tri- and tetra-cyclic mediations were prescribed to 65.8% of patients aged >65, and 59.0% of patients aged 31-65. Selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) were prescribed to 55.5% of patients. Older patients showed an increased probability (OR: 1.3 [1.26-1.34 95% CI], p < 0.0001) for tri- and tetra-cyclic medication, while younger patients showed an increased probability for SSRIs and SNRIs (OR: 1.23 [1.16-1.30 95% CI], p < 0.0001). CONCLUSION Age-related differences in anti-depressant medication prescription were shown, with older patients above 65 years predominantly receiving tri- and tetra-cyclic medication, while younger patients aged 18-30 received SSRIs more frequently. Further studies with homogeneous groups relating to comorbidity profile and disease severity are needed to fully understand age effects on treatment patterns.
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14
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Oguchi M, Takahashi T, Nitta Y, Kumano H. The Moderating Effect of Attention-Deficit Hyperactivity Disorder Symptoms on the Relationship Between Procrastination and Internalizing Symptoms in the General Adult Population. Front Psychol 2021; 12:708579. [PMID: 34764902 PMCID: PMC8575693 DOI: 10.3389/fpsyg.2021.708579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The symptoms of attention-deficit hyperactivity disorder (ADHD) are known to exacerbate the effect of cognitive-behavioral impairments on emotional burden. Although adults with ADHD frequently experience procrastination and internalizing symptoms such as depression and anxiety, few studies have examined whether the association between procrastination and internalizing symptoms differs by ADHD symptoms. Objective: This study aimed to examine the moderating effect of ADHD symptoms on the association between procrastination and internalizing symptoms. Method: A cross-sectional survey was conducted among 470 adults (mean age=26.57, standard deviation=2.93) using self-reported questionnaires: Adult ADHD Self-Report Scale, General Procrastination Scales, Patient Health Questionnaire-9, and State-Trait Anxiety Inventory. Conclusion: Participants with more substantial ADHD symptoms experienced more procrastination and internalizing symptoms than those with the less substantial ADHD symptoms. Therefore, procrastination constitutes the treatment target for those suffering from ADHD and comorbid internalizing symptoms. Alternatively, there was no enhancing effect of ADHD symptoms on the association between procrastination and internalizing symptoms. It is necessary to examine more precise and valid hypotheses and underlying mechanisms of procrastination in high and low ADHD symptom groups.
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Affiliation(s)
- Mana Oguchi
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Toru Takahashi
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Yusuke Nitta
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Hiroaki Kumano
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
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15
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Meinzer MC, Felton JW, Oddo LE, Rubin KH, Chronis-Tuscano A. Do ADHD Symptoms and Relationship Quality With Mothers and Best Friends Across High School Predict Depressive Symptoms for Adolescents? J Atten Disord 2021; 25:1699-1711. [PMID: 32506994 DOI: 10.1177/1087054720923088] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Symptoms of ADHD place adolescents at increased risk for depression. The transition from middle to high school may magnify depression risk. This study examined whether changes in adolescents' negative relationship quality with their mothers and best friends from eighth to 12th grades mediated the longitudinal relations between ADHD and depressive symptoms. Method: 368 adolescents (48.5% male) were initially recruited. Results: Boys with elevated ADHD symptoms in the eighth grade reported steeper increases in negative relationship quality with their mothers relative to girls, and that this trajectory mediated the relation between ADHD and depressive symptoms. ADHD symptoms were also associated with increases in negative friendship quality across high school for boys; however, this did not mediate the relation between ADHD and depressive symptoms for either sex. Conclusion: Growth in mother-adolescent negative relationship quality may be one mechanism that explains the development of depressive symptoms in adolescent boys with elevated ADHD symptoms.
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16
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Grimm O, van Rooij D, Hoogman M, Klein M, Buitelaar J, Franke B, Reif A, Plichta MM. Transdiagnostic neuroimaging of reward system phenotypes in ADHD and comorbid disorders. Neurosci Biobehav Rev 2021; 128:165-181. [PMID: 34144113 DOI: 10.1016/j.neubiorev.2021.06.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 06/13/2021] [Accepted: 06/13/2021] [Indexed: 02/08/2023]
Abstract
ADHD is a disorder characterized by changes in the reward system and which is highly comorbid with other mental disorders, suggesting common neurobiological pathways. Transdiagnostic neuroimaging findings could help to understand whether a dysregulated reward pathway might be the actual link between ADHD and its comorbidities. We here synthesize ADHD neuroimaging findings on the reward system with findings in obesity, depression, and substance use disorder including their comorbid appearance regarding neuroanatomical features (structural MRI) and activation patterns (resting-state and functional MRI). We focus on findings from monetary-incentive-delay (MID) and delay-discounting (DD) tasks and then review data on striatal connectivity and volumetry. Next, for better understanding of comorbidity in adult ADHD, we discuss these neuroimaging features in ADHD, obesity, depression and substance use disorder and ask whether ADHD heterogeneity and comorbidity are reflected by a common dysregulation in the reward system. Finally, we highlight conceptual issues related to heterogeneous paradigms, different phenotyping, longitudinal prediction and highlight some promising future directions for using striatal reward functioning as a clinical biomarker.
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Affiliation(s)
- Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.
| | - Daan van Rooij
- Donders Centre for Cognitive Neuroimaging, CNS Department, University Medical Centre Nijmegen, the Netherlands
| | - Martine Hoogman
- Donders Centre for Cognitive Neuroimaging, CNS Department, University Medical Centre Nijmegen, the Netherlands
| | - Marieke Klein
- Donders Centre for Cognitive Neuroimaging, CNS Department, University Medical Centre Nijmegen, the Netherlands; Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Psychiatry, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Jan Buitelaar
- Donders Centre for Cognitive Neuroimaging, CNS Department, University Medical Centre Nijmegen, the Netherlands
| | - Barbara Franke
- Donders Centre for Cognitive Neuroimaging, CNS Department, University Medical Centre Nijmegen, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Michael M Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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17
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Cortisol response to acute psychosocial stress in ADHD compared to conduct disorder and major depressive disorder: A systematic review. Neurosci Biobehav Rev 2021; 127:899-916. [PMID: 34089765 DOI: 10.1016/j.neubiorev.2021.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/26/2021] [Accepted: 06/01/2021] [Indexed: 01/15/2023]
Abstract
BERNHARD, A., J. S. Mayer, N. Fann, and C. M. Freitag. Cortisol response to acute psychosocial stress in ADHD compared to Conduct Disorder and Major Depressive Disorder: A systematic review. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2020. - Heterogeneous alterations of the cortisol stress response in Attention-deficit/hyperactivity Disorder (ADHD) were recently reported by a systematic literature review. To investigate the moderating effect of frequent psychiatric comorbidities, we systematically searched for studies on cortisol stress response to psychosocial stress in ADHD compared to Conduct Disorder (CD) and Major Depressive Disorder (MDD) following PRISMA guidelines. EBSCOhost and PubMed databases were searched in July 2020, employing relevant keywords. Nineteen studies met inclusion criteria. While blunted cortisol stress response was consistently reported in individuals with CD and/or Oppositional Defiant Disorder (ODD), alterations of cortisol stress response were less pronounced in ADHD. Consistently blunted cortisol stress response in ADHD was only found in children with comorbid CD/ODD. Results on cortisol stress response in children and adolescents with MDD were mixed, and no indication for influence of comorbid MDD on cortisol stress response in ADHD was found. Taken together, altered cortisol stress response in ADHD is driven by comorbidity with disruptive behavior disorders. Limitations of previous research and suggestions for future studies are discussed.
