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Fischer S, Nilsen C. ADHD in older adults - a scoping review. Aging Ment Health 2024:1-8. [PMID: 38622905 DOI: 10.1080/13607863.2024.2339994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES This scoping review presents an overview of the available research on symptoms, comorbidities, and associated challenges among older adults with ADHD. METHOD The literature study followed Arksey and O'Malley's five-stage framework. The search was conducted in ProQuest Central, Scopus, PsycInfo, CINAHL, and PubMed. Articles were included if they were peer-reviewed, ethically approved primary studies, written in the English language, concerning ADHD, and including people 60 years of age and older. RESULTS The review included 17 articles. Symptoms of ADHD persist throughout life. Older adults with ADHD experience similar core symptoms as younger individuals, but their manifestation and intensity may differ. The most common comorbidity found was mental illness, for example depression and anxiety. ADHD in older adults is linked to several challenges, such as difficulty with relationships and social isolation. CONCLUSION Older adults with ADHD face various symptoms, comorbidities, and challenges that affect their quality of life. Age-related changes can amplify ADHD symptoms and increase the perceived burden of illness. More research is needed to understand the complex relationship between these factors and enable tailored interventions to improve their quality of life and well-being.
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Affiliation(s)
- Silke Fischer
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
| | - Charlotta Nilsen
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
- Stress Research Institute, Department of Psychology, Stockholm University, Sweden
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
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Ruchkin V, Wallonius M, Odekvist E, Kim S, Isaksson J. Memory training with the method of loci for children and adolescents with ADHD-A feasibility study. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:137-145. [PMID: 36344263 DOI: 10.1080/21622965.2022.2141120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate if training with the memory technique Method of Loci (MoL) is feasible for children and adolescents with ADHD. Twelve children (aged 9-17 years) with ADHD participated. Training with MoL was done using a mobile application, memorizing a sequence of 20-80 pictures, intended to be carried out five times per week for 4 weeks. Feasibility was assessed with pre- and post-intervention ratings, and with interviews after the training. Qualitative data were analyzed with content analysis. Those who trained with MoL performed better on memory test and reported fewer ADHD symptoms after completing the training, as compared to their baseline levels. All of these children would recommend the training to peers but the duration of training varied considerably. The participants and their parents reported that the MoL training was easy and fun to use, although lack of motivation, distractions in every-day life, and lack of routines created challenges. We conclude that training with MoL was considered feasible by most of the participants. Future research should try to make the intervention more acceptable by motivating the participants and limiting potential distractions and involving larger study groups and controls to study the efficacy of the training.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Marwin Wallonius
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Emma Odekvist
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sharmeen Kim
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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Witrick B, Zhang D, Su D, Li Y, McCall WV, Hendricks B, Shi L. Medical Expenditures Associated with Attention-Deficit/Hyperactivity Disorder Among Adults in the United States by Age, 2015-2019. J Gen Intern Med 2023; 38:2082-2090. [PMID: 36781580 PMCID: PMC10361917 DOI: 10.1007/s11606-023-08075-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder is a common disorder that affects both children and adults. However, for adults, little is known about ADHD-attributable medical expenditures. OBJECTIVE To estimate the medical expenditures associated with ADHD, stratified by age, in the US adult population. DESIGN Using a two-part model, we analyzed data from Medical Expenditure Panel Survey for 2015 to 2019. The first part of the model predicts the probability that individuals incurred any medical costs during the calendar year using a logit model. The second part of the model estimates the medical expenditures for individuals who incurred any medical expenses in the calendar year using a generalized linear model. Covariates included age, sex, race/ethnicity, geographic region, Charlson comorbidity index, insurance, asthma, anxiety, and mood disorders. PARTICIPANTS Adults (18 +) who participated in the Medical Expenditure Panel Survey from 2015 to 2019 (N = 83,776). MAIN MEASURES Overall and service specific direct ADHD-attributable medical expenditures. KEY RESULTS A total of 1206 participants (1.44%) were classified as having ADHD. The estimated incremental costs of ADHD in adults were $2591.06 per person, amounting to $8.29 billion nationally. Significant adjusted incremental costs were prescription medication ($1347.06; 95% CI: $990.69-$1625.93), which accounted for the largest portion of total costs, and office-based visits ($724.86; 95% CI: $177.75-$1528.62). The adjusted incremental costs for outpatient visits, inpatient visits, emergency room visits, and home health visits were not significantly different. Among older adults (31 +), the incremental cost of ADHD was $2623.48, while in young adults (18-30), the incremental cost was $1856.66. CONCLUSIONS The average medical expenditures for adults with ADHD in the US were substantially higher than those without ADHD and the incremental costs were higher in older adults (31 +) than younger adults (18-30). Future research is needed to understand the increasing trend in ADHD attributable cost.
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Affiliation(s)
- Brian Witrick
- West Virginia Clinical and Translational Sciences Institute, PO Box 9102, Morgantown, WV, 26506, USA
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY, USA
| | - Dejun Su
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Yan Li
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Brian Hendricks
- West Virginia Clinical and Translational Sciences Institute, PO Box 9102, Morgantown, WV, 26506, USA
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, USA
| | - Lu Shi
- Clemson University, Clemson, SC, USA
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Dobrosavljevic M, Larsson H, Cortese S. The diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) in older adults. Expert Rev Neurother 2023; 23:883-893. [PMID: 37725058 DOI: 10.1080/14737175.2023.2250913] [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: 07/16/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION There is a striking knowledge gap on ADHD in older adults, and the diagnosis as well as treatment for ADHD in this age group. AREAS COVERED The authors first review the literature on the prevalence, functional impairment, and health comorbidities of ADHD across the lifespan. Next, they address the diagnostic criteria for ADHD in adults according to the DSM/ICD, available screening/diagnostic tools, differential diagnosis, and the validity of diagnostic criteria for ADHD in older adults. Finally, the authors focus on empirical evidence on the prevalence rates, medication response, and safety of pharmacological treatment of ADHD in older adults, and national and international clinical guidelines on the treatment of ADHD in this age group. EXPERT OPINION It is expected that future editions of the DSM and ICD will provide specifiers to the standard ADHD criteria, to better inform the diagnosis of ADHD in older adults. It is also expected that the increasing number of epidemiological studies will provide rigorous estimates on the prevalence, incidence, and burden of ADHD in older adults. One may expect an increasing number of RCTs assessing the efficacy/effectiveness and tolerability/safety of pharmacological as well as non-pharmacological interventions which will inform future guidelines on ADHD in older adults.
