1
|
Baboli R, Cao M, Martin E, Halperin JM, Wu K, Li X. Distinct structural brain network properties in children with familial versus non-familial attention-deficit/hyperactivity disorder (ADHD). Cortex 2024; 179:1-13. [PMID: 39089096 PMCID: PMC11401761 DOI: 10.1016/j.cortex.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/12/2024] [Accepted: 06/17/2024] [Indexed: 08/03/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is among the most prevalent, inheritable, and heterogeneous childhood-onset neurodevelopmental disorders. Children with a hereditary background of ADHD have heightened risk of having ADHD and persistent impairment symptoms into adulthood. These facts suggest distinct familial-specific neuropathological substrates in ADHD that may exist in anatomical components subserving attention and cognitive control processing pathways during development. The objective of this study is to investigate the topological properties of the gray matter (GM) structural brain networks in children with familial ADHD (ADHD-F), non-familial ADHD (ADHD-NF), as well as matched controls. A total of 452 participants were involved, including 132, 165 and 155 in groups of ADHD-F, ADHD-NF and typically developed children, respectively. The GM structural brain network was constructed for each group using graph theoretical techniques with cortical and subcortical structures as nodes and correlations between volume of each pair of the nodes within each group as edges, while controlled for confounding factors using regression analysis. Relative to controls, children in both ADHD-F and ADHD-NF groups showed significantly higher nodal global and nodal local efficiencies in the left caudal middle frontal gyrus. Compared to controls and ADHD-NF, children with ADHD-F showed distinct structural network topological patterns associated with right precuneus (significantly higher nodal global efficiency and significantly higher nodal strength), left paracentral gyrus (significantly higher nodal strength and trend toward significantly higher nodal local efficiency) and left putamen (significantly higher nodal global efficiency and trend toward significantly higher nodal local efficiency). Our results for the first time in the field provide evidence of familial-specific structural brain network alterations in ADHD, that may contribute to distinct clinical/behavioral symptomology and developmental trajectories in children with ADHD-F.
Collapse
Affiliation(s)
- Rahman Baboli
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA; Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ, USA
| | - Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA; Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ, USA
| | - Elizabeth Martin
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA
| | - Jeffrey M Halperin
- Department of Psychology, Queens College, City University of New York, NY, USA
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, China
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA; Department of Electrical and Computer Engineering, New Jersey Institute of Technology, NJ, USA.
| |
Collapse
|
2
|
Zain E, Sugimoto A, Egawa J, Someya T. Case report: Methylphenidate improved chronic pain in an adult patient with attention deficit hyperactivity disorder. Front Psychiatry 2023; 14:1091399. [PMID: 36970292 PMCID: PMC10038200 DOI: 10.3389/fpsyt.2023.1091399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionChronic pain remains a health problem that is difficult to treat adequately. Its unknown cause and complex comorbidity with other illnesses, including mental disorders, amplify the severity of symptoms, which consequently decreases the quality of life of patients long term. In our clinical practice, we coincidentally found evidence that methylphenidate (MPH) effectively managed chronic pain in an adult patient with attention deficit hyperactivity disorder (ADHD). The effectiveness of MPH in the treatment of ADHD is well-established; however, its utility in treating pain remains unclear.Case presentationWe present a rare case of a 43-year-old male patient with 15 years of chronic idiopathic pain symptoms that did not adequately respond to standard pain management, such as acetaminophen, non-opioid analgesics, and muscle relaxers. Pain also persisted after treatments with antidepressants and an epidural block. Furthermore, symptoms worsened following several sessions of modified electroconvulsive therapy. After a thorough assessment at our child and adolescent psychiatric outpatient clinic, we confirmed a diagnosis of adult ADHD with a predominantly inattentive type. Considering this newly established diagnosis, we prescribed osmotic-release oral system (OROS) methylphenidate. Within 1 month of treatment at a dose of 18 mg/day of OROS-MPH, the patient’s chronic pain unexpectedly improved dramatically, and the patient no longer experienced pain symptoms. The dosage of OROS-MPH was titrated monthly, reaching 72 mg/day as a maintenance dose, and ADHD symptoms improved after 4 months of treatment. The patient was followed up regularly for 7 years during his OROS-MPH treatment. No adverse effects were reported, including stimulant addiction. He was stable overall and functioned well in his daily activities. His pain never recurred.ConclusionThis case report suggests that MPH may be potentially effective in treating chronic pain. Further studies are needed to confirm whether MPH improved chronic pain simultaneously with or separately from the improvement in ADHD. Moreover, elucidating the anatomical sites and molecular pharmacological mechanisms related to the action of MPH in pain modulation and perception is essential. Such sites include the descending dopaminergic pain pathway and higher cortical areas. Furthering our understanding may reinforce the justification for treating chronic pain using MPH.
Collapse
Affiliation(s)
- Ekachaeryanti Zain
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Psychiatry, Faculty of Medicine, Mulawarman University, Samarinda, Indonesia
| | - Atsunori Sugimoto
- Department of Community Psychiatric Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Psychiatry, Niigata Psychiatric Center, Nagaoka, Japan
- *Correspondence: Atsunori Sugimoto,
| | - Jun Egawa
- Department of Psychiatry, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
3
|
Kosheleff AR, Mason O, Jain R, Koch J, Rubin J. Functional Impairments Associated With ADHD in Adulthood and the Impact of Pharmacological Treatment. J Atten Disord 2023; 27:669-697. [PMID: 36876491 PMCID: PMC10173356 DOI: 10.1177/10870547231158572] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Among untreated adults, functional impairments associated with ADHD are widespread and cumulative, and can include social, educational, and professional impairments, increased risk of accidents and mortality, and reduced quality of life. Here, we review the most prominent functional impairments in adults with ADHD and summarize evidence describing the potential role of medication in improving outcomes. METHOD Articles related to the search terms "ADHD," "adult," and functional impairments were identified through Google Scholar and PubMed and selected for inclusion based on four criteria: strength of evidence, relevance to current challenges in adult ADHD, impact on the field, and recency of the results. RESULTS We identified 179 papers to support the conclusions on the relationship between ADHD and functional impairments, and the impact of pharmacological therapy on functional impairments. CONCLUSION This narrative review provides evidence that pharmacological treatment can be effective in minimizing not only the symptoms of ADHD, but its functional consequences as well.
Collapse
Affiliation(s)
| | - Oren Mason
- Attention MD, Grand Rapids, MI, USA and Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Rakesh Jain
- Texas Tech University School of Medicine, Midland, TX, USA
| | | | | |
Collapse
|
4
|
de Oliveira C, Saka M, Bone L, Jacobs R. The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:167-193. [PMID: 36376610 PMCID: PMC9663290 DOI: 10.1007/s40258-022-00761-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mental health disorders in the workplace have increasingly been recognised as a problem in most countries given their high economic burden. However, few reviews have examined the relationship between mental health and worker productivity. OBJECTIVE To review the relationship between mental health and lost productivity and undertake a critical review of the published literature. METHODS A critical review was undertaken to identify relevant studies published in MEDLINE and EconLit from 1 January 2008 to 31 May 2020, and to examine the type of data and methods employed, study findings and limitations, and existing gaps in the literature. Studies were critically appraised, namely whether they recognised and/or addressed endogeneity and unobserved heterogeneity, and a narrative synthesis of the existing evidence was undertaken. RESULTS Thirty-eight (38) relevant studies were found. There was clear evidence that poor mental health (mostly measured as depression and/or anxiety) was associated with lost productivity (i.e., absenteeism and presenteeism). However, only the most common mental disorders were typically examined. Studies employed questionnaires/surveys and administrative data and regression analysis. Few studies used longitudinal data, controlled for unobserved heterogeneity or addressed endogeneity; therefore, few studies were considered high quality. CONCLUSION Despite consistent findings, more high-quality, longitudinal and causal inference studies are needed to provide clear policy recommendations. Moreover, future research should seek to understand how working conditions and work arrangements as well as workplace policies impact presenteeism.
Collapse
Affiliation(s)
- Claire de Oliveira
- Centre for Health Economics, University of York, York, UK.
- Hull York Medical School, Hull and York, UK.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | | | | | - Rowena Jacobs
- Centre for Health Economics, University of York, York, UK
| |
Collapse
|
5
|
Maciver D, Rutherford M, Johnston L, Curnow E, Boilson M, Murray M. An interdisciplinary nationwide complex intervention for lifespan neurodevelopmental service development: Underpinning principles and realist programme theory. FRONTIERS IN REHABILITATION SCIENCES 2023; 3:1060596. [PMID: 36794269 PMCID: PMC9922833 DOI: 10.3389/fresc.2022.1060596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/28/2022] [Indexed: 01/31/2023]
Abstract
Background People seeking support for neurodevelopmental differences often report waiting too long for assessment and diagnosis, as well as receiving inadequate support in educational and health settings. The National Autism Implementation Team (NAIT) developed a new national improvement programme in Scotland, focusing on assessment, diagnosis, educational inclusion, and professional learning. The NAIT programme was conducted within health and education services across the lifespan for a range of neurodevelopmental differences, including autism, developmental coordination disorder, developmental language disorder, and attention deficit hyperactivity disorder. NAIT included a multidisciplinary team, with the involvement of an expert stakeholder group, clinicians, teachers, and people with lived experience. This study explores how the NAIT programme was planned, delivered, and received over three years. Design We performed a retrospective evaluation. We collected data from review of programme documents, consultation with programme leads and consultation with professional stakeholders. A theory-based analysis was completed, drawing on the Medical Research Council Framework for developing and evaluating complex interventions, and realist analysis methods. We developed a programme theory of the contexts (C), mechanisms (M), and outcomes (O) influencing the NAIT programme, based on comparison and synthesis of evidence. A key focus was on identifying the factors that contributed to the successful implementation of NAIT activities across different domains, including practitioner, institutional and macro levels. Results On synthesis of the data, we identified the key principles underlying the NAIT programme, the activities and resources utilised by the NAIT team, 16 aspects of context, 13 mechanisms, and 17 outcome areas. Mechanisms and outcomes were grouped at practitioner level, service level and macro level. The programme theory is pertinent to observed practice changes across all stages of referral, diagnosis and support processes within health and education services for neurodivergent children and adults. Conclusions This theory-informed evaluation has resulted in a clearer and more replicable programme theory that can be used by others with similar aims. This paper illustrates the value of NAIT, as well as realist and complex interventions methodologies as tools for policymakers, practitioners, and researchers.