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18
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Oh Y, Park H, Kim S, Kim HS, Joung YS, Hong KS, Baek JH. Psychopathologic Profiles and Clusters in Tertiary Clinic Referred Patients with Adult Attention Deficit Hyperactivity Disorder: A Person-Centered Analysis. Psychiatry Investig 2021; 18:304-311. [PMID: 33951777 PMCID: PMC8103025 DOI: 10.30773/pi.2020.0331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/24/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Adult attention deficit hyperactivity disorder (ADHD) has a heterogeneous clinical presentation with patients showing very frequent emotional problems. In the present study, patients with adult ADHD were subtyped based on their psychopathology using a person-centered approach. METHODS In the present chart review study, detailed findings of psychological evaluation conducted as part of routine care were utilized. A total of 77 subjects with adult ADHD were included in the analysis. Detailed ADHD symptoms, psychiatric comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses, and severity of mood and anxiety symptoms were evaluated in the person-centered analysis. RESULTS Three clusters were generated using clustering analysis. DSM comorbid conditions did not significantly impact the clustering. Cluster 1 consisted of ADHD combined presentation (ADHD-C) with less mood symptoms, cluster 2 of ADHD predominantly inattentive presentation and cluster 3 of ADHD-C with significant mood symptoms. Patients in cluster 3 had adulthood functional impairment more frequently compared with patients in cluster 1. Patients in cluster 3 showed recurrent thoughts of death and suicidal ideation more frequently compared with patients in cluster 1. CONCLUSION Further studies are needed to confirm the relationships observed in the present study.
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Affiliation(s)
- Yunhye Oh
- Department of Child Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Hyewon Park
- Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Seonwoo Kim
- Center for Biomedical Statistics, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hye Seung Kim
- Center for Biomedical Statistics, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yoo-Sook Joung
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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19
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Abstract
Recent epidemiological evidence indicates that diagnosis of attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk for diseases of the basal ganglia and cerebellum, including Parkinson's disease (PD). The evidence reviewed here indicates that deficits in striatal dopamine are a shared component of the causal chains that produce these disorders. Neuropsychological studies of adult ADHD, prodromal PD, and early-stage PD reveal similar deficits in executive functions, memory, attention, and inhibition that are mediated by similar neural substrates. These and other findings are consistent with the possibility that ADHD may be part of the PD prodrome. The mechanisms that may mediate the association between PD and ADHD include neurotoxic effects of stimulants, other environmental exposures, and Lewy pathology. Understanding the nature of the association between PD and ADHD may provide insight into the etiology and pathogenesis of both disorders. The possible contribution of stimulants to this association may have important clinical and public health implications.
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20
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Shapero BG, Gibb BE, Archibald A, Wilens TE, Fava M, Hirshfeld-Becker DR. Risk Factors for Depression in Adolescents With ADHD: The Impact of Cognitive Biases and Stress. J Atten Disord 2021; 25:340-354. [PMID: 30198368 DOI: 10.1177/1087054718797447] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Youth diagnosed with ADHD are at heightened risk of depression. However, many do not develop depression. Individuals with specific cognitive biases are more likely to develop depression yet it remains untested whether these vulnerability-stress models apply to depression risk in youth with ADHD. Method: We examined whether interpretation and attention biases moderated the relation between stressful life events and depressive symptoms in a sample of adolescents (Mage = 14.42) with ADHD (n = 59) and without ADHD (n = 36). Results: Youth with ADHD experienced more stressful life events compared with those without ADHD. Interpretation biases moderated the association between stress and depressive symptoms in youth with and without ADHD. Attention biases moderated the association between stress and depressive symptoms in the non-ADHD youth only. Conclusion: These results enhance our understanding of vulnerability for depression in adolescence with ADHD and inform targeted prevention and treatment models during this critical developmental juncture.
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Affiliation(s)
- Benjamin G Shapero
- Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Boston, MA, USA
| | | | | | - Timothy E Wilens
- Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Boston, MA, USA
| | - Maurizio Fava
- Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Boston, MA, USA
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21
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Mayer JS, Bernhard A, Fann N, Boxhoorn S, Hartman CA, Reif A, Freitag CM. Cognitive mechanisms underlying depressive disorders in ADHD: A systematic review. Neurosci Biobehav Rev 2021; 121:307-345. [PMID: 33359622 DOI: 10.1016/j.neubiorev.2020.12.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 01/06/2023]
Abstract
The risk for major depressive disorder (MDD) is considerably increased in young adults with attention-deficit/hyperactivity disorder (ADHD) but underlying mechanisms are poorly understood. This review explores ADHD-specific neurocognitive impairments as possible underlying mechanisms for ADHD-depression comorbidity. Two systematic literature searches were conducted in EBSCOhost, PubMED, and Cochrane Reviews databases according to PRISMA guidelines. The first search identified 18 meta-analyses of cross-sectional and longitudinal studies on cognitive dysfunctions in MDD across the lifespan. The second search identified six original studies on reaction time variability in MDD. During acute depression, children and adults showed cognitive deficits that overlapped with some of the ADHD-related impairments. Findings from remitted patients, high-risk individuals, and few prospective studies suggest that a subset of these shared impairments, specifically executive dysfunctions (selective attention, verbal fluency, working memory) and long-term memory problems, are candidate pre-existing risk markers of depression. We discuss if and how these specific neurocognitive mechanisms may mediate developmental pathways from ADHD to depression. If replicated by longitudinal studies, these findings may guide future prevention strategies.
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Affiliation(s)
- Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
| | - Nikola Fann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
| | - Sara Boxhoorn
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
| | - Catharina A Hartman
- Interdisciplinary Centre Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Centre Groningen, CC 72, P.O. Box 30.001, 9700 RB Groningen, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
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22
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Stern A, Agnew-Blais J, Danese A, Fisher HL, Matthews T, Polanczyk GV, Wertz J, Arseneault L. Associations between ADHD and emotional problems from childhood to young adulthood: a longitudinal genetically sensitive study. J Child Psychol Psychiatry 2020; 61:1234-1242. [PMID: 32112575 PMCID: PMC7483180 DOI: 10.1111/jcpp.13217] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is associated with emotional problems, and their co-occurrence often leads to worse outcomes. We investigated the developmental associations between ADHD and emotional problems from childhood to early adolescence and examined the genetic and environmental contributions to their developmental link. We further tested whether this developmental association remained across the transition to young adulthood. METHODS We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2,232 British twins. In childhood, ADHD and emotional problems were assessed at ages 5, 7, 10 and 12 with mothers' and teachers' reports. At age 18, we used self-reported symptoms according to DSM-5 criteria for ADHD, and DSM-IV for anxiety and depression. RESULTS Longitudinal analyses showed that earlier ADHD was associated with later emotional problems consistently across childhood. However, earlier emotional problems were not associated with later ADHD symptoms. The developmental association between ADHD and later emotional problems in childhood was entirely explained by common genetic factors. Consistent with results in childhood, earlier symptoms of ADHD were associated with later emotional problems during the transition to young adulthood. CONCLUSIONS Our findings demonstrate that ADHD symptoms are predictors of the development of emotional problems, from childhood up to young adulthood, through shared genetic influences. Interventions targeting ADHD symptoms might prevent the development of emotional problems. Clinicians treating youth with ADHD must be aware of their risk for developing emotional problems and ought to assess, monitor and treat emotional problems alongside ADHD symptoms from childhood to adulthood.