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Affiliation(s)
- Maja Dobrosavljevic
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Life and Environmental Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham, UK
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York, NY, USA
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5
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Regan SL, Sugimoto C, Dawson HE, Williams MT, Vorhees CV. Latrophilin-3 heterozygous versus homozygous mutations in Sprague Dawley rats: Effects on egocentric and allocentric memory and locomotor activity. GENES, BRAIN, AND BEHAVIOR 2022; 21:e12817. [PMID: 35985692 PMCID: PMC9744505 DOI: 10.1111/gbb.12817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
Abstract
Latrophilin-3 (LPHN3) is a brain specific G-protein coupled receptor associated with increased risk of attention deficit hyperactivity disorder (ADHD) and cognitive deficits. CRISPR/Cas9 was used to generate a constitutive knockout (KO) rat of Lphn3 by deleting exon 3, based on human data that LPHN3 variants are associated with some cases of ADHD. Lphn3 KO rats are hyperactive with an attenuated response to ADHD medication and have cognitive deficits. Here, we tested KO, heterozygous (HET), and wildtype (WT) rats to determine if there was a gene-dosage effect. We tested the rats in home-cage activity starting at postnatal day (P)35 and P50, followed by tests of egocentric learning (Cincinnati water maze [CWM]), spatial learning (Morris water maze [MWM]), working memory (radial water maze [RWM]), incidental learning (novel object recognition [NOR]), acoustic startle response (ASR) habituation, tactile startle response (TSR) habituation, prepulse modification of acoustic startle, shuttle-box passive avoidance, conditioned freezing, and a mirror image version of the CWM. KO and HET rats were hyperactive. KO and HET rats had egocentric (CWM) and spatial deficits (MWM), increased startle response, and KO rats showed less conditioned freezing on contextual and cued memory; there were no effects on working memory (RWM) or passive avoidance. The selective gene-dosage effect in Lphn3 HET rats indicates that Lphn3 exhibits dominate expression on functions where it is most abundantly expressed (striatum, hippocampus) but not on behaviors mediated by regions of low expression. The data add further evidence to the impact of this synaptic protein on brain function and behavior.
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Affiliation(s)
- Samantha L. Regan
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of NeurologyCincinnati Children's Research FoundationCincinnatiOhioUSA,Department of Human GeneticsUniversity of Michigan Medical CenterAnn ArborMichiganUSA
| | - Chiho Sugimoto
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of NeurologyCincinnati Children's Research FoundationCincinnatiOhioUSA,Department of PhysiologyMichigan State UniversityEast LansingMichiganUSA
| | - Hannah E. Dawson
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of NeurologyCincinnati Children's Research FoundationCincinnatiOhioUSA
| | - Michael T. Williams
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of NeurologyCincinnati Children's Research FoundationCincinnatiOhioUSA
| | - Charles V. Vorhees
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of NeurologyCincinnati Children's Research FoundationCincinnatiOhioUSA
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Callahan BL, Plamondon A, Gill S, Ismail Z. Contribution of vascular risk factors to the relationship between ADHD symptoms and cognition in adults and seniors. Sci Rep 2021; 11:24276. [PMID: 34930996 PMCID: PMC8688479 DOI: 10.1038/s41598-021-03782-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
Symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood have been found to be predictive of compromised cognitive function, and possibly even dementia, in later adulthood. This study aimed to test vascular risk as a hypothesized moderator or mediator of this association, because individuals with elevated ADHD symptoms frequently have comorbid vascular disease or risk factors which are recognized to contribute to later-life cognitive decline. Data from 1,092 adults aged 18–85 were drawn from the Enhanced Nathan Kline Institute Rockland Sample. Childhood ADHD symptoms (assessed using the Adult ADHD Clinical Diagnostic Scale) were assessed as predictors of cognitive functioning in adulthood (assessed using subtests from the University of Pennsylvania Computerized Neurocognitive Battery, the Delis-Kaplan Executive Functioning System, and the Wechsler Memory Scale). Vascular risk factors (including diabetes, tobacco use, obesity, hypertension, and hypercholesterolemia) were tested as both a moderator and mediator of this relationship. Childhood ADHD symptoms and vascular risk factors were both independently associated with later-life cognition, but vascular risk was not a significant moderator or mediator of relationships between ADHD symptoms and cognition in statistical models. Results from this large community sample suggest that the relationship between ADHD symptoms and cognition is not accounted for by vascular risk. This question should also be investigated in clinical samples.
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Affiliation(s)
- Brandy L Callahan
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. .,Hotchkiss Brain Institute, Calgary, AB, Canada.