Collapse
Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
- Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh, UK
| | - Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Marie Boilson
- Fife Health and Social Care Partnership, Whytemans Brae Hospital, Kirkcaldy, United Kingdom
| | - Mairéad Murray
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Oscarsson M, Nelson M, Rozental A, Ginsberg Y, Carlbring P, Jönsson F. Stress and work-related mental illness among working adults with ADHD: a qualitative study. BMC Psychiatry 2022; 22:751. [PMID: 36451126 PMCID: PMC9714234 DOI: 10.1186/s12888-022-04409-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Though many adults with ADHD underperform professionally, are more stressed, and have more days of sickness absence compared to adults without ADHD, few studies have explored the experience of working as an adult with ADHD. This study explores the general experience of working with ADHD, including stress and work-related mental illness. METHODS Semi-structured telephone interviews were conducted with 20 working adults with ADHD. Interview topics included how the ADHD diagnosis and/or symptoms of ADHD may have affected participants on the job, how work may have affected participants' well-being, and the need for support and accommodation. Qualitative content analysis was used to explore verbatim transcripts from the interviews. RESULTS The analysis yielded three themes that describe some of the challenges of working with ADHD: Working and living with ADHD, Needs, and Special abilities, with a total of eight subcategories. Subcategories were Specific challenges; Relationships and cooperation; Negative consequences; Planning, prioritization, organization, and structure; Support, interventions, accommodations, and aids; Openness, understanding, and acceptance; Strategies; Strengths and qualities. CONCLUSION Further knowledge about the challenges of working with ADHD is needed in workplaces; where organizational support is lacking, much in terms of accommodations and aids is up to the employee, and the disclosure of diagnoses may be associated with great dilemma.
Collapse
Affiliation(s)
- Martin Oscarsson
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden.
| | - Martina Nelson
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Alexander Rozental
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | - Ylva Ginsberg
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | - Per Carlbring
- grid.10548.380000 0004 1936 9377Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden
| | - Fredrik Jönsson
- grid.10548.380000 0004 1936 9377Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden
| |
Collapse
|
8
|
Gémes K, Bergström J, Papola D, Barbui C, Lam AIF, Hall BJ, Seedat S, Morina N, Quero S, Campos D, Pinucci I, Tarsitani L, Deguen S, van der Waerden J, Patanè M, Sijbrandij M, Acartürk C, Burchert S, Bryant RA, Mittendorfer-Rutz E. Symptoms of anxiety and depression during the COVID-19 pandemic in six European countries and Australia - Differences by prior mental disorders and migration status. J Affect Disord 2022; 311:214-223. [PMID: 35598751 PMCID: PMC9119165 DOI: 10.1016/j.jad.2022.05.082] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Little is known about changes of mental health during the COVID-19 pandemic in potentially disadvantaged groups. We investigated changes in anxiety and depression symptoms during the first year of the pandemic in six European countries and Australia by prior mental disorders and migration status. METHODS Overall, 4674 adults answered a web-based survey in May-June 2020 and were followed by three repeated surveys up to February 2021. Information on psychosocial, financial and demographic, living conditions, prior mental disorders, depression and anxiety symptoms during the pandemic and migration status was collected. Weighted general estimation equations modelling was used to investigate the association between prior mental disorders, migration status, and symptoms over time. RESULTS Most participants were <40 years old (48%), women (78%) and highly educated (62%). The baseline prevalence of depressive and anxiety symptoms ranged between 19%-45% and 13%-35%, respectively. In most countries, prevalence rates remained unchanged throughout the pandemic and were higher among people with prior mental disorders than without even after adjustment for several factors. We observed interactions between previous mental disorders and symptoms of anxiety or depression over time in two countries. No difference by migration status was noted. LIMITATIONS Convenience sampling limits generalizability. Self-assessed symptoms of depression and anxiety might involve some misclassification. CONCLUSIONS Depression and anxiety symptoms were worse among individuals with prior mental disorders than without, but there was no clear trend of worsening mental health in the observed groups during the observed period.
Collapse
Affiliation(s)
- Katalin Gémes
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Jakob Bergström
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Agnes Iok Fong Lam
- Centre for Macau Studies, University of Macau, Macao (SAR), People's Republic of China
| | - Brian J Hall
- Center for Global Health Equity, New York University (Shanghai), Shanghai, People Republic of China; School of Public Health, New York University, New York, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Naser Morina
- Department of Consultation-Liason Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain; Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Irene Pinucci
- Department of Human Neurosciences, Sapienza University of Rome, Italy; Department of Clinical, Neuro-, and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Séverine Deguen
- INSERM U1136, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Research Team, Paris, France; EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, France
| | - Judith van der Waerden
- INSERM U1136, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Research Team, Paris, France
| | - Martina Patanè
- Department of Clinical, Neuro-, and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro-, and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ceren Acartürk
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Sebastian Burchert
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | | | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
9
|
The relationship between disease symptoms and restless legs syndrome in adult attention-deficit hyperactivity disorder without iron deficiency. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00226-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study aimed to investigate the frequency of restless legs syndrome (RLS) and the affecting factors in the attention-deficit hyperactivity disorder (ADHD) group without iron deficiency. Drug-naive ADHD patients were included in the study. Patients without iron deficiency filled out the adult ADHD Self Reporting Scale, the Wender Utah Rating Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory. Scale scores were compared in ADHD patients with and without RLS. Univariate and multivariate binary logistic regression analyses were used to determine the risk factors associated with RLS.
Results
A total of 120 ADHD patients participated in the study; 53 were predominantly inattentive ADHD patients (ADHD-I), and 67 were ADHD combined type (ADHD-C). RLS incidence was found to be 31.6%. ADHD symptoms, anxiety, and depression were found to be significantly more severe in patients with ADHD accompanying RLS. Also, anxiety and the presence of ADHD predicted RLS.
Conclusions
The presence of ADHD and accompanying anxiety was effective on RLS, regardless of iron deficiency. RLS is a comorbidity that frequently accompanies ADHD, and its diagnosis and treatment should not be ignored. This is the first study to investigate the frequency of RLS and accompanying factors by excluding iron deficiency in the ADHD group.
Collapse
|
10
|
Van Wijk CH, Martin JH, Meintjes WAJ. A Concise Occupational Mental Health Screening Tool for South African Workplaces. Front Psychol 2022; 13:895137. [PMID: 35707644 PMCID: PMC9190782 DOI: 10.3389/fpsyg.2022.895137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Mental health in the workplace is becoming of ever greater importance. General occupational health surveillance programmes are already in widespread use, with established referral systems for treatment and rehabilitation, and the same mechanisms could be expanded to include mental health screening and intervention. This study aimed to develop a concise composite mental health screening tool, based on analysis of existing data, for application in routine occupational health surveillance in South Africa. Data from workplace occupational health surveillance programs from 2,303 participants were analysed. Participants completed a number of questions/scaled items collated into a survey format, and partook in an interview with a psychologist. The data was analysed using frequency of positive self-reports, Chi square to calculate associations with outcomes, Receiver Operator Characteristic curve analysis to explore predictive ability, and binomial logistic regression to calculate the relative contribution of markers to outcomes. An exploratory factor analysis was further conducted on identified items. A general workplace model with 14 markers (and a maritime workplace model with 17 markers) were identified. The factor analysis suggested their organisation into five domains (similar for both models), namely neurocognitive health, common mental disorders, history of adaptation in occupational specific contexts, family-work interface, and stress overload. The study’s data-driven approach proposed a concise composite screener with less than 50 items, comprising five domains. This tool appears useful in identifying employees at risk for workplace injuries or poor mental health outcomes, and could be applied to related workplace settings in South Africa.
Collapse
Affiliation(s)
- Charles H Van Wijk
- Institute for Maritime Medicine, Simon's Town, South Africa.,Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jarred H Martin
- Department of Psychology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - W A J Meintjes
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
11
|
Gémes K, Björkenstam E, Rahman S, Gustafsson K, Taipale H, Tanskanen A, Ekselius L, Mittendorfer-Rutz E, Helgesson M. Occupational Branch and Labor Market Marginalization among Young Employees with Adult Onset of Attention Deficit Hyperactivity Disorder-A Population-Based Matched Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127254. [PMID: 35742503 PMCID: PMC9223828 DOI: 10.3390/ijerph19127254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
We compared labor market marginalization (LMM), conceptualized as days of unemployment, sickness absence and disability pension, across occupational branches (manufacturing, construction, trade, finance, health and social care, and education), among young employees with or without attention deficit hyperactivity disorder (ADHD) and examined whether sociodemographic and health-related factors explain these associations. All Swedish residents aged 19–29 years and employed between 1 January 2005 and 31 December 2011 were eligible. Individuals with a first ADHD diagnosis (n = 6030) were matched with ten controls and followed for five years. Zero-inflated negative binomial regression was used to model days of LMM with adjustments for sociodemographic and health-related factors. In total, 20% of those with ADHD and 59% of those without had no days of LMM during the follow-up. The median of those with LMM days with and without ADHD was 312 and 98 days. Having an ADHD diagnosis was associated with a higher incidence of LMM days (incident rate ratios (IRRs) 2.7–3.1) with no differences across occupational branches. Adjustments for sociodemographic and health-related factors explained most of the differences (IRRs: 1.4–1.7). In conclusion, young, employed adults with ADHD had a higher incidence of LMM days than those without, but there were no substantial differences between branches, even after adjusting for sociodemographic and health-related factors.