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Affiliation(s)
- Adi Stern
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Jessica Agnew-Blais
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Andrea Danese
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK,Department of Child and Adolescent Psychiatry, King’s College London, London, UK,National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Helen L. Fisher
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Timothy Matthews
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Guilherme V. Polanczyk
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, BR
| | - Jasmin Wertz
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Louise Arseneault
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
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23
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Simmons JA, Antshel KM. Bullying and Depression in Youth with ADHD: A Systematic Review. CHILD & YOUTH CARE FORUM 2020. [DOI: 10.1007/s10566-020-09586-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Silva LAD, Doyenart R, Henrique Salvan P, Rodrigues W, Felipe Lopes J, Gomes K, Thirupathi A, Pinho RAD, Silveira PC. Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:584-592. [PMID: 31081373 DOI: 10.1080/09603123.2019.1612041] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to verify the effects of swimming-learning program of mental health parameters, cognition and motor coordination in students with Attention Deficit Hyperactivity Disorder (ADHD). Thirty-three children of both sexes between 11 and 14 years were randomized into trained group (n = 18) and untrained group (n = 15). The training was performed for 8 weeks. Then, before and after 48 h of training period of both groups were submitted to find the mental health, cognition, motor coordination test, and physical fitness. Our results demonstrate that the aquatic exercise program significantly improved the depression parameters (p = 0.048), stress (p = 0.039), cognitive flexibility (p = 0.042) and selective attention (p = 0.047). In relation to motor coordination and physical fitness, the results showed significant improvements in the coordination of lower limbs laterality (p = 0.05), flexibility (p = 0.049), and abdominal resistance (p = 0.037). Taken together, the results suggest that swimming-learning program significantly improved the mental health, cognition, and motor coordination in children with ADHD.
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Affiliation(s)
- Luciano Acordi Da Silva
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Ramiro Doyenart
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Paulo Henrique Salvan
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Welber Rodrigues
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - João Felipe Lopes
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Karen Gomes
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Anand Thirupathi
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University , Shijiazhuang, Hebei, China
| | - Ricardo Aurino De Pinho
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná , Curitiba, Brazil
| | - Paulo Cesar Silveira
- Laboratory of Experimental Physiopathology, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
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Rohde C, Brink P, Østergaard SD, Nielsen J. The use of stimulants in depression: Results from a self-controlled register study. Aust N Z J Psychiatry 2020; 54:808-817. [PMID: 32447969 DOI: 10.1177/0004867420924076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effectiveness of stimulants in patients with depression, by using naturalistic outcome measures, such as psychiatric admissions, psychiatric bed-days and incidents of intentional self-harm or suicide attempts. METHODS Via linkage of the Danish nationwide health registers, we identified all patients with a diagnosis of depression initiating stimulants, including methylphenidate, modafinil, amphetamine, dexamphetamine or lisdexamphetamine, from 1995 to 2012. We used a mirror-image model to test whether redemption of a stimulant prescription was associated with a reduction in psychiatric admissions, inpatient days and incidents of intentional self-harm or suicide attempts. Specifically, the number of these outcomes in the 2 years leading up to redemption of a stimulant prescription was compared to the two subsequent years. Similar outcomes were used in a reverse mirror-image model to investigate the effect of stimulant termination. RESULTS A total of 3354, 935 and 105 patients diagnosed with depression redeemed prescriptions for methylphenidate, modafinil or amphetamine/dexamphetamine/lisdexamphetamine, respectively. Initiation of methylphenidate was not associated with a significant change in psychiatric admissions (mean: -0.02 admissions, p = 0.11) or inpatient days (mean: 0.13 days, p = 0.74). Similar findings were made for modafinil and the amphetamines. In addition, no clinically relevant change in psychiatric admissions or inpatient days was found after termination of a stimulant. After initiation of methylphenidate, the incidents of self-harm or suicide attempts were reduced by 54%, from 68 to 31 events (p = 0.004). No significant change in incidents of self-harm or suicide attempts were found for modafinil or the amphetamines. CONCLUSION This nationwide study, using naturalistic outcomes, does not support the use of stimulants in patients with depression. However, the use of methylphenidate was associated with a 54% reduction in incidents of self-harm or suicide attempts, indicating that methylphenidate may potentially be useful in patients with depression with suicidal- or self-harming behaviour. However, further studies are needed, before any firm conclusions can be made.
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Affiliation(s)
- Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Psykiatrisk Center Glostrup (Mental Health Center), Copenhagen University Hospital, Copenhagen, Denmark
| | - Philip Brink
- Department of Oncology, Vejle Hospital and University of Southern Denmark, Vejle, Denmark
| | - Søren D Østergaard
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jimmi Nielsen
- Psykiatrisk Center Glostrup (Mental Health Center), Copenhagen University Hospital, Copenhagen, Denmark
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Akingbuwa WA, Hammerschlag AR, Jami ES, Allegrini AG, Karhunen V, Sallis H, Ask H, Askeland RB, Baselmans B, Diemer E, Hagenbeek FA, Havdahl A, Hottenga JJ, Mbarek H, Rivadeneira F, Tesli M, van Beijsterveldt C, Breen G, Lewis CM, Thapar A, Boomsma DI, Kuja-Halkola R, Reichborn-Kjennerud T, Magnus P, Rimfeld K, Ystrom EIVIND, Jarvelin MR, Lichtenstein P, Lundstrom S, Munafò MR, Plomin R, Tiemeier H, Nivard MG, Bartels M, Middeldorp CM. Genetic Associations Between Childhood Psychopathology and Adult Depression and Associated Traits in 42 998 Individuals: A Meta-analysis. JAMA Psychiatry 2020; 77:715-728. [PMID: 32293669 PMCID: PMC7160753 DOI: 10.1001/jamapsychiatry.2020.0527] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/17/2020] [Indexed: 12/14/2022]
Abstract
Importance Adult mood disorders are often preceded by behavioral and emotional problems in childhood. It is yet unclear what explains the associations between childhood psychopathology and adult traits. Objective To investigate whether genetic risk for adult mood disorders and associated traits is associated with childhood disorders. Design, Setting, and Participants This meta-analysis examined data from 7 ongoing longitudinal birth and childhood cohorts from the UK, the Netherlands, Sweden, Norway, and Finland. Starting points of data collection ranged from July 1985 to April 2002. Participants were repeatedly assessed for childhood psychopathology from ages 6 to 17 years. Data analysis occurred from September 2017 to May 2019. Exposures Individual polygenic scores (PGS) were constructed in children based on genome-wide association studies of adult major depression, bipolar disorder, subjective well-being, neuroticism, insomnia, educational attainment, and body mass index (BMI). Main Outcomes and Measures Regression meta-analyses were used to test associations between PGS and attention-deficit/hyperactivity disorder (ADHD) symptoms and internalizing and social problems measured repeatedly across childhood and adolescence and whether these associations depended on childhood phenotype, age, and rater. Results The sample included 42 998 participants aged 6 to 17 years. Male participants varied from 43.0% (1040 of 2417 participants) to 53.1% (2434 of 4583 participants) by age and across all cohorts. The PGS of adult major depression, neuroticism, BMI, and insomnia were positively associated with childhood psychopathology (β estimate range, 0.023-0.042 [95% CI, 0.017-0.049]), while associations with PGS of subjective well-being and educational attainment were negative (β, -0.026 to -0.046 [95% CI, -0.020 to -0.057]). There was no moderation of age, type of childhood phenotype, or rater with the associations. The exceptions were stronger associations between educational attainment PGS and ADHD compared with internalizing problems (Δβ, 0.0561 [Δ95% CI, 0.0318-0.0804]; ΔSE, 0.0124) and social problems (Δβ, 0.0528 [Δ95% CI, 0.0282-0.0775]; ΔSE, 0.0126), and between BMI PGS and ADHD and social problems (Δβ, -0.0001 [Δ95% CI, -0.0102 to 0.0100]; ΔSE, 0.0052), compared with internalizing problems (Δβ, -0.0310 [Δ95% CI, -0.0456 to -0.0164]; ΔSE, 0.0074). Furthermore, the association between educational attainment PGS and ADHD increased with age (Δβ, -0.0032 [Δ 95% CI, -0.0048 to -0.0017]; ΔSE, 0.0008). Conclusions and Relevance Results from this study suggest the existence of a set of genetic factors influencing a range of traits across the life span with stable associations present throughout childhood. Knowledge of underlying mechanisms may affect treatment and long-term outcomes of individuals with psychopathology.