| | - André Plamondon
- Department of Educational Fundamentals and Practices, Laval University, Quebec, QC, Canada.,Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada
| | - Sascha Gill
- Hotchkiss Brain Institute, Calgary, AB, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute, Calgary, AB, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.,Departments of Psychiatry and Community Health Science, University of Calgary, Calgary, AB, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
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7
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Dobrosavljevic M, Zhang L, Garcia-Argibay M, Du Rietz E, Andershed H, Chang Z, Faraone S, Larsson H. Attention-deficit/hyperactivity disorder as a risk factor for dementia and mild cognitive impairment: a population-based register study. Eur Psychiatry 2021; 65:1-19. [PMID: 34924079 PMCID: PMC8792867 DOI: 10.1192/j.eurpsy.2021.2261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/11/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background Previous research has indicated that attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk for dementia, but studies are scarce and inconclusive. We aimed to investigate the association between ADHD, and dementia and mild cognitive impairment (MCI). Additionally, we aimed to investigate the impact of comorbid conditions, educational attainment, head injuries, other developmental disorders, and sex on the association. Methods The study population consisted of 3,591,689 individuals born between 1932 and 1963, identified from Swedish population-based registers. Cases of ADHD, dementia and MCI were defined according to ICD diagnostic codes and ATC codes for medication prescriptions. A Cox proportional hazards model was used to test the associations between ADHD, and dementia and MCI. Results Individuals with ADHD had an increased risk for dementia and MCI. After adjusting for sex and birth year, a hazard ratio (HR) was 2.92 (95% confidence interval 2.40–3.57) for dementia, and 6.21 (5.25–7.35) for MCI. Additional adjustment for psychiatric disorders (depression, anxiety, substance use disorder, and bipolar disorder) substantially attenuated the associations, HR = 1.62 (1.32–1.98) for dementia, and 2.54 (2.14–3.01) for MCI. Common metabolic disorders (hypertension, type 2 diabetes, and obesity), sleep disorders, head injuries, educational attainment, and other developmental disorders, had a limited impact on the association. The association between ADHD and dementia was stronger in men. Conclusions ADHD is a potential risk factor for dementia and MCI, although the risk significantly attenuates after controlling for psychiatric disorders. Further research is needed to confirm these findings and to explore underlying mechanisms of the associations.
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Affiliation(s)
| | - Le Zhang
- Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm,
Sweden
| | | | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm,
Sweden
| | - Henrik Andershed
- School of Law, Psychology and Social Work, Örebro
University, Örebro, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm,
Sweden
| | - Stephen Faraone
- Departments of Psychiatry and of Neuroscience and Physiology,
SUNY Upstate Medical University, Syracuse,
New York, USA
| | - Henrik Larsson
- School of Medical Sciences, Örebro University,
Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm,
Sweden
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8
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Callahan BL, Shammi P, Taylor R, Ramakrishnan N, Black SE. Longitudinal Cognitive Performance of Older Adults With ADHD Presenting to a Cognitive Neurology Clinic: A Case Series of Change Up to 21 Years. Front Aging Neurosci 2021; 13:726374. [PMID: 34867269 PMCID: PMC8634492 DOI: 10.3389/fnagi.2021.726374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The neuropsychological features of older adults with ADHD are largely unknown. This retrospective chart review aims to elucidate their cognitive trajectories using a case series of six older adults with ADHD presenting with memory complaints to a cognitive neurology clinic, whom we argue are a particularly relevant group to study due to their potential to mimic neurodegenerative syndromes. Methods: Participants were included if they were age 40 or older at intake, had ADHD based on DSM-5 criteria, and had cognitive data collected prior to 2014 with follow-up at least 5 years later. Results: Five men and one woman were included (M = 53.8 years at intake) and had an average of 135.0 months of follow-up data available. Despite notable between- and within-subject variability, cognition generally improved or remained stable across visits. Two participants experienced notable memory decline, but a global consideration of their performance in other domains suggests these deficits may be frontally-mediated. Conclusion: In this small sample, cognition remained generally unchanged across 5–21 years. Isolated impairments likely reflect substantial intra-individual variability across time and measures.
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Affiliation(s)
- Brandy L Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Prathiba Shammi
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rebecca Taylor
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Klein M, Souza-Duran FL, Menezes AKPM, Alves TM, Busatto G, Louzã MR. Gray Matter Volume in Elderly adults With ADHD: Associations of Symptoms and Comorbidities With Brain Structures. J Atten Disord 2021; 25:829-838. [PMID: 31262214 DOI: 10.1177/1087054719855683] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To investigate total and selected region-of-interest-based gray matter volume (GMV) in older adults with ADHD. Method: Twenty-five elderly (≥65 years old) patients with ADHD and 34 healthy controls underwent 1.5-T magnetic resonance imaging (MRI). We used voxel-based morphometry to compare GMV between groups and performed a correlation analysis with ADHD symptoms and comorbidities. Results: Findings revealed a smaller total GMV in males with ADHD and a smaller GMV in the right medial frontal orbital area extending toward the medial frontal superior, the frontal superior, and the subgenual anterior cingulate cortex (ACC) besides correlations between inattentiveness and ACC (bilaterally) and left cerebellum, hyperactivity/impulsivity and the left frontal inferior orbital, depression and caudate (bilaterally), and the right inferior parietal lobule. Conclusion: Neural correlates in regions related to attention, executive control, and affective processing suggest that impairments in frontostriatal and frontoparietal-cerebellar areas observed in adults with ADHD persist into old age.
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Affiliation(s)
- Margarete Klein
- Programa de Déficit de Atenção e Hiperatividade no Adulto (PRODATH). Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Fábio Luis Souza-Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Anny Karinna Pires Mendes Menezes
- Programa de Déficit de Atenção e Hiperatividade no Adulto (PRODATH). Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Tania Maria Alves
- Programa de Déficit de Atenção e Hiperatividade no Adulto (PRODATH). Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Geraldo Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mario R Louzã
- Programa de Déficit de Atenção e Hiperatividade no Adulto (PRODATH). Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
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Jamali Z, Ghaffari P, Aminabadi NA, Norouzi S, Shirazi S. Oral health status and oral health-related quality of life in children with attention-deficit hyperactivity disorder and oppositional defiant disorder. SPECIAL CARE IN DENTISTRY 2021; 41:178-186. [PMID: 33421188 DOI: 10.1111/scd.12563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/28/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
AIMS Oral diseases can affect various aspects of life in patients with attention deficit hyperactivity disorder/oppositional defiant disorder (ADHD/ODD). This study aimed to assess the oral health status and oral health-related quality of life (OHRQOL) in ADHD/ODD children. METHODS Forty ADHD/ODD and 80 control children aged 3-7 years old were included in the study. Gingival index (GI), dmft score, and the pediatric oral health-related quality of life (POQL) questionnaire were used to determine the oral health status and OHRQOL, respectively. RESULTS The mean dmft and GI were significantly higher in the ADHD/ODD group than the control group (P = .002 and P = .001). In the ADHD/ODD children, the total score of OHRQOL and the mean scores of the emotional, physical, role, and social domains were lower than that in the control group (P = .0004, P = .027, P = .002, P = .014, and P = .043, respectively). Poisson's regression showed that there was a significant relationship between OHRQOL and dmft scores (P-value < .001). However, the association between GI and OHRQOL scores was not significant. CONCLUSION Higher dmft and GI scores were found in children with ADHD/ODD than the control children. A lower POQL score was detected in ADHD/ODD patients, which translates to a better level of OHRQOL.