Collapse
Affiliation(s)
- Katalin Gémes
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
- Correspondence:
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
- Department of Medical Sciences, Uppsala University, 75185 Uppsala, Sweden
| | - Syed Rahman
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
| | - Klas Gustafsson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
| | - Heidi Taipale
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
- Niuvanniemi Hospital, FI-70240 Kuopio, Finland;
- School of Pharmacy, University of Eastern Finland, FI-70211 Kuopio, Finland
| | | | - Lisa Ekselius
- Department Women’s and Children’s Health, Uppsala University, 75237 Uppsala, Sweden;
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
| | - Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.B.); (S.R.); (K.G.); (H.T.); (E.M.-R.); (M.H.)
| |
Collapse
|
12
|
Spalding W, Farahbakhshian S, Maculaitis MC, Peck EY, Goren A. The Association of Oral Stimulant Medication Adherence with Work Productivity among Adults with ADHD. J Atten Disord 2022; 26:831-842. [PMID: 34137280 PMCID: PMC8859664 DOI: 10.1177/10870547211020113] [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] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Examine associations between oral psychostimulant pharmacotherapy adherence, work productivity, and related indirect costs among US adults with ADHD. METHODS Medication adherence (Medication Adherence Reasons Scale [MAR-Scale]), work productivity and activity impairment (Work Productivity and Activity Impairment-General Health questionnaire), and ADHD symptom level (Adult ADHD Self-Report Scale version 1.1 Symptom Checklist) were assessed in this noninterventional online survey of adults who self-reported having an ADHD diagnosis and were currently receiving oral psychostimulant treatment for ≥3 months. RESULTS Of 602 respondents, 395 had low/medium adherence (LMA: MAR-Scale total score ≥1) and 207 had high adherence (HA: MAR-Scale total score 0). After adjusting for covariates, the LMA group had significantly greater levels of absenteeism, absenteeism-related indirect costs, and total indirect costs (all p < .01) than the HA group. CONCLUSION In adults with ADHD using oral psychostimulants, lower medication adherence was associated with greater absenteeism and indirect costs.
Collapse
Affiliation(s)
- William Spalding
- Shire, A Member of the Takeda Group of Companies, Lexington, MA, USA,William Spalding, Shire, A Member of the Takeda Group of Companies, 300 Shire Way, Lexington, MA 02421, USA.
| | | | | | | | | |
Collapse
|
13
|
Martin-Key NA, Stevenson A, Roy P. Investigating the Clinical Utility of the Combined Use of Objective and Subjective Measures of ADHD During Treatment Optimization. J Clin Psychopharmacol 2022; 42:146-153. [PMID: 33605643 PMCID: PMC8884177 DOI: 10.1097/jcp.0000000000001350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study investigated the clinical utility of the combined use of objective and subjective measures of attention-deficit/hyperactivity disorder (ADHD) prepharmacological and postpharmacological treatment. METHODS Adults with ADHD (N = 77) completed the Quantified Behavioral Test, self-ratings of ADHD-related symptoms, and quality of life measures pretreatment and posttreatment. RESULTS The use of objective and subjective measures of ADHD-related symptoms during initiation and follow-up of pharmacological treatment resulted in significant improvements in quality of life after 6 months. Both objective and subjective measures captured changes in ADHD-related symptoms, with more patients showing clinically relevant treatment effects on objective measures. Convergence rates between objective and subjective measures were low to moderate, and improvements on these measures correlated with increased quality of life. CONCLUSIONS Objective and subjective measures of ADHD capture important components of the condition. The findings from this study have important implications for clinical practice.
Collapse
Affiliation(s)
- Nayra A. Martin-Key
- From the Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom
| | | | - Perry Roy
- Carolina Attention Specialists, Charlotte, NC
| |
Collapse
|
14
|
Diamant I, Rusou Z. Measuring Failures Proneness: Scale Development and Preliminary Validations. Front Psychol 2021; 12:757051. [PMID: 34966324 PMCID: PMC8711769 DOI: 10.3389/fpsyg.2021.757051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Behavioral failures can serve as precursors for accidents. Yet, individual differences in the predisposition to behavioral failures have predominantly been investigated within relatively narrow parameters, with the focus limited to subsets of behaviors or specific domains. A broader perspective might prove useful in illuminating correlations between various forms of accidents. The current research was undertaken as one step toward developing the concept of behavioral failures proneness in its multidimensional aspect. We report the initial stage of the development and validation of the Failures Proneness questionnaire (FP): a brief, multifaceted, self-report scale of common behavioral failures in everyday settings. In a preliminary phase we conceived an extensive pool of prospective items. Study 1 identified and validated the factor-structure of FP and reduced the scale to a brief measure of 16 items. Study 2 corroborated the factor structure of the FP and evaluated its construct validity by assessing its relationship with the Five Factor Model (FFM) of personality traits. Study 3 tested the criterion-related validity of the FP by assessing its ability to predict deviant behaviors. These studies provide evidence of the FP's performance in generating valuable information on a broad range of behavioral antecedents of accidents.
Collapse
Affiliation(s)
- Irene Diamant
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
| | - Zohar Rusou
- Department of Education and Psychology, The Open University of Israel, Ra’anana, Israel
| |
Collapse
|
15
|
Vargas-Schaffer G, Steverman A, Potvin V. Monitoring Pharmacological Treatment in Patients With Chronic Noncancer Pain. Cureus 2021; 13:e20358. [PMID: 34912657 PMCID: PMC8666110 DOI: 10.7759/cureus.20358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/07/2022] Open
Abstract
Chronic pain has been not recognized as a chronic illness, and its far-reaching impacts are often ignored. Chronic noncancer pain (CNCP) is a chronic disease and health care professionals need recommendations on how to monitor treatments, patients and long-term side effects of the different medications used to control CNCP. CNCP patients make up a vulnerable population due to the various associated pathologies and the challenging socio-economic conditions experienced by many of these patients. CNCP is more common among older adults, females, cancer survivors, indigenous peoples, veterans, and populations affected by social inequities and discrimination. These social determinants can lead to a complex interplay between chronic pain, mental illness, and substance use disorders. Given these realities, long-term pharmacological and side effect surveillance is more complex. Follow-up of patients with CNCP is a challenge for physicians, and thus it is important to provide recommendations on how to monitor treatments and long-term side effects of the different medications used to control CNCP.
Collapse
Affiliation(s)
- Grisell Vargas-Schaffer
- Anesthesiology and Pain Medicine, Pain Center Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, CAN
| | - Allen Steverman
- Family Medicine, Pain Center Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, CAN
| | - Veronique Potvin
- Anesthesiology, Pain Center Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, CAN
| |
Collapse
|
16
|
van Wijk CH, Martin JH, Maree DJ. Clinical validation of brief mental health scales for use in South African occupational healthcare. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2021. [DOI: 10.4102/sajip.v47i0.1895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
17
|
Doyle N, McDowall A. Diamond in the rough? An “empty review” of research into “neurodiversity” and a road map for developing the inclusion agenda. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2021. [DOI: 10.1108/edi-06-2020-0172] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe aims of the paper were to highlight the dearth of applied practitioner research concerning the expression of neurodiversity at work and develop an epistemological framework for a future research agenda.Design/methodology/approachA systematic empty review protocol was employed, with three a priori research questions, inquiring as to the extent of neurodiversity research within mainstream work psychology, psychology in general and lastly within cross-disciplinary academic research. The results of the final search were quality checked and categorized to illustrate where studies relevant to practice are currently located.FindingsThe academic literature was found to be lacking in contextualized, practical advice for employers or employees. The location and foci of extracted studies highlighted a growing science-practitioner gap.Research limitations/implicationsThe research focused on common neurominority conditions such as autism and dyslexia; it is acknowledged that the neurodiversity definition itself is broader and more anthropological in nature. A need for a comprehensive research agenda is articulated, and research questions and frameworks are proposed.Practical implicationsGuidance is given on applying disability accommodation to both individual and organizational targets.Social implicationsThe disability employment gap is unchanged since legislation was introduced. The neurodiversity concept is no longer new, and it is time for multi-disciplinary collaborations across science and practice to address the questions raised in this paper.Originality/valueThis paper offers an original analysis of the neurodiversity paradox, combining systematic inquiry with a narrative synthesis of the extant literature. The conceptual clarification offers clear directions for researchers and practitioners.
Collapse
|
18
|
Steele LM, Pindek S, Margalit O. The Advantage of Disadvantage: Is ADHD Associated with Idea Generation at Work? CREATIVITY RESEARCH JOURNAL 2021. [DOI: 10.1080/10400419.2021.1916368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
19
|
Van Wijk CH, Meintjes WAJ. Associations Between Adverse Underwater Events and ADHD Diagnosis Among Military Divers. J Atten Disord 2021; 25:848-850. [PMID: 31319735 DOI: 10.1177/1087054719864654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Adult ADHD (A-ADHD) has been associated with an increased risk of accidents and workplace injuries. ADHD within professional diving may have major potential occupational health and safety implications, as accidents underwater may have severe consequences. The study investigated any association of increased risk for adverse underwater incidents with an ADHD diagnosis. Method: This analysis used retrospective records from 156 navy divers and computed an odds ratio using cases of ADHD and cases of underwater accidents. Results: Although the odds ratio was increased, it failed to reach significance. Conclusion: We do not yet have statistical evidence suggesting that the risk for adverse underwater events is significantly increased among the ADHD group in this sample of navy divers. Sufficiently powered studies are required to further address the potential risk of A-ADHD in working divers.
Collapse
Affiliation(s)
- Charles H Van Wijk
- Institute for Maritime Medicine, Simon's Town, South Africa.,Stellenbosch University, Cape Town, South Africa
| | | |
Collapse
|
20
|
Chhibber A, Watanabe AH, Chaisai C, Veettil SK, Chaiyakunapruk N. Global Economic Burden of Attention-Deficit/Hyperactivity Disorder: A Systematic Review. PHARMACOECONOMICS 2021; 39:399-420. [PMID: 33554324 DOI: 10.1007/s40273-020-00998-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children and adults. Previous systematic reviews have provided estimates of ADHD-associated costs but were limited to the USA and Europe. OBJECTIVES This study aimed to systematically summarise all global evidence on the economic burden of ADHD. METHODS A systematic search for published studies on costs of ADHD was conducted in EconLit, EMBASE, PubMed, ERIC, and PsycINFO. Additional literature was identified by searching the reference lists of eligible studies. The quality of the studies was assessed using the Larg and Moss checklist. RESULTS This review included 44 studies. All studies were conducted in high-income countries and were limited to North America and Europe except for four studies: two in Asia and two in Australia. Most studies were retrospective and undertook a prevalence-based study design. Analysis revealed a substantial economic impact associated with ADHD. Estimates based on total costs ranged from $US831.38 to 20,538 for per person estimates and from $US356 million to 20.27 billion for national estimates. Estimates based on marginal costs ranged from $US244.15 to 18,751.00 for per person estimates and from $US12.18 million to 141.33 billion for national estimates. Studies that calculated economic burden across multiple domains of direct, indirect, and education and justice system costs for both children and adults with ADHD reported higher costs and translated gross domestic product than did studies that captured only a single domain or age group. CONCLUSIONS Despite the wide variation in methodologies in studies reviewed, the literature suggests that ADHD imposes a substantial economic burden on society. There is a dire need for cost-of-illness research in low- and middle-income countries to better inform the treatment and management of ADHD in these countries. In addition, guidelines on the conduct and reporting of economic burden studies are needed as they may improve standardisation of cost-of-illness studies.