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Affiliation(s)
- Wonuola A. Akingbuwa
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Anke R. Hammerschlag
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Eshim S. Jami
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Andrea G. Allegrini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ville Karhunen
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Hannah Sallis
- University of Bristol School of Psychological Science, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragna B. Askeland
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Bart Baselmans
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Elizabeth Diemer
- Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Fiona A. Hagenbeek
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Alexandra Havdahl
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hamdi Mbarek
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Qatar Genome Programme, Qatar Foundation, Doha, Qatar
| | - Fernando Rivadeneira
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Erasmus MC, Department of Epidemiology, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Erasmus MC, Department of Internal Medicine, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Martin Tesli
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- National Institute of Health Research Biomedical Research Centre, South London and Maudsley National Health Services Foundation Trust, London, London, United Kingdom
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Anita Thapar
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Dorret I. Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kaili Rimfeld
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - EIVIND Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Medical Research Council–Public Health England Centre for Environment and Health, Imperial College London, London, United Kingdom
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
- Institute of Biomedicine and Biocenter of Oulu, Oulu, Finland
- Department of Life Sciences, Brunel University London College of Health and Life Sciences, London, United Kingdom
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Lundstrom
- Centre for Ethics Law and Mental Health, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Marcus R. Munafò
- University of Bristol School of Psychological Science, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol National Health Services Foundation Trust, University of Bristol, Bristol, United Kingdom
| | - Robert Plomin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Henning Tiemeier
- Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Social and Behavioral Science, Harvard T. H. Chan School of Medicine, Boston, Massachusetts
| | - Michel G. Nivard
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Christel M. Middeldorp
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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Changes in College Student Endorsement of ADHD Symptoms across DSM Edition. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09797-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Chen LC, Chen YH, Bai YM, Chen TJ, Chen MH, Su TP. Antidepressant resistance in adolescents with major depressive disorder: A nationwide longitudinal study. J Affect Disord 2020; 262:293-297. [PMID: 31733920 DOI: 10.1016/j.jad.2019.11.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Studies have suggested that psychiatric comorbidities have major effects on antidepressant resistance in adult patients with major depressive disorder (MDD). However, the association between psychiatric comorbidities and antidepressant resistance remains unclear in adolescents with MDD. METHODS A total of 10,624 adolescents with MDD were selected from the Taiwan National Health Insurance Research Database between 2001 and 2010 and followed for one year. Treatment-resistant depression (TRD) was defined as unresponsiveness to at least two antidepressants, and treatment resistant tendency was defined as unresponsiveness to the first antidepressant. Psychiatric comorbidities, such as anxiety disorders, substance use disorders, and attention deficit hyperactivity disorder (ADHD), were assessed as confounding factors. RESULTS In our study, only 1.7% (n = 184) of adolescents with MDD met the TRD criteria but 23.3% (n = 2480) were classified as exhibiting treatment resistant tendency. Anxiety disorders (OR: 2.34, 95% CI: 1.73-3.16) and substance use disorders (OR: 2.41, 95% CI: 1.28-4.54) exhibited a correlation with TRD, and ADHD (OR: 1.34, 95% CI: 1.08-1.66) was associated with treatment resistant tendency. CONCLUSIONS Approximately one-fourth of adolescents with MDD respond poorly to the first antidepressant treatment. The psychiatric comorbidities of anxiety disorders, substance use disorders, and ADHD may increase the risk of treatment resistance in adolescents with MDD.
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Affiliation(s)
- Li-Chi Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yu-Hsiung Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.
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29
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Grimm O, Weber H, Kittel-Schneider S, Kranz TM, Jacob CP, Lesch KP, Reif A. Impulsivity and Venturesomeness in an Adult ADHD Sample: Relation to Personality, Comorbidity, and Polygenic Risk. Front Psychiatry 2020; 11:557160. [PMID: 33381055 PMCID: PMC7768074 DOI: 10.3389/fpsyt.2020.557160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/12/2020] [Indexed: 12/25/2022] Open
Abstract
While impulsivity is a basic feature of attention-deficit/hyperactivity disorder (ADHD), no study explored the effect of different components of the Impulsiveness (Imp) and Venturesomeness (Vent) scale (IV7) on psychiatric comorbidities and an ADHD polygenic risk score (PRS). We used the IV7 self-report scale in an adult ADHD sample of 903 patients, 70% suffering from additional comorbid disorders, and in a subsample of 435 genotyped patients. Venturesomeness, unlike immediate Impulsivity, is not specific to ADHD. We consequently analyzed the influence of Imp and Vent also in the context of a PRS on psychiatric comorbidities of ADHD. Vent shows a distinctly different distribution of comorbidities, e.g., less anxiety and depression. PRS showed no effect on different ADHD comorbidities, but correlated with childhood hyperactivity. In a complementary analysis using principal component analysis with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ADHD criteria, revised NEO Personality Inventory, Imp, Vent, and PRS, we identified three ADHD subtypes. These are an impulsive-neurotic type, an adventurous-hyperactive type with a stronger genetic component, and an anxious-inattentive type. Our study thus suggests the importance of adventurousness and the differential consideration of impulsivity in ADHD. The genetic risk is distributed differently between these subtypes, which underlines the importance of clinically motivated subtyping. Impulsivity subtyping might give insights into the organization of comorbid disorders in ADHD and different genetic background.
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Affiliation(s)
- Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.,Klinik für Psychiatrie und Psychotherapie der Medius Klinik, Kirchheim unter Teck, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.,Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany
| | - Thorsten M Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Christian P Jacob
- Klinik für Psychiatrie und Psychotherapie der Medius Klinik, Kirchheim unter Teck, Germany
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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30
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Delibas DH, Erdogan E, Gulseren S. Evaluation of clinical and suicidal behavior characteristics among urban, Turkish middle-age depressive patients with comorbid attention deficit hyperactivity disorder. Indian J Psychiatry 2019; 61:612-617. [PMID: 31896868 PMCID: PMC6862990 DOI: 10.4103/psychiatry.indianjpsychiatry_448_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND In the presence of attention deficit hyperactivity disorder (ADHD) together with additional psychiatric diseases, the treatment process and prognosis of both ADHD and psychiatric comorbidity are adversely affected. AIMS The aim of this study is to compare the characteristics concerning suicidal behavior of the patients diagnosed with major depressive disorder either having (ADHD+) or not having (ADHD-) adult ADHD comorbidity and their responses to depression treatment. MATERIALS AND METHODS Ninety-six inpatients were included in the study. Sociodemographic data form, the Hamilton Depression Rating Scale (HDRS), the Wender Utah Rating Scale (WURS), the Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale, and the Personal and Social Performance Scale (PSP) were applied to the cases. RESULTS HDRS scores were found to be significantly high (P < 0.000) in the ADHD+ group during admission and discharge. However, there was no difference found in terms of PSP scores (P = 0.46) during discharge. In the ADHD+ group, the depressive episode started at an earlier age (P < 0.011). The idea of suicide (P < 0.018) and suicidal attempts (P < 0.022) was found to be higher in this group compared to the ADHD- group. ADHD+ patients had more suicidal attempts requiring more medical intervention (P < 0.001). CONCLUSION Depression starts at an early age in individuals with comorbid ADHD diagnosis, and the progress of the depression treatment changes negatively. This patient group is at greater risk in terms of suicidal behavior. Therefore, it should be considered by the clinicians that ADHD can associate with depression while making the follow-up plans for the cases diagnosed with depression.