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Affiliation(s)
- Zahra Jamali
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Ghaffari
- Department of Pediatric Dentistry, Faculty of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Naser Asl Aminabadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanaz Norouzi
- Department of Psychiatry (Child and Adolescent Ward), Razi Psychiatry Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
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Prakash J, Chatterjee K, Guha S, Srivastava K, Chauhan VS. Adult attention-deficit Hyperactivity disorder: From clinical reality toward conceptual clarity. Ind Psychiatry J 2021; 30:23-28. [PMID: 34483520 PMCID: PMC8395556 DOI: 10.4103/ipj.ipj_7_21] [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] [Received: 01/09/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 11/07/2022] Open
Abstract
There is ambiguity about the clinical picture and concept of attention-deficit hyperactivity disorder (ADHD) in adults. Relevant literature was extracted from various search engines, analyzed, and interpreted. Available literature suggests a significant prevalence of ADHD in the adult population affecting the quality of socio-occupational functioning. Inattentiveness was more commonly present than hyperactivity-impulsivity. Frequent comorbidities with other psychiatric disorders like anxiety disorders and substance use disorders were noted. Pharmacological management and psychotherapy have been found effective in its management. ADHD is a disorder across the lifespan and fairly prevalent among adults. Greater awareness and more research are required for a better understanding of Adult ADHD and its effective management.
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Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - K. Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - S. Guha
- Private Consultant Psychiatrist, Sr Lecturer UQ School of Medicine and Griffith University School of Medicine, Australia
| | - K. Srivastava
- Department of Clinical Psychologist, Armed Forces Medical College, Pune, Maharashtra, India
| | - V. S. Chauhan
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
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Rodríguez C, Torrance M, Betts L, Cerezo R, García T. Effects of ADHD on Writing Composition Product and Process in School-Age Students. J Atten Disord 2020; 24:1735-1745. [PMID: 28490212 DOI: 10.1177/1087054717707048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This study examined the relationship between ADHD and writing performance. Method: Students in Grades 3 to 7, 84 with ADHD and 135 age- and gender-matched controls completed a writing task (including process logs), and measures of working memory and attention. Results: Students with ADHD wrote texts of similar length but with poorer structure, coherence, and ideation. In all, 6.7% of the variance in writing quality was explained by whether or not the student had an ADHD diagnosis, after control for IQ and age-within-year, with ADHD students producing text that was less coherent, well structured, and ideationally rich, and spending less time thinking about and reviewing their text. Half of the effect on text quality could be attributed to working memory and sustained attention effects. Conclusion: ADHD has some effect on writing performance, which can, in part, be explained by working memory and attentional deficits.
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Nyström A, Petersson K, Janlöv AC. Being Different but Striving to Seem Normal: The Lived Experiences of People Aged 50+ with ADHD. Issues Ment Health Nurs 2020; 41:476-485. [PMID: 32267788 DOI: 10.1080/01612840.2019.1695029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This qualitative study explored the day-to-day life of people aged 50+ diagnosed with ADHD. A phenomenological-hermeneutical method was chosen for the analysis. Two themes including sub-themes were revealed. The first theme, Being different and trying to handle my inner self, concerned emotional self-regulation, emotional resilience, social skills, and personal resource management. The second theme, Trying to adapt to fit in with people around me, concerned relationships, work, and personal finances. The comprehensive understanding was interpreted as Being different but striving to seem normal.
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Affiliation(s)
- Anne Nyström
- Faculty of Health Sciences, Department of Nursing and Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Kerstin Petersson
- Department of Health Sciences, Faculty of Medicine, Lund University. Lund, Sweden
| | - Ann-Christin Janlöv
- Faculty of Health Sciences, Department of Nursing and Health Sciences, Kristianstad University, Kristianstad, Sweden
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14
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Deshmukh P, Patel D. Attention Deficit Hyperactivity Disorder and Its Treatment in Geriatrics. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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15
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Thorell L, Holst Y, Chistiansen H, Kooij J, Bijlenga D, Sjöwall D. Neuropsychological deficits in adults age 60 and above with attention deficit hyperactivity disorder. Eur Psychiatry 2020; 45:90-96. [DOI: 10.1016/j.eurpsy.2017.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 11/27/2022] Open
Abstract
AbstractObjective:Neuropsychological deficits are of major importance in ADHD, yet no previous studies have assessed clinically referred samples of older adults. The authors compared older adults with ADHD (60–75 years) with both younger adults with ADHD (18–45 years) and older healthy controls with regard to various neuropsychological deficits.Methods:Well-established tests were used to investigate working memory, inhibition, switching, planning, fluency, and speed of processing. Self-ratings of executive functioning and delay-related behaviors were also included. Both variable-oriented and person-oriented analyses were conducted.Results:Older adults with ADHD differed from controls with regard to working memory, inhibition, switching, and delay-related behaviors. In comparison to younger adults with ADHD, they performed at a similar level with regard to working memory and planning, but significantly better with regard to inhibition, switching, fluency, speed of processing, and delay aversion. Despite several significant group differences relative to controls, person-oriented analyses demonstrated that a majority of older adults with ADHD performed within the average range on each test and 20% showed no clear deficit within any neuropsychological domain.Conclusions:The results are in line with models of heterogeneity that have identified different neuropsychological subtypes in ADHD as well as a subgroup of patients without any clear neuropsychological deficits. For older adults with ADHD, it will be important to assess their functioning across time as normal aging is related to memory decline and these patients could therefore end up with severe deficits as they grow older, which in turn could have serious negative effects on daily life functioning.