Collapse
Affiliation(s)
- Anindit Chhibber
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | | | | | - Sajesh K Veettil
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA.
- School of Pharmacy, Monash University, Subang Jaya, Malaysia.
| |
Collapse
|
21
|
Onandia-Hinchado I, Pardo-Palenzuela N, Diaz-Orueta U. Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review. J Neural Transm (Vienna) 2021; 128:893-937. [PMID: 33620582 DOI: 10.1007/s00702-021-02302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.
Collapse
Affiliation(s)
| | | | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Room 3.11, John Hume Building, North Campus, Maynooth, Co. Kildare, Ireland.
| |
Collapse
|
22
|
Brunkhorst-Kanaan N, Libutzki B, Reif A, Larsson H, McNeill RV, Kittel-Schneider S. ADHD and accidents over the life span - A systematic review. Neurosci Biobehav Rev 2021; 125:582-591. [PMID: 33582234 DOI: 10.1016/j.neubiorev.2021.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/06/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023]
Abstract
Studies have demonstrated an increased risk of accidents and injuries in children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). However, little is known about how accident risk may alter over the lifespan. Additionally, it would be important to know if the most common types of accidents and injuries differ in ADHD patients over different age groups. Furthermore, there is increasing evidence of an ameliorating effect of ADHD medication on accident risk. Lastly, the underlying risk factors and causal mechanisms behind increased accident risk remain unclear. We therefore conducted a systematic review focusing on the above described research questions. Our results suggested that accident/injury type and overall risk changes in ADHD patients over the lifespan. ADHD medication appeared to be similarly effective at reducing accident risk in all age groups. However, studies with direct comparisons of accident/injuries and effects of medication at different age groups or in old age are still missing. Finally, comorbidities associated with ADHD such as substance abuse appear to further increase the accident/injury risk.
Collapse
Affiliation(s)
- Nathalie Brunkhorst-Kanaan
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt/Main, Germany
| | - Berit Libutzki
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Andreas Reif
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt/Main, Germany
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, 171 77 Stockholm, Sweden; Örebro University, School of Medical Sciences, Campus USÖ, S-701 82 Örebro, Sweden
| | - Rhiannon V McNeill
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Margarete-Höppel-Platz 1, D-97082 Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt/Main, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Margarete-Höppel-Platz 1, D-97082 Würzburg, Germany
| |
Collapse
|
23
|
Adamou M, Asherson P, Arif M, Buckenham L, Cubbin S, Dancza K, Gorman K, Gudjonsson G, Gutman S, Kustow J, Mabbott K, May-Benson T, Muller-Sedgwick U, Pell E, Pitts M, Rastrick S, Sedgwick J, Smith K, Taylor C, Thompson L, van Rensburg K, Young S. Recommendations for occupational therapy interventions for adults with ADHD: a consensus statement from the UK adult ADHD network. BMC Psychiatry 2021; 21:72. [PMID: 33541313 PMCID: PMC7863422 DOI: 10.1186/s12888-021-03070-z] [Citation(s) in RCA: 3] [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: 06/01/2020] [Accepted: 01/25/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND ADHD is neurodevelopmental disorder which persists into adulthood. Presently, therapeutic approaches are mainly pharmacological and psychological whilst the role, scope and approaches of occupational therapists have not been adequately described. RESULTS In this consensus statement we propose that by assessing specific aspects of a person's occupation, occupational therapists can deploy their unique skills in providing specialist interventions for adults with ADHD. We also propose a framework with areas where occupational therapists can focus their assessments and give practice examples of specific interventions. CONCLUSIONS Occupational therapists have much to offer in providing interventions for adults with ADHD. A unified and flexible approach when working with adults with ADHD is most appropriate and further research on occupational therapy interventions is needed.
Collapse
Affiliation(s)
- Marios Adamou
- School of Human & Health Sciences, University of Huddersfield, Huddersfield, UK.
| | - Philip Asherson
- grid.14105.310000000122478951MRC Social Genetic and Developmental Psychiatry Research Centre, London, UK
| | - Muhammad Arif
- grid.420868.00000 0001 2287 5201Leicestershire Partnership NHS Trust, Leicestershire, UK
| | - Louise Buckenham
- grid.500653.50000000404894769Northamptonshire Healthcare NHS Foundation Trust, Northamptonshire, UK ,The Royal College of Occupational Therapy and Heath Care Professionals Council, London, UK
| | | | - Karina Dancza
- grid.486188.b0000 0004 1790 4399Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Kirstie Gorman
- grid.439737.d0000 0004 0382 8292Lancashire Care NHS Foundation Trust, Lancashire, UK
| | - Gísli Gudjonsson
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England
| | - Sharon Gutman
- grid.21729.3f0000000419368729Columbia University, New York, USA
| | - James Kustow
- grid.451052.70000 0004 0581 2008Barnet,Enfield and Haringey NHS Trust, London, UK
| | - Kerry Mabbott
- grid.500653.50000000404894769Northamptonshire Healthcare NHS Foundation Trust, Northamptonshire, UK ,The Royal College of Occupational Therapy and Heath Care Professionals Council, London, UK
| | | | | | - Emma Pell
- grid.499523.00000 0000 8880 3342South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK
| | - Mark Pitts
- grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Jane Sedgwick
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England
| | | | - Clare Taylor
- grid.439450.f0000 0001 0507 6811South West London and St George’s Mental Health NHS Trust, London, UK
| | - Lucy Thompson
- grid.499523.00000 0000 8880 3342South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK
| | - Kobus van Rensburg
- grid.500653.50000000404894769Northamptonshire Healthcare NHS Foundation Trust, Northamptonshire, UK
| | | |
Collapse
|
24
|
Trantou A, Carlsen HK, Anderson C, Steingrimsson S. Sickness Absence Recommendation Among Outpatients With ADHD and Comorbidity: A Latent Class Analysis. J Atten Disord 2021; 25:209-216. [PMID: 29882460 DOI: 10.1177/1087054718780338] [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] [Indexed: 11/15/2022]
Abstract
Objective: Determine sickness absence recommendation (SAR) prevalence for treatment-seeking patients with ADHD depending on comorbidity. Method: Population-based patient chart review of ADHD outpatients aged 19 to 29 years. The outcome, SAR, included both available financial benefit forms; activity compensation and sickness benefit. Latent class analyses (LCA) of demography and psychiatric comorbidities were performed both with and without SAR as an outcome variable. Results: Overall, 38% received SAR. Latent classes ranged from a from a small class of only females with personality disorders where all had SAR to larger groups characterized by lower comorbidity where 15% to 29% had SAR. In between these extremes were other classes of (a) neurodevelopmental disorders, for example, autism diagnosis or intellectual disabilities, and (b) high rate of anxiety disorder, where SAR rates ranged 46% to 65%. Conclusion: Treatment-seeking ADHD patients can be categorized into clinically relevant subgroups providing opportunities to structure rehabilitation efforts to the individuals' needs.
Collapse
Affiliation(s)
- Aikatarini Trantou
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanne K Carlsen
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Anderson
- Institute of Neuroscience and Physiology/Occupational therapy, Sahlgrenska Academy, University of Gothenburg,Gothenburg, Sweden
| | - Steinn Steingrimsson
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden.,Centre of Ethics, Law and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
25
|
Abbass K, Corbisiero S, Stieglitz RD. Development and psychometric properties of the ADHD-SCL-90-R screening scale for adult ADHD. J Clin Psychol 2020; 77:1428-1442. [PMID: 33188720 DOI: 10.1002/jclp.23088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 10/06/2020] [Accepted: 10/25/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Adult attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder with serious impairments, but it often remains undetected. The aim of the study was to develop an ADHD screening scale from the Symptom Check-List-90-R (SCL-90-R) and describe its psychometric properties. The item selection was based on the ADHD-specific Conners' Adult ADHD Rating Scale (CAARS-S:L). METHOD In total, 412 subjects of an ADHD Special Consultations Unit were investigated, who completed the SCL-90-R, CAARS-S:L, and ADHD Self-Rating Behavior Questionnaire. RESULTS The ADHD-SCL-90-R Screening Scale consisted of 16 items with a four-factor structure, including Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability, and Problems with Self-Concept. It showed excellent internal consistency (Cronbachs α = .90) and good convergent validity (r = .57-.59). Sensitivity was 78%, specificity was 56%, and the discriminatory power was acceptable (area under the curve = 0.74). CONCLUSION The newly developed ADHD-SCL-90-R Screening Scale showed good psychometric properties, and it has a versatile application in clinical practice.
Collapse
Affiliation(s)
- Karen Abbass
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Salvatore Corbisiero
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Rolf-Dieter Stieglitz
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland.,Psychiatric Clinics, University of Basel, Basel, Switzerland
| |
Collapse
|
26
|
Doyle N. Neurodiversity at work: a biopsychosocial model and the impact on working adults. Br Med Bull 2020; 135:108-125. [PMID: 32996572 PMCID: PMC7732033 DOI: 10.1093/bmb/ldaa021] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The term neurodiversity is defined and discussed from the perspectives of neuroscience, psychology and campaigners with lived experience, illustrating the development of aetiological theories for included neurodevelopmental disorders. The emerging discourse is discussed with relevance to adults, social inclusion, occupational performance and the legislative obligations of organizations. SOURCES OF DATA Literature is reviewed from medicine, psychiatry, psychology, sociology and popular press. No new data are presented in this article. AREAS OF AGREEMENT There is consensus regarding some neurodevelopmental conditions being classed as neurominorities, with a 'spiky profile' of executive functions difficulties juxtaposed against neurocognitive strengths as a defining characteristic. AREAS OF CONTROVERSY The developing nomenclature is debated and the application of disability status versus naturally occurring difference. Diagnosis and legal protections vary geographically, resulting in heretofore unclear guidance for practitioners and employers. GROWING POINTS The evolutionary critique of the medical model, recognizing and updating clinical approaches considering the emerging consensus and paradigmatic shift. AREAS TIMELY FOR DEVELOPING RESEARCH It is recommended that research addresses more functional, occupational concerns and includes the experiences of stakeholders in research development, moving away from diagnosis and deficit towards multi-disciplinary collaboration within a biopsychosocial model.