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Affiliation(s)
- Dursun Hakan Delibas
- Department of Psychiatry, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Esin Erdogan
- Department of Psychiatry, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Seref Gulseren
- Department of Psychiatry, Izmir Ataturk Training and Research Hospital, Katip Çelebi University, İzmir, Turkey
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Pond E, Fowler K, Hesson J. The Influence of Socioeconomic Status on Psychological Distress in Canadian Adults With ADD/ADHD. J Atten Disord 2019; 23:940-948. [PMID: 27288904 DOI: 10.1177/1087054716653214] [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 The primary purpose of this study was to examine the relationship between socioeconomic status (SES) and psychological distress in individuals self-reporting a diagnosis of attention deficit disorder (ADD)/ADHD. METHOD This correlational study encompasses cross-sectional data from 488 male and female adults (20-64 years) who reported that they have been diagnosed with ADD/ADHD. Psychological distress was measured with the Kessler Psychological Distress Scale (K10). RESULTS Adults with ADD/ADHD and high incomes have significantly lower K10 scores than Canadians with ADD/ADHD and low incomes. Income, but not education, was significant in predicting psychological distress among the sample. Canadian adults with ADD/ADHD have an increased risk for developing psychological distress and comorbid psychiatric disorders. CONCLUSION The findings suggest that negative outcomes associated with ADD/ADHD are not necessarily pervasive. High income may serve as a protective factor for psychological distress among adults with ADD/ADHD.
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Affiliation(s)
- Emily Pond
- 1 Memorial University of Newfoundland, St. John's, Canada
| | - Ken Fowler
- 1 Memorial University of Newfoundland, St. John's, Canada
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Relational impairments, sluggish cognitive tempo, and severe inattention are associated with elevated self-rated depressive symptoms in adolescents with ADHD. ACTA ACUST UNITED AC 2019; 11:289-298. [PMID: 30852727 DOI: 10.1007/s12402-019-00293-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Abstract
This study examines how ADHD-related symptoms and impairments interact to predict depression symptoms in young adolescents with ADHD. A sample of 342 adolescents (71% male, mean age = 13 years old) with DSM-IV-TR diagnosed ADHD completed baseline clinical assessments upon entry to a psychosocial treatment study for ADHD. Ratings of ADHD and sluggish cognitive tempo (SCT) symptoms, and social and academic impairment were obtained from parents, while ratings of depressive symptoms and conflict with parents were obtained from youth. Among adolescents with ADHD, elevated depressive symptoms were associated with higher SCT symptom severity, lower hyperactive/impulsive (HI) symptom severity, higher social impairments, higher conflict with parents, and lower academic problems. Interaction effects indicated that clinically significant depressive symptoms were most likely to occur when high levels of parent-youth conflict were present along with high inattentive (IN) symptoms, high SCT, and/or low HI. Among children and adolescents with ADHD, depression prevention efforts might target IN/SCT symptom management, as well as improving interpersonal relationships with parents and peers. Future work is needed to verify these findings longitudinally.
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Kostev K, Teichgräber F, Konrad M, Jacob L. Association between chronic somatic conditions and depression in children and adolescents: A retrospective study of 13,326 patients. J Affect Disord 2019; 245:697-701. [PMID: 30447568 DOI: 10.1016/j.jad.2018.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/23/2018] [Accepted: 11/03/2018] [Indexed: 12/13/2022]
Abstract
AIMS The goal of this study was to analyze the association between chronic somatic conditions and depression diagnosis in children and adolescents. METHODS The present case-control study included 13,326 children and adolescents with depression as well as controls without depression followed in 243 pediatric practices between 2010 and 2015. Cases and controls were matched by age, gender, index year, and physician. The effect of several chronic disorders in terms of the risk of developing depression was estimated using logistic regression models. RESULTS Depression was diagnosed in 0.7% of the population. The prevalence of depression increased with age from 0.2% in individuals aged 7 years to 2.0% in those aged 15 years. Depression was significantly associated with anorexia nervosa (OR = 6.69), ADHD (OR = 2.32), chronic sinusitis (OR = 1.82), short stature due to endocrine disorder (OR = 1.70), obesity (OR = 1.57), disorders of the thyroid gland (OR = 1.53) and certain disorders involving the immune mechanism (OR = 1.42). The risk of a depression diagnosis also increased with the number of chronic conditions (one condition: OR = 1.69; two conditions: OR = 1.81; more than two conditions: OR = 2.03). CONCLUSIONS Depression was associated with several chronic disorders and the number of such conditions in pediatric practices in Germany. Therefore, depression should be regularly assessed in young patients affected by chronic disorders.
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Affiliation(s)
- Karel Kostev
- Epidemiology, IQVIA, Darmstädter Landstraße 108, Frankfurt, 60598, Germany.
| | | | - Marcel Konrad
- Health & Social, FOM University of Applied Sciences for Economics and Management, Frankfurt am Main, Germany
| | - Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
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Tsai FJ, Tseng WL, Yang LK, Gau SSF. Psychiatric comorbid patterns in adults with attention-deficit hyperactivity disorder: Treatment effect and subtypes. PLoS One 2019; 14:e0211873. [PMID: 30730956 PMCID: PMC6366698 DOI: 10.1371/journal.pone.0211873] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022] Open
Abstract
Psychiatric comorbidities are common in individuals with attention-deficit/hyperactivity disorder (ADHD). In this study, we sought to evaluate the effects of medication and childhood ADHD subtypes on psychiatric comorbidities among adults with ADHD as compared to healthy adult controls. We assessed 121 drug-naïve adults with ADHD, 93 treated adults with ADHD, and 145 healthy controls (age 18–36 years) using semi-structured psychiatric interviews, intelligence tests, and medical records. Drug-naïve adults with ADHD had more comorbidities than treated adults with ADHD and controls. Childhood ADHD-combined subtype, relative to ADHD-inattentive subtype, was associated with higher risks of comorbidities. Current medication treatment was associate with a higher risk for anxiety disorders, and longer treatment duration was associated with lower risks of mood disorders and sleep disorders. Our results indicate that no medication treatment, short treatment duration, and childhood ADHD-combined subtype are associated with increased risks for psychiatric comorbidities among adults with ADHD.
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Affiliation(s)
- Fang-Ju Tsai
- Department of Psychiatry, National Taiwan University and College of Medicine, Taipei, Taiwan
- Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Wan-Ling Tseng
- Emotion and Development Branch, National Institute of Mental Heath, National Institutes of Health, Department of Health and Human Sevices, Bethesda, MD, United States of America
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University and College of Medicine, Taipei, Taiwan
- Beitou Branch, Tri-Service General Hospital, National Medical Defense Center, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Adult outcomes of childhood disruptive disorders in offspring of depressed and healthy parents. J Affect Disord 2019; 244:107-112. [PMID: 30340098 PMCID: PMC6434691 DOI: 10.1016/j.jad.2018.10.086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Longitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders. METHOD Offspring (N = 267) of parents with or without major depression (MDD), but no ASPD or bipolar disorders were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested. RESULTS Eighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AOR = 3.42, p < 0.0001), bipolar disorder (AOR = 3.10, p = 0.03), and substance use disorders (AOR = 5.69, p < 0.0001) by age 18, as well as poorer school performance and global functioning. DDs continued to predict MDD and substance use outcomes in adulthood, even after accounting for presence of the corresponding disorder in childhood (MDD: hazards ratio, HR = 3.25, p < 0.0001; SUD, HR = 2.52, p < 0.0001). Associations were similar among the offspring of parents with and without major depression. DDs did not predict adulthood ASPD in either group. LIMITATIONS Associations are largely accounted for by conduct disorder (CD), as there were few offspring with ADHD, and oppositional defiant disorder (ODD) was not diagnosed at the time this study began. CONCLUSION If there is no familial risk for ASPD, bipolar disorder or substance use, childhood DDs do not lead to ASPD in adulthood; however, the children still have poorer prognosis into midlife. Early treatment of children with DD, particularly CD, while carefully considering familial risk for these disorders, may help mitigate later adversity.