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16
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Bathelt J, Koolschijn PC, Geurts HM. Age-variant and age-invariant features of functional brain organization in middle-aged and older autistic adults. Mol Autism 2020; 11:9. [PMID: 31993112 PMCID: PMC6977283 DOI: 10.1186/s13229-020-0316-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background The majority of research effort into autism has been dedicated to understanding mechanisms during early development. As a consequence, research on the broader life course of an autism spectrum condition (ASC) has largely been neglected and almost nothing is known about ASC beyond middle age. Differences in brain connectivity that arise during early development may be maintained across the lifespan and may play protective or detrimental roles in older age. Method This study explored age-related differences in functional connectivity across middle and older age in clinically diagnosed autistic adults (n = 44, 30-73 years) and in an age-matched typical comparison group (n = 45). Results The results indicated parallel age-related associations in ASC and typical aging for the local efficiency and connection strength of the default mode network and for the segregation of the frontoparietal control network. In contrast, group differences in visual network connectivity are compatible with a safeguarding interpretation of less age-related decline in brain function in ASC. This divergence was mirrored in different associations between visual network connectivity and reaction time variability in the ASC and comparison group. Limitations The study is cross-sectional and may be affected by cohort effects. As all participants received their autism diagnosis in adulthood, this might hinder generalizability. Conclusion These results highlight the complexity of aging in ASC with both parallel and divergent trajectories across different aspects of functional network organization.
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Affiliation(s)
- Joe Bathelt
- Dutch Autism & ADHD Research Center, Brain & Cognition, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands
| | - P. Cédric Koolschijn
- Dutch Autism & ADHD Research Center, Brain & Cognition, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands
| | - Hilde M. Geurts
- Dutch Autism & ADHD Research Center, Brain & Cognition, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands
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17
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Klein M, Silva MA, Belizario GO, Rocca CCDA, Padua Serafim AD, Louzã MR. Longitudinal Neuropsychological Assessment in Two Elderly Adults With Attention-Deficit/Hyperactivity Disorder: Case Report. Front Psychol 2019; 10:1119. [PMID: 31191384 PMCID: PMC6546833 DOI: 10.3389/fpsyg.2019.01119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/29/2019] [Indexed: 11/26/2022] Open
Abstract
The neuropsychological deficits in attention-deficit/hyperactivity disorder (ADHD) may present clinical features similar to mild and/or major neurocognitive disorder and may act as a confounding factor, making it difficult to detect cognitive decline. In this paper, we present the results of longitudinal neuropsychological evaluations in two elderly women with ADHD. Three neuropsychological assessments were performed in two women with ADHD (60 and 77 years old) between 2010 and 2013 at intervals varying from 12 to 15 months. We used structural magnetic resonance imaging to rule out significant abnormalities that could account for cognitive impairment. The results showed two different cognitive profiles with fluctuations in performance over these 2 years, sometimes with improvement and sometimes with decline of some functions such as attention, memory, inhibitory control, and reaction time. To minimize confounding aspects of these fluctuations in clinical practice, we used a longer follow-up with the application of a reliable change index and a minimum of three spaced assessments to provide a more consistent baseline cognitive profile. Our findings did not indicate a consistent cognitive decline, suggesting a less pessimistic perspective about cognitive impairments that could be a prodrome of ADHD-related dementia.
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Affiliation(s)
- Margarete Klein
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria Aparecida Silva
- Institute of Psychiatry, Clinical Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Antonio De Padua Serafim
- Clinical Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Department of Psychology, Methodist University of São Paulo, São Bernardo do Campo, Brazil
| | - Mario R Louzã
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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18
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Detection of adult attention deficit hyperactivity disorder with cognitive complaint: Experience of a French memory center. Rev Neurol (Paris) 2019; 175:358-366. [PMID: 31056192 DOI: 10.1016/j.neurol.2018.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/13/2018] [Accepted: 09/13/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a frequent neurodevelopmental mental disorder. It can persist in adulthood and be expressed as a cognitive complaint. METHODS We conducted a descriptive study in a French memory center concerning patients seen over a period of two years. All patients for whom the final diagnosis was ADHD were included. All patients benefited from standard neuropsychological tests and a psychiatric specific consultation. RESULTS Thirteen patients were included with an average age of 50.2±19 years. Main complaints related to memory, attention, focusing and organizational functioning. These difficulties had negative social, professional and academic consequences. ADHD history in descendants was noted in 46% of patients. More than 20% of subjects had motor, verbal or mental restlessness. Neuropsychological assessment highlighted impaired performances in executive functions (38%), sustained attention (67%), divided attention (45%), working memory (46%) and information processing speed (75%). A psychiatric history or comorbidities were present in 85% of patients, mostly of the anxio-depressive type. The more prevalent presentations of ADHD were the combined (38%) and inattentive (38%) types. DISCUSSION Adult ADHD can masquerade as a cognitive impairment, including a stable cognitive complaint from infancy to old age. Inattentive, hyperactive and impulsive symptoms change with time and become more internalized (such as concentration difficulties or mental restlessness). No neuropsychological pattern has been reported but fluctuating deficits in sustained, divided attention, working memory and information processing speed are frequently observed in adult ADHD. A specific psychiatric expertise is essential in diagnosis and care for ADHD and its commonly associated psychiatric comorbidities.