Collapse
Affiliation(s)
- Nancy Doyle
- Department of Organizational Psychology, Birkbeck University of London, London, UK
| |
Collapse
|
27
|
van Wijk C, Firfirey N. A brief screen for attention-deficit/hyperactivity disorder in the South African workplace. S Afr J Psychiatr 2020; 26:1500. [PMID: 33101727 PMCID: PMC7564909 DOI: 10.4102/sajpsychiatry.v26i0.1500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 08/03/2020] [Indexed: 11/11/2022] Open
|
28
|
Notzon DP, Pavlicova M, Glass A, Mariani JJ, Mahony AL, Brooks DJ, Levin FR. ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders. J Atten Disord 2020; 24:1487-1492. [PMID: 27033880 PMCID: PMC5568505 DOI: 10.1177/1087054716640109] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To estimate the prevalence of ADHD and determine an effective screening test for ADHD in a population-seeking treatment for cannabis use disorders. Method: The Conners Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; CAADID) was used to generate sensitivity and specificity data for ADHD screening tests, which were then administered to 99 participants seeking treatment for cannabis use disorders to estimate ADHD prevalence. Results: The prevalence estimated from the Wender Utah Rating Scale (WURS) was 45% (sensitivity = 0.88, sensitivity of 0.75), from the Conners Adult ADHD Rating Scale (CAARS) 34% (sensitivity = 0.80, specificity = 0.91), from the WURS + CAARS 36% (sensitivity = 0.71, specificity = 0.95), and from the Adult ADHD Self-Report Scale (ASRS) 46% (sensitivity = 0.61, specificity = 0.86). Conclusion: The prevalence of ADHD in adults seeking treatment for cannabis use disorders is estimated to be between 34% and 46%. The WURS paired with the CAARS provides excellent sensitivity and specificity for the diagnosis of ADHD in this population.
Collapse
Affiliation(s)
- Daniel P. Notzon
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| | | | | | - John J. Mariani
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| | | | | | - Frances R. Levin
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| |
Collapse
|
29
|
Suzuki T, Wada K, Muzembo BA, Ngatu NR, Yoshii S, Ikeda S. Autistic and Attention Deficit/Hyperactivity Disorder Traits Are Associated with Suboptimal Performance among Japanese University Students. JMA J 2020; 3:216-231. [PMID: 33150256 PMCID: PMC7590390 DOI: 10.31662/jmaj.2020-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/08/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction: Recent estimates suggest that there is a substantial number of Japanese students with developmental disabilities. This study aimed to examine potential associations between autistic, autistic subcomponents, and attention deficit/hyperactivity disorder (ADHD) traits with student performance (as measured by presenteeism) and class attendance among Japanese university students. Methods: Participants comprised 721 students from different regions of Japan who completed a self-administered internet survey. Autistic and ADHD traits were measured using an abridged version of the autism spectrum quotient (AQ-Short) and adult ADHD self-report scale (ASRS). Presenteeism, which is an indicator of student performance, was assessed using the modified World Health Organization Health and Work Performance Questionnaire. Class attendance during the past year was self-reported by participants. Results: Students with high levels of autistic traits and high levels of ADHD traits were significantly more likely to report poor student performance (odds ratio [OR] = 3.07, 95% confidence interval [95% CI]: 1.90–4.96; and OR = 2.13, 95% CI: 1.32–3.42, respectively). Regarding autistic trait subcomponents, students with high levels of preference for routine (OR = 2.39, 95% CI: 1.38–4.13) and high levels of difficulties with social skills (OR = 1.81, 95% CI: 1.03–3.18) were also significantly more likely to report poor student performance. There were borderline significant associations between traits of attention-switching difficulties and poor student performance (OR = 1.78, 95% CI: 1.00–3.15). Regarding ADHD trait subcomponents, students with high levels of inattention (OR = 2.88, 95% CI: 1.32–6.26) were also significantly more likely to report poor student performance. Students with both high levels of autistic traits and high levels of ADHD traits were more likely to report poor student performance than those with high levels of only one trait type. There were, however, no statistically significant associations between these traits and low class attendance risk. Conclusions: Sickness presenteeism was significantly associated with high levels of both autistic traits and ADHD traits among Japanese university students.
Collapse
Affiliation(s)
- Tomoko Suzuki
- Department of Public Health, School of Medicine, International University of Health and Welfare (IUHW), Narita, Japan
| | - Koji Wada
- Department of Public Health, School of Medicine, International University of Health and Welfare (IUHW), Narita, Japan
| | - Basilua Andre Muzembo
- Department of Public Health, School of Medicine, International University of Health and Welfare (IUHW), Narita, Japan
| | - Nlandu R Ngatu
- Department of Public Health, School of Medicine, International University of Health and Welfare (IUHW), Narita, Japan
| | - Shiho Yoshii
- Graduate School of Medicine, International University of Health and Welfare (IUHW), Tokyo, Japan
| | - Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare (IUHW), Narita, Japan
| |
Collapse
|
30
|
Van Wijk CH, Meintjes WAJ. Adult attention-deficit/hyperactivity disorder prevalence among commercial divers in South Africa. Diving Hyperb Med 2020; 50:164-167. [PMID: 32557419 DOI: 10.28920/dhm50.2.164-167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/24/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Adult attention-deficit/hyperactivity disorder (ADHD) is associated with increased chance of workplace accidents, psychiatric comorbidities, other risky behaviours and sophisticated psychopharmacological treatment. These factors all contribute to a potentially complex risk profile within the commercial diving context. In order to make informed decisions regarding ADHD and commercial diving, further description of this condition among commercial divers is required. This paper reports on a study that aimed to determine the prevalence of adult ADHD among commercial divers. METHODS The study used a self-reporting survey-type questionnaire to determine likely diagnosis, based on Diagnostic and Statistical Manual of Mental Disorders, 5th ed. criteria, in a group of 245 commercial divers in South Africa. RESULTS Fourteen cases (5.7% of the sample) met criteria for ADHD. The majority of the cases presented with combined type, and reflected mild forms of ADHD. Adult ADHD did not appear to occur in significantly different proportions across the biographical variables of age, education or diving qualification. CONLCUSION Based on this small survey, adult ADHD may be over-represented in commercial diving in South Africa, compared to general workplace populations. However, ADHD may not necessarily be a contra-indication to commercial diving.
Collapse
Affiliation(s)
- Charles H Van Wijk
- Institute for Maritime Medicine, Simon's Town, South Africa.,Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Corresponding author: Dr Charles H Van Wijk, PO Box 494, Simon's Town 7995, South Africa,
| | - W A Jack Meintjes
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
31
|
Affiliation(s)
- Russell A. Barkley
- Editor of The ADHD Report and a Clinical professor of Psychiatry at the Virginia Commonwealth University Medical Center in Richmond, VA. He can be contacted by email at:
| |
Collapse
|
32
|
Caisley H, Müller U. Adherence to medication in adults with attention deficit hyperactivity disorder and pro re nata dosing of psychostimulants: A systematic review. Eur Psychiatry 2020; 27:343-9. [DOI: 10.1016/j.eurpsy.2012.01.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 01/19/2012] [Indexed: 10/28/2022] Open
Abstract
AbstractAdherence to a regular medication regimen may be challenging for adults with attention deficit hyperactivity disorder (ADHD). Some report taking psychostimulants on a pro re nata (PRN) basis. This review aims to establish the rate of adherence, and reasons for and consequences of non-adherence to medication for ADHD in adults, and to review literature on PRN dosing of psychostimulants in these patients. A systematic literature search was conducted. Four primary research studies have investigated the rate of adherence to medication in adults with ADHD. Mean adherence rate in two studies ranged from 52% to 87%. A number of possible reasons for poor adherence have been suggested. Prospective studies are needed to further define the rate of adherence and causes of poor adherence. Evidence examining whether differences in adherence affect clinical outcomes is equivocal. Therefore, caution should be applied to the assumption that maximising adherence to regular medication regimens will improve clinical outcomes. Two articles acknowledge that patients take medication on a PRN basis. Studies comparing the effectiveness of a regular and PRN regimen of psychostimulants are needed. If PRN dosing is as effective as a regular regimen, advantages might include enhanced doctor-patient communication, reduced side effects and cost savings.
Collapse
|
33
|
Pawaskar M, Fridman M, Grebla R, Madhoo M. Comparison of Quality of Life, Productivity, Functioning and Self-Esteem in Adults Diagnosed With ADHD and With Symptomatic ADHD. J Atten Disord 2020; 24:136-144. [PMID: 31043096 PMCID: PMC6935829 DOI: 10.1177/1087054719841129] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective: Investigate the association between diagnosis and outcomes in adults with symptoms of ADHD. Method: The Validate Attitudes and Lifestyle Issues in Depression, ADHD and Troubles with Eating (VALIDATE) study collected sociodemographic and clinical characteristics data, and responses from validated questionnaires on health-related quality of life (HRQoL), work productivity, functioning, and self-esteem. ADHD-diagnosed respondents (n = 444) were matched with respondents with symptomatic ADHD (n = 1,055) within the same sex-by-age group using propensity score matching. Effects of ADHD diagnosis on each outcome were adjusted for covariates that remained imbalanced after matching, using generalized mixed models. Results: After matching, symptomatic respondents (n = 867) had worse outcomes than ADHD-diagnosed respondents (n = 436), as measured by the Work Productivity and Activity Impairment: General Health questionnaire and Sheehan Disability Scale (p < .001). ADHD-diagnosed respondents had better mean EuroQol five-dimensional five-level (EQ-5D-5L) scores and Rosenberg Self-Esteem Scale scores than symptomatic respondents (p < .001). Conclusion: ADHD-diagnosed individuals are more likely to experience better functional performance, work-related productivity, HRQoL, and self-esteem than individuals with symptomatic ADHD.