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Behbahani M, Zargar F, Assarian F, Akbari H. Effects of Mindful Parenting Training on Clinical Symptoms in Children with Attention Deficit Hyperactivity Disorder and Parenting Stress: Randomized Controlled Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:596-604. [PMID: 30510336 PMCID: PMC6230940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Children with attention deficit hyperactivity disorder (ADHD) are at risk of impairment in multiple domains. This study aimed to investigate the effectiveness of mindful parenting training in reducing clinical symptoms in children with ADHD and parenting stress of their parents. METHODS This randomized clinical trial was conducted on 2 groups (experimental and control) in 3 phases (pretest, posttest, and 8 weeks' follow-up). Sixty children with ADHD, who had been referred by the child psychiatrist in the Iranian city of Kashan in the second half of the year 2016, were selected along with their mothers. The mothers were assigned to one of the 2 groups via permuted blocked randomization. The mothers completed the parenting stress index-short form (PSI-SF 36) and the Swanson, Nolan, and Pelham Parent and Teacher rating scale (SNAP-IV). All the children in both groups received pharmacotherapy with either risperidone or Ritalin. The intervention group received 8 sessions (1 session each week, each session lasting 90 minutes) of mindful parenting training based on the Kabat-Zinn protocol. The data were analyzed using SPSS, version 20, via the t test, χ2 test, repeated measures analysis of variance, and nonparametric Friedman test. RESULTS This study showed a reduction in parenting stress, negative parent-child interactions, and children's problematic characteristics in the mindful parenting training group compared with the control group in the posttest and follow-up. Our results also demonstrated a significant improvement in ADHD symptoms in the experimental group by comparison with the control group in the posttest and follow-up. CONCLUSION Mindful parenting training was effective in reducing parenting stress and ADHD symptoms in our intervention group. Trial Registration Number: IRCT2016021026505N1.
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Affiliation(s)
- Mahdiyeh Behbahani
- Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Zargar
- Department of Psychiatry and Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Assarian
- Department of Psychiatry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hosein Akbari
- Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
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Franke B, Michelini G, Asherson P, Banaschewski T, Bilbow A, Buitelaar JK, Cormand B, Faraone SV, Ginsberg Y, Haavik J, Kuntsi J, Larsson H, Lesch KP, Ramos-Quiroga JA, Réthelyi JM, Ribases M, Reif A. Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Eur Neuropsychopharmacol 2018; 28:1059-1088. [PMID: 30195575 PMCID: PMC6379245 DOI: 10.1016/j.euroneuro.2018.08.001] [Citation(s) in RCA: 314] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 06/25/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is highly heritable and the most common neurodevelopmental disorder in childhood. In recent decades, it has been appreciated that in a substantial number of cases the disorder does not remit in puberty, but persists into adulthood. Both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use, depression, anxiety, and accidents. However, course and symptoms of the disorder and the comorbidities may fluctuate and change over time, and even age of onset in childhood has recently been questioned. Available evidence to date is poor and largely inconsistent with regard to the predictors of persistence versus remittance. Likewise, the development of comorbid disorders cannot be foreseen early on, hampering preventive measures. These facts call for a lifespan perspective on ADHD from childhood to old age. In this selective review, we summarise current knowledge of the long-term course of ADHD, with an emphasis on clinical symptom and cognitive trajectories, treatment effects over the lifespan, and the development of comorbidities. Also, we summarise current knowledge and important unresolved issues on biological factors underlying different ADHD trajectories. We conclude that a severe lack of knowledge on lifespan aspects in ADHD still exists for nearly every aspect reviewed. We encourage large-scale research efforts to overcome those knowledge gaps through appropriately granular longitudinal studies.
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Affiliation(s)
- Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Giorgia Michelini
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Philip Asherson
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andrea Bilbow
- Attention Deficit Disorder Information and Support Service (ADDISS), Edgware, UK; ADHD-Europe, Brussels, Belgium
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Bru Cormand
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York Upstate Medical University, New York, USA; K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Ylva Ginsberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Jan Haavik
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Jonna Kuntsi
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany; Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE NAP-B Molecular Psychiatry Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - Marta Ribases
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
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Jacob L, Haro JM, Koyanagi A. Attention deficit hyperactivity disorder symptoms and disordered eating in the English general population. Int J Eat Disord 2018; 51:942-952. [PMID: 30256445 DOI: 10.1002/eat.22934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/12/2018] [Accepted: 07/12/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder (ADHD) symptoms and eating problems often coexist, but many of the previous studies have not taken into account key variables which may be important in this association. Thus, the goal of this study was to assess the association between ADHD symptoms and disordered eating, while taking into account of a variety of factors. METHOD This study used cross-sectional, nationally representative data from 7,403 people aged ≥16 years from England who participated in the 2007 Adult Psychiatric Morbidity Survey (APMS). ADHD symptoms were assessed with the Adult ADHD Self-Report Scale (ASRS) Screener. Questions from the five-item SCOFF screening instrument were used to identify possible ED. Multivariable logistic regression analyses were conducted. RESULTS The prevalence of possible eating disorder (ED) was much higher among those with ADHD symptoms (ASRS score ≥14) compared to those without ADHD symptoms (19.2 vs. 5.7%). ADHD symptoms were associated with possible ED (odds ratio [OR] = 3.48; 95% confidence interval [CI] = 2.56-4.72) after adjustment for age, sex, and ethnicity. After further adjustment for alcohol dependence, drug use, intelligence quotient, stressful life events, perceived stress, impulsivity, depression, anxiety disorder, and borderline personality disorder (BPD) traits, the OR was attenuated to 1.32 (95% CI = 0.82-2.13). Anxiety and BPD were the factors that led to the largest degree of attenuation. DISCUSSION A high prevalence of disordered eating in individuals with ADHD was observed. Factors such as co-existing anxiety and BPD traits may be particularly important in this association. Future research should focus on the factors involved in the association between ADHD symptoms and disordered eating behavior.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
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Oppositional behavior and longitudinal predictions of early adulthood mental health problems in chronic tic disorders. Psychiatry Res 2018; 266:301-308. [PMID: 29576412 DOI: 10.1016/j.psychres.2018.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 01/24/2018] [Accepted: 03/13/2018] [Indexed: 11/23/2022]
Abstract
Chronic tic disorders (TD) are associated with a number of psychological problems such as attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive behavior (OCB), oppositional-defiant disorder (ODD) as well as anxious and depressive symptoms. ODD is often considered a risk factor for many psychological symptoms and recent work suggests that different ODD dimensions show independent predictions of later psychological problems. This study examined the longitudinal predictions between ODD dimensions of Irritability and Defiance and the most frequent comorbidities in TD from childhood to early adulthood. From an initial sample of 135, parent reports were obtained on 58 participants with TD using standard clinical questionnaires and semi-structured interviews. Defiance symptoms decreased from baseline to follow-up whereas Irritability symptoms were more stable over time. In multiple regressions, Irritability in childhood predicted anxiety and OCB in early adulthood while Defiance in childhood predicted ADHD and conduct disorder symptoms in early adulthood. No developmental link was found for depressive symptoms. Results indicate that ODD dimensions are developmentally linked to both internalizing and externalizing adult mental health symptoms in TD.