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19
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Mahadevan J, Kandasamy A, Benegal V. Situating adult attention-deficit/hyperactivity disorder in the externalizing spectrum: Etiological, diagnostic, and treatment considerations. Indian J Psychiatry 2019; 61:3-12. [PMID: 30745648 PMCID: PMC6341912 DOI: 10.4103/psychiatry.indianjpsychiatry_549_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Adult attention-deficit/hyperactivity disorder (ADHD) has a population prevalence of 5%. However, its prevalence is much higher in mental health and substance use treatment settings. It is associated with significant physical and psychiatric morbidity, as well as social, occupational, and legal consequences. Adult ADHD is considered to be a part of the externalizing spectrum with which it shares both homotypic comorbidity and heterotypic continuity across the lifespan. This is attributable to a shared genetic basis, which interacts with environmental risk factors such as nutritional deficiencies and psychosocial adversity to bring about epigenetic changes. This is seen to result in a lag in brain maturation particularly in the areas of the brain related to executive functioning (top-down regulation) such as the prefrontal and cingulate cortices. This delay when coupled with impairments in reward processing, leads to a preference for immediate small rewards and is common to externalizing disorders. Adult ADHD is increasingly understood to not merely be associated with the classically described symptoms of hyperactivity, impulsivity and inattention, but also issues with motivation, emotional recognition and regulation, excessive mind wandering, and behavioral self-regulation. These symptoms are also observed in other disorders which overlap with the externalizing spectrum such as oppositional defiant disorder, conduct disorder, antisocial and borderline personality disorder. It is therefore important to develop both broad-based and specific interventions to be able to target these deficits which can reduce the burden and improve outcomes.
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Affiliation(s)
- Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Arun Kandasamy
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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20
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Das D, Cherbuin N, Anstey KJ, Abhayaratna W, Easteal S. Regional Brain Volumes and ADHD Symptoms in Middle-Aged Adults: The PATH Through Life Study. J Atten Disord 2017; 21:1073-1086. [PMID: 24567365 DOI: 10.1177/1087054714523316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We investigated whether volumetric differences in ADHD-associated brain regions are related to current symptoms of inattention and hyperactivity in healthy middle-aged adults and whether co-occurring anxiety/depression symptoms moderate these relationships. METHOD ADHD Self-Report Scale and Brief Patient Health Questionnaire were used to assess current symptoms of inattention, hyperactivity, anxiety, and depression in a population-based sample ( n = 269). Brain volumes, measured using a semi-automated method, were analyzed using multiple regression and structural equation modeling to evaluate brain volume-inattention/hyperactivity symptom relationships for selected regions. RESULTS Volumes of the left nucleus accumbens and a region overlapping the dorsolateral prefrontal cortex were positively associated with inattention symptoms. Left hippocampal volume was negatively associated with hyperactivity symptoms. The brain volume-inattention/hyperactivity symptom associations were stronger when anxiety/depression symptoms were controlled for. CONCLUSION Inattention and hyperactivity symptoms in middle-aged adults are associated with different brain regions and co-occurring anxiety/depression symptoms moderate these brain-behavior relationships.
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Affiliation(s)
- Debjani Das
- 1 Australian National University, Canberra, Australia
| | | | | | - Walter Abhayaratna
- 1 Australian National University, Canberra, Australia.,2 Canberra Hospital and Health Services, Australia
| | - Simon Easteal
- 1 Australian National University, Canberra, Australia
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21
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Callahan BL, Bierstone D, Stuss DT, Black SE. Adult ADHD: Risk Factor for Dementia or Phenotypic Mimic? Front Aging Neurosci 2017; 9:260. [PMID: 28824421 PMCID: PMC5540971 DOI: 10.3389/fnagi.2017.00260] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 07/21/2017] [Indexed: 12/21/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) has historically been considered a disorder of childhood and adolescence. However, it is now recognized that ADHD symptoms persist into adulthood in up to 60% of individuals. Some of the cognitive symptoms that characterize ADHD (inability to provide sustained attention or mental effort, difficulty organizing or multi-tasking, forgetfulness) may closely resemble symptoms of prodromal dementia, also often referred to as mild cognitive impairment (MCI), particularly in patients over age 50. In addition to the overlap in cognitive symptoms, adults with ADHD and those with MCI may also share a number of behavioral and psychiatric symptoms, including sleep disturbances, depression, and anxiety. As a result, both syndromes may be difficult to distinguish clinically in older patients, particularly those who present to memory clinics with subjective cognitive complaints and fear the onset of a neurodegenerative process: is it ADHD, MCI, or both? Currently, it is unclear whether ADHD is associated with incipient dementia or is being misdiagnosed as MCI due to symptom overlap, as there exist data supporting either possibility. Here, we aim to elucidate this issue by outlining three hypothetical ways in which ADHD and MCI might relate to each other, providing an overview of the evidence relevant to each hypothesis, and delineating areas for future research. This is a question of considerable importance, with implications for improved diagnostic specificity of early dementia, improved accuracy of disease prevalence estimates, and better identification of individuals for targeted treatment.