Collapse
Affiliation(s)
| | - Moshe Fridman
- AMF Consulting, Inc., Los Angeles, CA, USA
- Moshe Fridman, AMF Consulting, Inc., 846 S. Citrus Ave., Los Angeles, CA 90036, USA.
| | | | | |
Collapse
|
34
|
Fruchter E, Marom-Harel H, Fenchel D, Kapra O, Ginat K, Portuguese S, Weiser M. Functioning of Young Adults With ADHD in the Military. J Atten Disord 2019; 23:1470-1474. [PMID: 27269006 DOI: 10.1177/1087054716652478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To assess the functioning of young adults with ADHD in a military setting. Method: In all, 14,655 young adults with ADHD (mean age at first examination 17.8 ± 0.7) attending mandatory service in the Israeli military were compared with matched controls on several functioning domains. Results: Young adults with ADHD had more sessions with mental health care professionals, physician appointments, sick days, and disqualifications of professions than controls (p < .001). Young adults with ADHD were also less medically fit for combat service (odds ratio [OR] = 0.75, 95% confidence interval [CI] = [0.72, 0.79]), more medically unfit for military service in general (OR = 1.26, 95% CI = [1.13, 1.40]), and had higher rates of overweight and obesity (p < .001). In addition, they were more likely to be diagnosed with a personality disorder (OR = 1.29, 95% CI = [1.07, 1.53]) or with minor affective and anxiety disorders (OR = 1.33, 95% CI = [1.06, 1.67]) than matched controls. Conclusion: These results support a negative effect of ADHD on the functioning of young adults in a military setting.
Collapse
Affiliation(s)
- Eyal Fruchter
- 1 IDF Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | | | | | - Ori Kapra
- 2 Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Keren Ginat
- 1 IDF Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | | | - Mark Weiser
- 2 Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.,3 Tel Aviv University, Tel Aviv-Yafo, Israel
| |
Collapse
|
35
|
Reyes MM, Schneekloth TD, Hitschfeld MJ, Karpyak VM. Impact of Sex and ADHD Status on Psychiatric Comorbidity in Treatment-Seeking Alcoholics. J Atten Disord 2019; 23:1505-1513. [PMID: 30394819 DOI: 10.1177/1087054718807997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: To assess for intrasex and intersex differences in psychiatric comorbidity according to ADHD status in treatment-seeking adults with alcohol use disorders (AUDs). Method: This study was a secondary analysis of data utilizing descriptive statistics from 472 treatment-seeking alcoholics who completed the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). Results: The prevalence of ADHD in males and females was 6.0% and 6.4%, respectively. Males with ADHD and AUDs had higher rates of current and lifetime drug use disorders, current depressive disorders, and current and lifetime anxiety disorders than male alcoholics without ADHD. No intrasex differences in psychiatric comorbidities were identified in female alcoholics with respect to ADHD status. Males with ADHD and AUDs were more likely to have had opioid dependence than ADHD-positive females. No other intersex differences were found. Conclusion: Positive ADHD status was associated with increased psychiatric comorbidity among treatment-seeking alcoholic men.
Collapse
|
36
|
Van Wijk CH. Adult ADHD in the South African workplace: the usefulness of a self-report screening measure and preliminary prevalence estimates. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2019. [DOI: 10.1177/0081246319870780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the South African context, resource constraints often preclude the comprehensive assessment of large numbers of people for the likelihood of Adult Attention-Deficit/Hyperactivity Disorder (ADHD). Primary screening through a self-report measure may be useful to stream at-risk individuals towards diagnostic assessment services, as well as being useful in population and workplace based research. The present study set out, first, to investigate the usefulness of a self-report ADHD scale to identify at-risk individuals, and, second, to provide preliminary prevalence estimates for Adult ADHD, guided by Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria, in a South African workplace sample. Workers in full-time skilled employment ( N = 1,917), aged 18–44, completed a self-report Adult ADHD scale, and participated in an interview with a psychologist. Their scale data, using three different scoring and interpretation systems, were subjected to statistical analysis. Favourable internal reliability and positive predictive validity were found. Different interpretation systems provided different prevalence estimations: using DSM-5 criteria, a total prevalence estimate of 3.3 % was calculated (attention deficit subtype = 0.9%, hyperactivity-impulsivity subtype = 1.0%, and combined subtype = 1.4%). The positive predictive validity found with this sample suggests that this scale can be used constructively in research or screening contexts to identify at-risk individuals. Furthermore, preliminary prevalence estimates for Adult ADHD, guided by DSM-5 criteria, are now available for a South African workplace sample.
Collapse
Affiliation(s)
- Charles H Van Wijk
- Institute for Maritime Medicine, Simon’s Town, South Africa
- Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| |
Collapse
|
37
|
Furuhashi Y. Unexpected effect of Zolpidem in a patient with attention deficit hyperactivity disorder. Asian J Psychiatr 2019; 44:68-69. [PMID: 31325762 DOI: 10.1016/j.ajp.2019.07.012] [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: 03/28/2019] [Revised: 06/12/2019] [Accepted: 07/05/2019] [Indexed: 11/30/2022]
Abstract
Sleep-related eating disorder (SRED) is characterized by recurrent episodes of eating during the night, accompanied by partial consciousness and followed by limited recall. Zolpidem is a sedative-hypnotic drug commonly used to treat sleep disorders. Zolpidem reduces sleep latency and increases the total time of sleep. Here, we described a case of a patient with attention-deficit/hyperactivity disorder (ADHD) who suffered from zolpidem-induced SRED. The symptoms disappeared when the use of zolpidem as discontinuation. To the best of our knowledge, this is the first documented case of SRED induced by the use of zolpidem in a patient with ADHD.
Collapse
Affiliation(s)
- Yuko Furuhashi
- Shizuoka University, 836, Ohya, Shizuoka, 422-8529, Japan.
| |
Collapse
|
38
|
Kok BC, Reed DE, Wickham RE, Brown LM. Adult ADHD Symptomatology in Active Duty Army Personnel: Results From the Army Study to Assess Risk and Resilience in Servicemembers. J Atten Disord 2019; 23:968-975. [PMID: 27753640 DOI: 10.1177/1087054716673451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although the prevalence of adult ADHD has been well established in the general population, few studies have examined the prevalence of ADHD symptoms in the military. METHOD The present study used data from 21,449 active duty soldiers, whose responses were collected as part of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Positive ADHD screens were identified using two alternative scoring methods of the Adult Self-Report ADHD Scale Screener. RESULTS The estimated prevalence of ADHD in this sample was 7.6% and 9.0% depending on diagnostic method. Contrary to initial hypotheses that ADHD would be highest in the 18- to 19-year-old age-group, the age distribution of ADHD in this study was centered around the 25- to 29-year-old age-group. CONCLUSIONS The findings of this study indicate that adult ADHD symptoms are common in Army personnel, and are not limited to the youngest cohorts. Implications on screening, administrative policy, and future research directions are also discussed.
Collapse
Affiliation(s)
- Brian C Kok
- 1 Pacific Graduate School of Psychology at Palo Alto University, CA, USA
| | - David E Reed
- 1 Pacific Graduate School of Psychology at Palo Alto University, CA, USA
| | - Robert E Wickham
- 1 Pacific Graduate School of Psychology at Palo Alto University, CA, USA
| | - Lisa M Brown
- 1 Pacific Graduate School of Psychology at Palo Alto University, CA, USA
| |
Collapse
|
39
|
Vildalen VU, Brevik EJ, Haavik J, Lundervold AJ. Females With ADHD Report More Severe Symptoms Than Males on the Adult ADHD Self-Report Scale. J Atten Disord 2019; 23:959-967. [PMID: 27461728 DOI: 10.1177/1087054716659362] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate gender differences in self-reported ADHD symptoms in a group of adults with ADHD and a control group. METHODS A total of 682 adults with ADHD (49.9% females) and 882 controls (59.2% females) completed the Adult ADHD Self-Report Scale (ASRS), listing the 18 symptoms included in the diagnostic criteria of ADHD. RESULTS Within the ADHD group, females reported more severe symptoms of inattention and hyperactivity/impulsivity than males. This higher symptom report of females was not found in the control group, where the number of severe inattention symptoms rather was higher in males. CONCLUSION The results suggest that childhood symptoms of ADHD may have gone unnoticed in girls, emphasizing the need for longitudinal studies of ADHD symptoms across the life span.
Collapse
Affiliation(s)
- Victoria U Vildalen
- 1 Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Erlend J Brevik
- 1 Department of Biological and Medical Psychology, University of Bergen, Norway.,2 Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,3 K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
| | - Jan Haavik
- 2 Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,3 K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway.,4 Department of Biomedicine, University of Bergen, Norway
| | - Astri J Lundervold
- 1 Department of Biological and Medical Psychology, University of Bergen, Norway.,3 K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
| |
Collapse
|
40
|
Yeh YC, Huang MF, Wu YY, Hu HF, Yen CF. Pain, Bullying Involvement, and Mental Health Problems Among Children and Adolescents With ADHD in Taiwan. J Atten Disord 2019; 23:809-816. [PMID: 28836888 DOI: 10.1177/1087054717724514] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to examine the relationships of pain and pain-induced functional impairment with bullying involvement, as well as the relationships between pain and mental health problems among 474 children and adolescents with ADHD. METHOD The levels of pain, pain-induced functional impairment, involvement in bullying, depression, anxiety, ADHD symptoms, and sleep quality were assessed. RESULTS Both victims of verbal and relational bullying and victims of physical bullying were more likely to have pain and pain-induced functional impairment than nonvictims. The perpetrators of verbal and relational bullying were more likely to have pain than the nonperpetrators. Participants with pain and pain-induced functional impairment experienced more severe depression and anxiety and worse sleep quality than did those without pain or pain-induced functional impairment. CONCLUSION Clinical and educational professionals should consider the possibility of involvement in bullying and comorbid depression, anxiety, and poor sleep quality among ADHD children and adolescents with pain problems.