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De Crescenzo F, Ziganshina LE, Yudina EV, Kaplan YC, Ciabattini M, Wei Y, Hoyle CHV. Noradrenaline reuptake inhibitors (NRIs) for attention deficit hyperactivity disorder (ADHD) in adults. Hippokratia 2018. [DOI: 10.1002/14651858.cd013044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Franco De Crescenzo
- Catholic University of the Sacred Heart; Institute of Psychiatry and Psychology; L.go A. Gemelli 8 Rome Italy 00168
| | - Liliya Eugenevna Ziganshina
- Kazan (Volga region) Federal University; Research & Education Centre for Evidence-Based Medicine Cochrane Russia; 18 Kremlevskaya Street, 420008 14-15 Malaya Krasnaya Street, 420015 Kazan Tatarstan Russian Federation
- Kazan (Volga region) Federal University; Department of Basic and Clinical Pharmacology; Kazan Russian Federation
| | - Ekaterina V Yudina
- Kazan (Volga region) Federal University; Research & Education Centre for Evidence-Based Medicine Cochrane Russia; 18 Kremlevskaya Street, 420008 14-15 Malaya Krasnaya Street, 420015 Kazan Tatarstan Russian Federation
- Kazan (Volga region) Federal University; Department of Basic and Clinical Pharmacology; Kazan Russian Federation
| | - Yusuf Cem Kaplan
- Izmir Katip Celebi University School of Medicine; Department of Pharmacology; Izmir Turkey 35360
| | | | - Yinghui Wei
- University of Plymouth; Centre for Mathematical Sciences, School of Computing, Electronics and Mathematics; Plymouth UK
| | - Charles HV Hoyle
- Kazan (Volga region) Federal University; Research & Education Centre for Evidence-Based Medicine Cochrane Russia; 18 Kremlevskaya Street, 420008 14-15 Malaya Krasnaya Street, 420015 Kazan Tatarstan Russian Federation
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Meinzer MC, Hartley CM, Hoogesteyn K, Pettit JW. Development and Open Trial of a Depression Preventive Intervention for Adolescents With Attention-Deficit/Hyperactivity Disorder. COGNITIVE AND BEHAVIORAL PRACTICE 2018; 25:225-239. [PMID: 31787832 DOI: 10.1016/j.cbpra.2017.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for experiencing unipolar depressive symptoms and disorders. The current study describes the development of a behaviorally oriented depression preventive intervention tailored for adolescents with ADHD targeting variables empirically shown to mediate ADHD and depression (i.e., reward responsivity, emotion regulation, and family support). Eight adolescents with a history of ADHD and currently elevated depressive symptoms and their parents participated in an open trial of the Behaviorally Enhancing Adolescents' Mood (BEAM) program. Adolescents and their parents reported high satisfaction with BEAM. Staff reported BEAM was easy to implement with high adherence. Following BEAM, there were significant reductions in parent-report of adolescents' depressive symptoms and emotion regulation at posttreatment and the 6-week follow-up and adolescent-report of reward responsivity at posttreatment. Case vignettes are also provided to illustrate implementation of the BEAM program. In spite of the small sample, lack of a control group, and some discrepancies across informants, results overall support the feasibility and acceptability of the BEAM program, and suggest it has promise in reducing depressive symptoms in adolescents with ADHD.
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Abstract
OBJECTIVE ADHD is associated with elevated rates of comorbid depressive disorders, yet the nature and development of this comorbidity remain understudied. We hypothesized that a longer period of prior ADHD treatment, being less likely to engage in maladaptive cognitive/behavioral coping strategies, and less severe ADHD symptoms would predict greater likelihood of lifetime resilience to depression. METHOD Seventy-seven adults with ADHD completed diagnostic interviews, clinician-administered symptom rating scales, a stressful life events measure, and self-report questionnaires. We used logistic regression analyses to identify factors associated with resilience to depression. RESULTS Adults with more extensive ADHD treatment histories were more likely to be resilient to depression. Those who were less likely to report ruminative thinking patterns and cognitive-behavioral avoidance were also more resilient. Severity of current or childhood ADHD symptoms and recent negative life events did not predict resilience. CONCLUSION Results identify protective factors that may promote the resiliency to ADHD-depression comorbidity.
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Mayer JS, Hees K, Medda J, Grimm O, Asherson P, Bellina M, Colla M, Ibáñez P, Koch E, Martinez-Nicolas A, Muntaner-Mas A, Rommel A, Rommelse N, de Ruiter S, Ebner-Priemer UW, Kieser M, Ortega FB, Thome J, Buitelaar JK, Kuntsi J, Ramos-Quiroga JA, Reif A, Freitag CM. Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial. Trials 2018; 19:140. [PMID: 29482662 PMCID: PMC5828138 DOI: 10.1186/s13063-017-2426-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/18/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day-night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD. METHODS This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 - < 30 years, will be screened at the four study centers. To establish effect sizes, the sample size was planned at the liberal significance level of α = 0.10 (two-sided) and the power of 1-β = 80% in order to find medium effects. Secondary outcomes measures including change in obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up. DISCUSSION This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and obesity, a larger scale confirmatory phase-III trial may be warranted. TRIAL REGISTRATION German Clinical Trials Register, DRKS00011666. Registered on 9 February 2017. ClinicalTrials.gov, NCT03371810. Registered on 13 December 2017.
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Affiliation(s)
- Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany.
| | - Katharina Hees
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Juliane Medda
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Philip Asherson
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mariano Bellina
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Michael Colla
- Department of Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - Pol Ibáñez
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Elena Koch
- Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Antonio Martinez-Nicolas
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Chronobiology Research Group, Department of Physiology, Faculty of Biology, University of Murcia. Campus Mare Nostrum. IUIE. IMIB-Arrixaca. Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Adrià Muntaner-Mas
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Physical Activity and Exercise Sciences Research Group, University of Balearic Islands, Palma, Spain
| | - Anna Rommel
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nanda Rommelse
- Department of Psychiatry, Radboudumc, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Saskia de Ruiter
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Ulrich W Ebner-Priemer
- Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Johannes Thome
- Department of Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - Jan K Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Jonna Kuntsi
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
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Shura RD, Miskey HM, Williams VG, Jadidian A, Rowland JA. Informing Evidence-Based Assessment of ADHD in Veterans and Service Members. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Robert D. Shura
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina, and Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine
| | - Holly M. Miskey
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina, and Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine
| | - Vanessa G. Williams
- Patient Care Services Psychology, Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado
| | - Alex Jadidian
- Mental Health & Behavioral Sciences Service Line, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Jared A. Rowland
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina, and Department of Neurobiology and Anatomy, Wake Forest School of Medicine
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45
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Torrente F, López P, Lischinsky A, Cetkovich-Bakmas M, Manes F. Depressive symptoms and the role of affective temperament in adults with attention-deficit/hyperactivity disorder (ADHD): A comparison with bipolar disorder. J Affect Disord 2017; 221:304-311. [PMID: 28688349 DOI: 10.1016/j.jad.2017.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/10/2017] [Accepted: 06/17/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the characteristics of depressive symptoms and the influence of affective temperament in adults with attention-deficit/hyperactivity disorder (ADHD), in comparison with bipolar disorder (BD) patients and healthy controls (HCs). METHOD Sixty patients with ADHD, 50 patients with BD, and 30 HCs were assessed with instruments for measuring depressive symptoms (Beck Depression Inventory-II), and affective temperaments (Temperament Scale of Memphis, Pisa and San Diego, self-administered version; TEMPS-A). In addition, participants were evaluated with scales for measuring ADHD symptoms, impulsiveness, anxiety, executive dysfunction, and quality of life. RESULTS ADHD patients showed levels of depressive symptoms similar to BD patients and higher than HCs. Only neurovegetative symptoms of depression differentiated ADHD and BD groups (BD > ADHD). Depressive symptoms in ADHD patients correlated positively with core ADHD, impulsivity, anxiety, and dysexecutive symptoms and negatively with quality of life. Thirty-eight percent of patients with ADHD scored above the cutoff for at least one affective temperament. Cyclothymic was the more common affective temperament (25%). ADHD patients with affective temperamental traits were more depressed and impulsive than patients without those traits and showed a symptomatic profile analogous to BD patients. LIMITATIONS The small size of resultant samples when ADHD group was stratified by the presence of affective temperament. In addition, results may not generalize to less severe ADHD patients from the community. CONCLUSIONS Concomitant depressive symptoms constitute a common occurrence in adults with ADHD that carries significant psychopathological and functional consequences. The concept of affective temperaments may be an interesting link for explaining depressive symptomatology and emotional impulsivity in a subgroup of patients with ADHD, beyond the classic idea of comorbidity.