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Affiliation(s)
- Brandy L Callahan
- Department of Psychology, University of CalgaryCalgary, AB, Canada.,Hotchkiss Brain InstituteCalgary, AB, Canada.,Sunnybrook Health Sciences Centre, Sunnybrook Research InstituteToronto, ON, Canada
| | - Daniel Bierstone
- LC Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences CentreToronto, ON, Canada.,Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Donald T Stuss
- Faculty of Medicine, University of TorontoToronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and University of TorontoToronto, ON, Canada
| | - Sandra E Black
- Sunnybrook Health Sciences Centre, Sunnybrook Research InstituteToronto, ON, Canada.,LC Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences CentreToronto, ON, Canada.,Faculty of Medicine, University of TorontoToronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and University of TorontoToronto, ON, Canada.,Heart and Stroke Foundation Canadian Partnership in Stroke Recovery, Sunnybrook Health Sciences CentreToronto, ON, Canada.,Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of TorontoToronto, ON, Canada
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Abstract
Zusammenfassung. Klassifizierungs- und Strukturierungsmöglichkeiten psychischer Störungen und Konstrukte sind in den letzten Jahren zu einem Schwerpunkt empirischer Forschung geworden. Im Mittelpunkt steht dabei die Debatte um die bisherige kategoriale versus einer neuen dimensionalen Sichtweise. ADHS gehört zu den Störungsbildern, für welche ein dimensionales Konzept plausibel erscheint. Empirische Belege hierfür liefern verschiedene taxonomische Studien an Kindern und Jugendlichen mit ADHS. Für Erwachsene gibt es bisher nur wenig empirische Untersuchungen zu dem Thema. Daher ist die vorliegende Studie eine erste Auseinandersetzung mit der Beschaffenheit von ADHS bei Erwachsenen, wobei den Befunden bei Kindern folgend von einer dimensionalen Struktur ausgegangen wird. Zwei Stichproben wurden zur Beantwortung der Fragestellung herangezogen: 605 Personen einer gesunden Normalstichprobe und 722 Personen aus einer klinischen Stichprobe, bestehend aus 336 Personen ohne ADHS-Diagnose und 386 Personen mit ADHS-Diagnose. Untersucht wurden alle Personen mittels der ADHS-Selbstbeurteilungsskala (ADHS-SB). Zur statistischen Überprüfung der Fragestellung wurden Diskriminanzanalysen und eine Faktorenanalyse durchgeführt, weiterhin wurden finite Mischverteilungsmodelle mit Hilfe des EM-Algorithmus gerechnet. Die Diskriminanzanalysen konnten zeigen, dass Grenzwerte nur bedingt dazu in der Lage sind, zwischen Personen mit und ohne ADHS zu diskriminieren. Die Faktorenanalyse ergab für alle Gruppen die gleiche Zwei-Faktoren-Lösung der ADHS, welche auch vom DSM-5 vorgeschlagen wird (Unaufmerksamkeit, Hyperaktivität/Impulsivität). Weiterhin wiesen die Mischmodelle der verschiedenen Gruppen keine Unterschiede auf, welche eine kategoriale Sichtweise rechtfertigen würden. Insgesamt ist eine dimensionale Struktur des Störungsbildes auch bei Erwachsenen als wahrscheinlich anzunehmen. Dies bedeutet, dass die Symptome der ADHS extreme Ausprägungen normaler psychischer Phänomene darstellen und es keine klaren Grenzen zwischen Personen mit und ohne einer adulten ADHS gibt. Trotz möglicher dimensionaler Struktur handelt es sich bei der ADHS um eine psychische Störung. Das Abklären funktioneller Beeinträchtigungen könnte vermehrt helfen, Behandlungswürdigkeit festzustellen.
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Affiliation(s)
- Hannes Bitto
- Fakultät für Psychologie, Abteilung für Klinische Psychologie und Psychiatrie der Universität Basel, Schweiz
| | - Beatrice Mörstedt
- Fakultät für Psychologie, Abteilung für Klinische Psychologie und Psychiatrie der Universität Basel, Schweiz
| | - Sylvia Faschina
- Fakultät für Psychologie, Abteilung für Klinische Psychologie und Psychiatrie der Universität Basel, Schweiz
| | - Rolf-Dieter Stieglitz
- Fakultät für Psychologie, Abteilung für Klinische Psychologie und Psychiatrie der Universität Basel, Schweiz
- Abteilung für Klinische Psychologie und Psychiatrie der Universitären Psychiatrischen Kliniken Basel, Schweiz
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23
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Surman CBH, Goodman DW. Is ADHD a valid diagnosis in older adults? ACTA ACUST UNITED AC 2017; 9:161-168. [DOI: 10.1007/s12402-017-0217-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/04/2017] [Indexed: 11/24/2022]
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24
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Alpak G, Selek S, Bulut M, Bulbul F, Unal A, Virit O, Kilic OHT, Gergerlioglu HS, Savas HA. High Catalase and Low Thiol Levels in Adult-ADHD Patients. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20140429091127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Gokay Alpak
- Gaziantep University School of Medicine, Department of Psychiatry, Gaziantep - Turkey
| | - Salih Selek
- Istanbul Medeniyet University, Department of Psychiatry, Istanbul - Turkey
| | - Mahmut Bulut
- Dicle University School of Medicine, Department of Psychiatry, Diyarbakir - Turkey
| | - Feridun Bulbul
- Gaziantep University School of Medicine, Department of Psychiatry, Gaziantep - Turkey
| | - Ahmet Unal
- Selcuk University School of Medicine, Department of Physiology, Konya - Turkey
| | - Osman Virit
- Gaziantep University School of Medicine, Department of Psychiatry, Gaziantep - Turkey
| | | | | | - Haluk Asuman Savas
- Gaziantep University School of Medicine, Department of Psychiatry, Gaziantep - Turkey
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25
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Luders E, Kurth F, Das D, Oyarce DE, Shaw ME, Sachdev P, Easteal S, Anstey KJ, Cherbuin N. Associations between corpus callosum size and ADHD symptoms in older adults: The PATH through life study. Psychiatry Res Neuroimaging 2016; 256:8-14. [PMID: 27619071 DOI: 10.1016/j.pscychresns.2016.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/22/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
Abstract
Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life. Here, we investigated in a large population-based sample of 280 adults (150 males, 130 females) in their late sixties and early seventies whether ADHD symptoms correlate with callosal thickness. In addition, we tested for significant sex interactions, which were followed by correlation analyses stratified by sex. Within males, there were significant negative correlations with respect to inattention and hyperactivity in various callosal regions, including the anterior third, anterior and posterior midbody, isthmus, and splenium. A thinner corpus callosum may be associated with fewer fibers or less myelination of fibers. Thus, the observed negative correlations suggest impaired inter-hemispheric communication channels necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. Interestingly, within females, callosal thickness was positively related to hyperactivity in a small area within the rostral body, suggesting a sexually dimorphic neurobiology of ADHD symptoms. Altogether, the present results may reflect a lasting relationship between callosal morphology and ADHD symptoms throughout life.
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Affiliation(s)
- Eileen Luders
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, USA; Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, Australia
| | - Florian Kurth
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, USA
| | - Debjani Das
- John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Daniela E Oyarce
- Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, Australia
| | - Marnie E Shaw
- Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, Australia
| | - Perminder Sachdev
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Simon Easteal
- John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, Australia.