Collapse
Affiliation(s)
- Yi-Chun Yeh
- 1 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,2 School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Mei-Feng Huang
- 1 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,2 School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Yu-Yu Wu
- 3 YuNing Psychiatry Clinic, Taipei, Taiwan
| | - Huei-Fan Hu
- 4 Department of Psychiatry, Tainan Municipal Hospital, Taiwan
| | - Cheng-Fang Yen
- 1 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,2 School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| |
Collapse
|
41
|
Mohammadzadeh S, Ahangari TK, Yousefi F. The effect of memantine in adult patients with attention deficit hyperactivity disorder. Hum Psychopharmacol 2019; 34:e2687. [PMID: 30663824 DOI: 10.1002/hup.2687] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hyperactivity disorder and attention deficit are common neurological disorders in children and adolescents. The symptoms of hyperactivity are decreased in adults, and attention deficit is more noticeable. This study was carried out to evaluate the effect of memantine on adult patients with attention deficit hyperactivity disorder (ADHD). MATERIALS AND METHODS In a double-blind clinical trial study, 40 patients aged 18 to 45 years with ADHD were selected on the basis on the Diagnosis and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria, and randomly assigned memantine or placebo. Before starting the treatment, Conners' screening questionnaire was completed for each patient, and the subjects were entered the study after acquiring minimum acceptable score in the questionnaire. RESULTS The mean age of patients who were receiving memantine and placebo was about 34.7 ± 4.48 and 31.5 ± 7.4 years, respectively. The results have shown a significant difference in the behavior and attention deficit between the two groups treated with memantine and placebo during 6 weeks (p < 0.001). Also, there was a significant difference in the third and sixth weeks between treatment groups in hyperactivity and attention deficit index (p = 0.001). CONCLUSION The results of this study indicated that memantine was effective in reducing symptoms of Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability.
Collapse
Affiliation(s)
- Soleiman Mohammadzadeh
- Child and Adolescent Psychiatrist, Neurosciences Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Tina Kaveh Ahangari
- Neurosciences Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fayegh Yousefi
- Neurosciences Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
42
|
Nagata M, Nagata T, Inoue A, Mori K, Matsuda S. Effect Modification by Attention Deficit Hyperactivity Disorder (ADHD) Symptoms on the Association of Psychosocial Work Environments With Psychological Distress and Work Engagement. Front Psychiatry 2019; 10:166. [PMID: 30971966 PMCID: PMC6445946 DOI: 10.3389/fpsyt.2019.00166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 03/06/2019] [Indexed: 12/22/2022] Open
Abstract
Objective: The aim of this study was to examine how attention-deficit hyperactivity disorder (ADHD) symptoms play an interaction effect on the association between psychosocial work environments and health (psychological distress/work engagement) among workers. Methods: This is a cross-sectional study of 2,693 employees at a pharmaceutical company using a self-administered questionnaire evaluating ADHD symptoms (Adult ADHD Self-Report Scale Screener), psychosocial work environments (job demands, job control and social support), and health outcomes (psychological distress; K6, and work engagement; Utrecht Work Engagement Scale). Multiple regression analyses were applied to assess the interaction between ADHD symptoms and psychosocial work environments on health outcomes. Results: The prevalence of workers with ADHD symptoms was 5.9% (n = 159). Significant interaction effects of ADHD symptoms × job control and ADHD symptoms × social support were observed (β = -0.067, p < 0.01 and β = -0.052, p < 0.01, respectively) on psychological distress after adjustment of age, sex, occupation and education. The interaction effect of ADHD symptoms × each psychosocial work environment was not observed on work engagement. Conclusions: Job control and social support were more influential factors that were related to psychological distress in accordance with ADHD symptoms. This study also found no difference of the interaction between psychosocial work environments and ADHD symptoms on work engagement. To the best of our knowledge, this study was first to clarify the effect of ADHD symptoms on the association between psychosocial work environments and health outcomes (psychological distress/work engagement). These findings can aid employers how to arrange better work environments for workers with ADHD symptoms.
Collapse
Affiliation(s)
- Masako Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.,Data Science Center for Occupational Health, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shinya Matsuda
- Data Science Center for Occupational Health, University of Occupational and Environmental Health, Kitakyushu, Japan.,Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| |
Collapse
|
43
|
Matthies S, Sadohara-Bannwarth C, Lehnhart S, Schulte-Maeter J, Philipsen A. The Impact of Depressive Symptoms and Traumatic Experiences on Quality of Life in Adults With ADHD. J Atten Disord 2018; 22:486-496. [PMID: 27590436 DOI: 10.1177/1087054716654568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE We assessed factors influencing quality of life (QoL) in adults with ADHD. METHOD QoL, traumatic childhood experiences, and depression were assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI), respectively, in 60 adult ADHD outpatients and 60 age- and gender-matched controls. RESULTS Emotional neglect or abuse had occurred significantly more often during childhood in adults with ADHD. Depressive symptoms were rated significantly higher by ADHD patients. QoL was significantly lower in adults with ADHD, and the variables depression, ADHD symptom severity, and traumatic load, accounted for ~60% of variance in overall QoL. CONCLUSION QoL is significantly reduced in adult ADHD patients. Depressive symptoms and traumatic childhood experiences influence QoL. Treatment for adult ADHD patients should take the high interdependence of depressive symptoms, childhood trauma, and QoL into consideration.
Collapse
|
44
|
Persistence and Adherence to Psychostimulants, and Psychological Well-Being Up to 3 Years After Specialized Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Naturalistic Follow-Up Study. J Clin Psychopharmacol 2017; 37:689-696. [PMID: 29049077 DOI: 10.1097/jcp.0000000000000787] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Little is known about the long-term persistence and adherence of psychostimulant use in adults with attention-deficit/hyperactivity disorder (ADHD) and its relationship to their psychological well-being. METHODS The persistence and adherence to psychostimulants and psychological well-being were examined in adults with ADHD in a naturalistic follow-up, starting directly after discharge from their specialized treatment of ADHD at an outpatient ADHD clinic. Ninety-six patients were included at the time of discharge, who were interviewed by telephone at 6 months, 1 year, and 3 years after discharge. RESULTS At the time of discharge, 78% used a psychostimulant prescribed by a psychiatrist. Of those on psychostimulants at the time of discharge, approximately half still used any of these psychostimulants 3 years after discharge. However, adherence rates were good for those who persisted to use psychostimulants. The female sex and middle educational level (relative to a higher educational level) were near-significantly related to nonpersistence, and having a higher educational level and the combined ADHD subtype were related to nonadherence. In turn, nonadherence was related to worse general functioning, lower mood, and poorer sleep quality. CONCLUSIONS The importance of adherence should be discussed at the time of discharge, especially with female ADHD patients, those with a higher educational level, and those with a combined ADHD subtype, because nonadherence is associated with poorer outcomes.
Collapse
|
45
|
Ustun B, Adler LA, Rudin C, Faraone SV, Spencer TJ, Berglund P, Gruber MJ, Kessler RC. The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5. JAMA Psychiatry 2017; 74:520-527. [PMID: 28384801 PMCID: PMC5470397 DOI: 10.1001/jamapsychiatry.2017.0298] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/08/2017] [Indexed: 11/14/2022]
Abstract
Importance Recognition that adult attention-deficit/hyperactivity disorder (ADHD) is common, seriously impairing, and usually undiagnosed has led to the development of adult ADHD screening scales for use in community, workplace, and primary care settings. However, these scales are all calibrated to DSM-IV criteria, which are narrower than the recently developed DSM-5 criteria. Objectives To update for DSM-5 criteria and improve the operating characteristics of the widely used World Health Organization Adult ADHD Self-Report Scale (ASRS) for screening. Design, Setting, and Participants Probability subsamples of participants in 2 general population surveys (2001-2003 household survey [n = 119] and 2004-2005 managed care subscriber survey [n = 218]) who completed the full 29-question self-report ASRS, with both subsamples over-sampling ASRS-screened positives, were blindly administered a semistructured research diagnostic interview for DSM-5 adult ADHD. In 2016, the Risk-Calibrated Supersparse Linear Integer Model, a novel machine-learning algorithm designed to create screening scales with optimal integer weights and limited numbers of screening questions, was applied to the pooled data to create a DSM-5 version of the ASRS screening scale. The accuracy of the new scale was then confirmed in an independent 2011-2012 clinical sample of patients seeking evaluation at the New York University Langone Medical Center Adult ADHD Program (NYU Langone) and 2015-2016 primary care controls (n = 300). Data analysis was conducted from April 4, 2016, to September 22, 2016. Main Outcomes and Measures The sensitivity, specificity, area under the curve (AUC), and positive predictive value (PPV) of the revised ASRS. Results Of the total 637 participants, 44 (37.0%) household survey respondents, 51 (23.4%) managed care respondents, and 173 (57.7%) NYU Langone respondents met DSM-5 criteria for adult ADHD in the semistructured diagnostic interview. Of the respondents who met DSM-5 criteria for adult ADHD, 123 were male (45.9%); mean (SD) age was 33.1 (11.4) years. A 6-question screening scale was found to be optimal in distinguishing cases from noncases in the first 2 samples. Operating characteristics were excellent at the diagnostic threshold in the weighted (to the 8.2% DSM-5/Adult ADHD Clinical Diagnostic Scale population prevalence) data (sensitivity, 91.4%; specificity, 96.0%; AUC, 0.94; PPV, 67.3%). Operating characteristics were similar despite a much higher prevalence (57.7%) when the scale was applied to the NYU Langone clinical sample (sensitivity, 91.9%; specificity, 74.0%; AUC, 0.83; PPV, 82.8%). Conclusions and Relevance The new ADHD screening scale is short, easily scored, detects the vast majority of general population cases at a threshold that also has high specificity and PPV, and could be used as a screening tool in specialty treatment settings.