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Affiliation(s)
- Fernando Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
| | - Pablo López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Alicia Lischinsky
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Marcelo Cetkovich-Bakmas
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Facundo Manes
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
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Neural substrates of trait impulsivity, anhedonia, and irritability: Mechanisms of heterotypic comorbidity between externalizing disorders and unipolar depression. Dev Psychopathol 2017; 28:1177-1208. [PMID: 27739396 DOI: 10.1017/s0954579416000754] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Trait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.
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Tong L, Shi H, Li X. Associations among ADHD, Abnormal Eating and Overweight in a non-clinical sample of Asian children. Sci Rep 2017; 7:2844. [PMID: 28588278 PMCID: PMC5460237 DOI: 10.1038/s41598-017-03074-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 04/24/2017] [Indexed: 11/30/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has been found to be comorbid with obesity in adults, but the association in children is uncertain. Because the underlying mechanism of comorbidity in children has not been researched sufficiently, this study aims to explore the associations among ADHD, abnormal eating, and body mass index (BMI), as well as the mediating effect of depression in children. We conducted a cross-sectional study of 785 primary students in China. The parent-report version of ADHD Rating Scale-IV (ADHDRS-IV), the Child Eating Behaviour Questionnaire (CEBQ) and the Children’s Eating Attitude Test (ChEAT) were used to identify ADHD symptoms and abnormal eating. The Child Behavior Checklist (CBCL) was applied to assess depression. Structural Equation Modeling was carried out to clarify the associations between ADHD symptoms, depression, abnormal eating, and overweight of students. We found that ADHD positively contributed to emotional eating and Bulimia Nervosa symptoms. However, neither emotional eating nor Bulimia Nervosa symptoms was related to BMI in children. We also found that ADHD significantly contributed to depression, and depression directly predicted emotional eating. In conclusion, ADHD increased the risk of abnormal eating in children, while no significant relationship existed between ADHD and BMI. Comorbid depression raised the risk of emotional eating, rather than Bulimia Nervosa symptoms.
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Affiliation(s)
- Lian Tong
- Department of Maternal, Child and Adolescent health, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Chinese Ministry of Education, Shanghai, China.
| | - Huijing Shi
- Department of Maternal, Child and Adolescent health, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Chinese Ministry of Education, Shanghai, China
| | - Xiaoru Li
- Department of Psychology, School of Social Development and Public Policy, Fudan University, Shanghai, China
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Jang BY, Bu SY. Nutritional Status of Korean Children and Adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Clin Nutr Res 2017; 6:112-121. [PMID: 28503507 PMCID: PMC5426209 DOI: 10.7762/cnr.2017.6.2.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 12/01/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) has been associated with an elevated risk for obesity but this seems to be paradoxical to the fact that many youths with ADHD have symptoms of hyperactivity. People diagnosed with ADHD tend to have a high risk of developing undesirable diet habits and consequently have health related problems. However, less attention has been paid to obesity in ADHD while many efforts have been devoted to the prevention of childhood obesity in mentally normal people. Hence the purpose of this study was to explore the nutritional status and life habits of children and adolescents with ADHD (n = 76) based on degree of obesity by utilizing the Korean National Health and Nutrition Examination Survey (KNHANES) data from 2005–2013. As results the levels of blood pressure, total triglycerides and the fat intake relative to total energy intake in overweight ADHD group were higher than those in normal weight group. Interestingly, overweight ADHD subjects consumed significantly less amount of iron compared to normal weight ADHD subjects and the level of serum ferritin was lower in the overweight ADHD group (59.0 ng/mL) than in the normal weight ADHD group (47.9 ng/mL). After adjusting total energy intake, total vegetable consumption was 14.3% lower in overweight group compared to the consumption in normal weight group. These results indicate a plausible relationship of iron status and obesity in ADHD subjects but this relationship may not be specific to ADHD. A future study with case-control design is necessary to investigate the association of obesity, nutrient intake, and cognitive/mental status of ADHD.
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Affiliation(s)
- Bo Young Jang
- Department of Food and Nutrition, Daegu University, Gyeongsan 38453, Korea
| | - So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan 38453, Korea
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Purper-Ouakil D, Porfirio MC, Le Strat Y, Falissard B, Gorwood P, Masi G. What do childhood attention deficit/hyperactivity symptoms in depressed adults tell us about the bipolar spectrum? Psychiatry Res 2017; 249:244-251. [PMID: 28126580 DOI: 10.1016/j.psychres.2016.12.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 06/15/2016] [Accepted: 12/31/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND This study aims to establish if adult patients with major depressive disorder (MDD) and childhood Attention Deficit/Hyperactivity disorder (ADHD) symptoms would be more frequently within the bipolar spectrum than depressed patients without childhood ADHD. METHODS This study was carried out in outpatients recruited by psychiatrists in private practice, with 3963 participants being included in the final sample. Clinicians filled out questionnaires about current depressive symptoms in their patients, lifetime bipolar symptoms, global assessment of functioning and parental history of both major depression and bipolar disorder. Patients assessed current level of anxiety and depressive symptoms and antecedents of childhood ADHD symptoms. RESULTS Depressed adults with significant childhood ADHD symptoms had a specific pattern of their major depressive episode compared to depressed patients without such symptoms. Subjects with childhood ADHD symptoms were more likely to report lifetime symptoms of mania/hypomania and to have a parent with type I or II bipolar disorder. The developmental trajectories of familial risk for lifetime bipolar symptoms showed that parental bipolar disorder influenced lifetime bipolar symptoms both through a direct pathway and an indirect pathway involving childhood ADHD symptoms. Childhood ADHD and number of depressive symptoms both made direct contributions to lifetime bipolar symptoms.
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Affiliation(s)
- D Purper-Ouakil
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, Montpellier, France.
| | - M C Porfirio
- Unit of Child Neurology and Psychiatry of "Tor Vergata", University of Rome, Italy
| | - Y Le Strat
- AP-HP Hôpital Louis Mourier, 178 Rue des Renouillers, 92700 Colombes, France; INSERM U894 Centre Psychiatrie et Neurosciences, Paris, France
| | - B Falissard
- INSERM U1178, Maison de Solenn, Paris, France
| | - P Gorwood
- INSERM U894 Centre Psychiatrie et Neurosciences, Paris, France; CMME Saint Anne Hospital, Hôpital Sainte-Anne (Paris-Descartes University), France
| | - G Masi
- Stella Maris Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
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ADHD and the Development of Depression: Commentary on the Prevalence, Proposed Mechanisms, and Promising Interventions. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2017; 4:1-4. [PMID: 33282629 DOI: 10.1007/s40474-017-0106-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has been identified as a significant risk factor for the development of later depression. Furthermore, their comorbid presentation results in greater levels of impairment than either disorder in isolation. Research has pointed to several causal mechanisms by which ADHD co-occurs with depression including the persistence of ADHD symptoms, reward responsivity, and emotion dysregulation as well as parenting/family factors and maternal depression. Stemming from this mechanistic research, interventions have been developed in recent years that aim to prevent depression in youth with ADHD. The Behaviorally Enhancing Adolescents Mood (BEAM) Program and The Integrated Parenting Intervention for ADHD (IPI-A) have both demonstrated promising results. Directions for future research are discussed with an emphasis on neurobiological mechanisms and the dissemination/implementation of interventions to reduce risk for depression among youth with ADHD in community care settings.
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