Collapse
Affiliation(s)
- Berk Ustun
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge
| | - Lenard A. Adler
- Department of Psychiatry, New York University Langone School of Medicine, New York
- Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine
| | - Cynthia Rudin
- Department of Computer Science, Duke University, Durham, North Carolina
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina
| | - Stephen V. Faraone
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse
- Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse
| | - Thomas J. Spencer
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
| | | | - Michael J. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
46
|
Schoeman R, Liebenberg R. The South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder. THE SOUTH AFRICAN JOURNAL OF PSYCHIATRY : SAJP : THE JOURNAL OF THE SOCIETY OF PSYCHIATRISTS OF SOUTH AFRICA 2017. [PMID: 30263194 DOI: 10.4102/sajpsychiatry.v23i0.1060.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/26/2022]
Abstract
Disclaimer These guidelines do not aim to provide a comprehensive review of all the pertinent literature comprising the evidence base and, as such, should be utilised in conjunction with other guidelines as well as the responsibility of practitioners to maintain a high level of personal knowledge and expertise. Despite the known efficacy of treatment and the substantial costs of untreated attention-deficit/hyperactivity disorder (ADHD), access to healthcare and treatment is not a given for many patients in South Africa (SA). In SA, there is poor identification and treatment of common mental disorders at primary healthcare level and limited access to specialist resources with a service delivery and treatment gap of up to 75%. Medication options are also often limited in emerging markets and in SA psychiatrists, and patients do not have access to the medication armamentarium available in established markets. Furthermore, the majority of South Africans currently utilise the public healthcare sector and may not have access to treatment options referred to in these guidelines. These guidelines should therefore not be seen as a policy document. The process The South African Society of Psychiatrists' Special Interest Group (SIG) for adult ADHD was launched on 25 September 2015, with doctors Rykie Liebenberg and Renata Schoeman as convenor and co-convenor, respectively. The overall objective of the ADHD SIG is to improve the basket of care available to patients with ADHD. This is only possible through a combined and concerted effort of individuals with a special interest in and passion for ADHD to improve knowledge about and funding for the care of individuals with the disorder. One of the specific aims of the ADHD SIG was to develop South African guidelines for the diagnosis and treatment of adult ADHD specifically and update guidelines for the treatment of child, adolescent and adult ADHD. Dr Schoeman has recently completed her MBA at the University of Stellenbosch Business School with a thesis entitled 'A funding model proposal for private health insurance for adult attention-deficit/hyperactivity disorder in the South African context'. This is first South African study exploring the situation with regard to the prevalence and treatment of adult ADHD. Dr Schoeman was tasked by the SIG with the drafting of guidelines. Dr Liebenberg provided valuable input. The guidelines were then circulated to the SIG members, as well as the Chair of the Public Sector SIG, for written feedback and evidence-based suggestions which were then incorporated into the guidelines. The final guidelines were circulated for written approval by the SIG members, followed by formal approval at a SIG meeting held on 14 August 2016, after which it was submitted to the South African Society of Psychiatrists (SASOP) and Psychiatry Management Group (PsychMG) boards for recommendation and ratification.
Collapse
Affiliation(s)
- Renata Schoeman
- Stellenbosch University Business School, Stellenbosch University, South Africa.,Private Practice, South Africa
| | | |
Collapse
|
47
|
Schoeman R, Liebenberg R. The South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder. S Afr J Psychiatr 2017; 23:1060. [PMID: 30263194 PMCID: PMC6138063 DOI: 10.4102/sajpsychiatry.v23i0.1060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022] Open
Abstract
DISCLAIMER These guidelines do not aim to provide a comprehensive review of all the pertinent literature comprising the evidence base and, as such, should be utilised in conjunction with other guidelines as well as the responsibility of practitioners to maintain a high level of personal knowledge and expertise. Despite the known efficacy of treatment and the substantial costs of untreated attention-deficit/hyperactivity disorder (ADHD), access to healthcare and treatment is not a given for many patients in South Africa (SA). In SA, there is poor identification and treatment of common mental disorders at primary healthcare level and limited access to specialist resources with a service delivery and treatment gap of up to 75%. Medication options are also often limited in emerging markets and in SA psychiatrists, and patients do not have access to the medication armamentarium available in established markets. Furthermore, the majority of South Africans currently utilise the public healthcare sector and may not have access to treatment options referred to in these guidelines. These guidelines should therefore not be seen as a policy document. THE PROCESS The South African Society of Psychiatrists' Special Interest Group (SIG) for adult ADHD was launched on 25 September 2015, with doctors Rykie Liebenberg and Renata Schoeman as convenor and co-convenor, respectively. The overall objective of the ADHD SIG is to improve the basket of care available to patients with ADHD. This is only possible through a combined and concerted effort of individuals with a special interest in and passion for ADHD to improve knowledge about and funding for the care of individuals with the disorder. One of the specific aims of the ADHD SIG was to develop South African guidelines for the diagnosis and treatment of adult ADHD specifically and update guidelines for the treatment of child, adolescent and adult ADHD. Dr Schoeman has recently completed her MBA at the University of Stellenbosch Business School with a thesis entitled 'A funding model proposal for private health insurance for adult attention-deficit/hyperactivity disorder in the South African context'. This is first South African study exploring the situation with regard to the prevalence and treatment of adult ADHD. Dr Schoeman was tasked by the SIG with the drafting of guidelines. Dr Liebenberg provided valuable input. The guidelines were then circulated to the SIG members, as well as the Chair of the Public Sector SIG, for written feedback and evidence-based suggestions which were then incorporated into the guidelines. The final guidelines were circulated for written approval by the SIG members, followed by formal approval at a SIG meeting held on 14 August 2016, after which it was submitted to the South African Society of Psychiatrists (SASOP) and Psychiatry Management Group (PsychMG) boards for recommendation and ratification.
Collapse
Affiliation(s)
- Renata Schoeman
- Stellenbosch University Business School, Stellenbosch University, South Africa
- Private Practice, South Africa
| | | |
Collapse
|
48
|
Fuermaier ABM, Hüpen P, De Vries SM, Müller M, Kok FM, Koerts J, Heutink J, Tucha L, Gerlach M, Tucha O. Perception in attention deficit hyperactivity disorder. ACTA ACUST UNITED AC 2017; 10:21-47. [PMID: 28401487 DOI: 10.1007/s12402-017-0230-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
Abstract
A large body of research demonstrated that individuals with attention deficit hyperactivity disorder (ADHD) suffer from various neuropsychological deficits. In contrast, less is known and only divergent evidence exists on perceptual functions of individuals with ADHD. This is problematic as neuropsychological and perceptual functions are closely interrelated and are often difficult to disentangle in behavioral assessments. This study presents the conduct and results of a systematic literature review on perceptual functions in children and adults with ADHD. This review considers studies using psychophysical methods (objective measurements) and self- and informant reports (subjective measurements). Results indicate that individuals with ADHD have altered perceptual functions in various domains as compared to typically developing individuals. Increased perceptual functions in individuals with ADHD were found with regard to olfactory detection thresholds, whereas reduced perceptual functions were evident for aspects of visual and speech perception. Moreover, individuals with ADHD were found to experience discomfort to sensory stimuli at a lower level than typically developing individuals. Alterations of perceptual functions in individuals with ADHD were shown to be moderated by various factors, such as pharmacological treatment, cognitive functions, and symptom severity. We conclude by giving implications for daily life functioning and clinical practice.
Collapse
Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Philippa Hüpen
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Stefanie M De Vries
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Morgana Müller
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Francien M Kok
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Joost Heutink
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Centre of Expertise for Blind and Partially Sighted People, Royal Dutch Visio, 9752 AC, Haren, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Manfred Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Centre for Mental Health, University Hospital of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| |
Collapse
|
49
|
Neely KA, Wang P, Chennavasin AP, Samimy S, Tucker J, Merida A, Perez-Edgar K, Huang-Pollock C. Deficits in inhibitory force control in young adults with ADHD. Neuropsychologia 2017; 99:172-178. [PMID: 28284985 DOI: 10.1016/j.neuropsychologia.2017.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 02/06/2023]
Abstract
Poor inhibitory control is a well-established cognitive correlate of adults with ADHD. However, the simple reaction time (RT) task used in a majority of studies records performance errors only via the presence or absence of a single key press. This all-or-nothing response makes it impossible to capture subtle differences in underlying processes that shape performance. Subsequently, all-or-nothing tasks may underestimate the prevalence of executive function deficits in ADHD. The current study measured inhibitory control using a standard Go/No-Go RT task and a more sensitive continuous grip force task among adults with (N=51, 22 female) and without (N=51, 29 female) ADHD. Compared to adults without ADHD, adults with ADHD made more failed inhibits in the classic Go/No-Go paradigm and produced greater and more variable force during motor inhibition. The amount of force produced on failed inhibits was a stronger predictor of ADHD-related symptoms than the number of commissions in the standard RT task. Adults with ADHD did not differ from those without ADHD on the mean force and variability of force produced in Go trials. These findings suggest that the use of a precise and continuous motor task, such as the force task used here, provides additional information about the nature of inhibitory motor control in adults with ADHD.
Collapse
Affiliation(s)
- Kristina A Neely
- Department of Kinesiology, The Pennsylvania State University, PA 16802, USA.
| | - Peiyuan Wang
- Department of Kinesiology, The Pennsylvania State University, PA 16802, USA
| | - Amanda P Chennavasin
- Department of Biomedical Engineering, The Pennsylvania State University, PA 16802, USA
| | - Shaadee Samimy
- Department of Kinesiology, The Pennsylvania State University, PA 16802, USA
| | - Jacqueline Tucker
- Department of Biomedical Engineering, The Pennsylvania State University, PA 16802, USA
| | - Andrea Merida
- Department of Biomedical Engineering, The Pennsylvania State University, PA 16802, USA
| | - Koraly Perez-Edgar
- Department of Psychology, The Pennsylvania State University, PA 16802, USA
| | | |
Collapse
|
50
|
Stickley A, Koyanagi A, Takahashi H, Kamio Y. ADHD symptoms and pain among adults in England. Psychiatry Res 2016; 246:326-331. [PMID: 27750114 DOI: 10.1016/j.psychres.2016.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 09/21/2016] [Accepted: 10/02/2016] [Indexed: 12/16/2022]
Abstract
Prior research has produced conflicting findings on the association between attention-deficit/hyperactivity disorder (ADHD) and pain, while studies among community-dwelling adults are lacking. This study examined the association between ADHD symptoms and pain in the general adult population, and the extent to which this association is influenced by comorbid common mental disorders (CMDs). Data came from the 2007 Adult Psychiatric Morbidity Survey which included a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) Screener was used to obtain information on ADHD symptoms, while pain was assessed by the degree to which it interfered with work activity in the previous month. The Clinical Interview Schedule Revised (CIS-R) was used to evaluate six categories of CMDs. In a binary logistic regression analysis adjusted for socio-demographic factors and physical health conditions, an ADHD symptom score ≥14 was strongly associated with extreme pain (odds ratio [OR]: 3.15, 95% confidence interval [CI]: 2.09-4.74). The OR was attenuated greatly after further adjustment for CMDs (OR: 1.64, 95% CI: 1.05-2.58) but remained statistically significant. Adults with ADHD symptoms have higher odds for experiencing pain. CMDs are influential in this association but do not fully explain it.
Collapse
Affiliation(s)
- Andrew Stickley
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Hidetoshi Takahashi
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
| |
Collapse
|