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26
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Mörstedt B, Corbisiero S, Stieglitz RD. Normierung der Adult ADHD Self-Report-Scale-V1.1 und der ADHS Selbstbeurteilungsskala an einer repräsentativen deutschsprachigen Stichprobe. DIAGNOSTICA 2016. [DOI: 10.1026/0012-1924/a000154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Zusammenfassung. Die beiden Verfahren Adult ADHD Self-Report-Scale-V1.1 (ASRS-V1.1) und ADHS-Selbstbeurteilungsskala (ADHS-SB) sind häufig eingesetzte Instrumente zur Diagnostik einer adulten ADHS. Für beide Verfahren steht allerdings eine Normierung für die deutschsprachige Allgemeinbevölkerung bisher aus. Zur Erstellung von repräsentativen Normwerten der Skalen für die Allgemeinbevölkerung wurden N = 640 Personen (300 Männer, 340 Frauen) in der deutschsprachigen Schweiz rekrutiert. Mit Hilfe von Varianzanalysen mit den Haupteffekten Geschlecht und Alter wurde ermittelt, dass altersspezifische Normen sinnvoll sind. Es wurden daher für beide Selbstbeurteilungsverfahren Normierungen für die Gesamtbevölkerung, als auch für verschiedene Altersränge (18 – 19; 20 – 39; 40 – 64 und über 64) bestimmt. Für beide Selbstbeurteilungsverfahren wurden Prozentränge und Stanine-Werte berechnet. Infolgedessen wurden kritische Werte entwickelt, bei deren Erreichen unbedingt eine genaue ADHS Abklärung stattfinden sollte.
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27
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Kysow K, Park J, Johnston C. The use of compensatory strategies in adults with ADHD symptoms. ACTA ACUST UNITED AC 2016; 9:73-88. [PMID: 27614892 DOI: 10.1007/s12402-016-0205-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/27/2016] [Indexed: 11/28/2022]
Abstract
This study examined the use of compensatory strategies reported by adults with ADHD symptoms and their relation to measures of functioning. Forty-nine adults (55.1 % female) completed a structured diagnostic interview to assess ADHD, and responses were coded for compensatory strategies: Adaptation, Paying Attention, Organization, External Support, and Avoidance. The majority of adults with ADHD symptoms reported using compensatory strategies, and their reported strategy use in childhood was related to their use in adulthood. No gender differences were found in the use of strategies, although Organization and External Support were used more often for inattention than for hyperactive/impulsive symptoms. Use of the compensatory strategy, Adaptation, was significantly related to measures of functioning, and the use of strategies reduced the negative relationship between ADHD symptoms and parenting difficulties. Results encourage the development of compensatory strategies among adults with ADHD symptoms, as well as provide recommendations for treatment programs.
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Affiliation(s)
- Kate Kysow
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Joanne Park
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Charlotte Johnston
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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Huemer J, Riegler A, Völkl-Kernstock S, Wascher A, Lesch OM, Walter H, Skala K. The influence of reported ADHD and substance abuse on suicidal ideation in a non-clinical sample of young men. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2016; 30:131-137. [PMID: 27714599 PMCID: PMC5063908 DOI: 10.1007/s40211-016-0198-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 09/12/2016] [Indexed: 01/09/2023]
Abstract
This study intended to determine whether former and current ADHD symptomatology is associated with suicidal ideation in a non-clinical sample of 18 year old males. We performed a cross sectional descriptive study of 3280 men during the examination for military service. The investigation included a screening for substance abuse, past (WURS) and current (ADHD symptom checklist) ADHD symptomatology and an interview about suicidal ideations. We found a correlation of suicidal ideations with a history of ADHD symptomatology. ADHD symptoms were strongly consistent over time. These results indicate that a history of (diagnosed or undiagnosed) ADHD could be a predictor for suicidal ideations. Surveying a history of ADHD in primary care might help identify subjects at risk for suicidal tendencies.
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Affiliation(s)
- Julia Huemer
- Dept. of Child and Adolescent Psychiatry, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Anita Riegler
- Dept. of Psychiatry, University of Vienna, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Dept. of Child and Adolescent Psychiatry, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | | | - Otto M Lesch
- Dept. of Psychiatry, University of Vienna, Vienna, Austria
| | | | - Katrin Skala
- Dept. of Child and Adolescent Psychiatry, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Abstract
BACKGROUND The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. METHOD A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. RESULTS ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70-80 years than the group 50-60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. CONCLUSION It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk-benefit ratio when pharmacotherapy is considered to be a possible treatment.
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Affiliation(s)
- Terje Torgersen
- Department of Østmarka, St Olav’s Hospital, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjorn Gjervan
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, Helse Nord-Trondelag Hospital Trust, Kirkegata, Levanger, Norway
| | - Michael B Lensing
- NevSom, Norwegian Center of Expertise for Neurodevelopmental Disorders and Hypersomnias, Women and Children’s Division, Oslo University Hospital, Oslo, Norway
| | - Kirsten Rasmussen
- St Olav’s Hospital, Broset Center for Research and Education in Forensic Psychiatry, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Stickley A, Koyanagi A, Ruchkin V, Kamio Y. Attention-deficit/hyperactivity disorder symptoms and suicide ideation and attempts: Findings from the Adult Psychiatric Morbidity Survey 2007. J Affect Disord 2016; 189:321-8. [PMID: 26469299 DOI: 10.1016/j.jad.2015.09.061] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 09/27/2015] [Accepted: 09/28/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Adults with attention-deficit/hyperactivity disorder (ADHD) may have an increased risk of engaging in suicidal behavior. This study examined this association in the general adult population where there has been little research. METHODS Data came from the Adult Psychiatric Morbidity Survey 2007. This was a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) was used to obtain information on ADHD symptoms. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of common mental disorder (CMD). Information was also obtained on the lifetime and past 12-month occurrence of suicide ideation and attempts. Logistic regression analysis was used to examine these associations. RESULTS After adjusting for comorbid disorders, adults with more ADHD symptoms had significantly higher odds for suicidal behavior. When a single cut-off point was used to classify ADHD (ASRS score ≥14), odds ratios ranged from 1.62 (lifetime suicide attempt) to 2.43 (past 12-month suicide ideation). When ADHD symptoms were categorized by strata (I: a score of 0-9; II: 10-13; III: 14-17; IV: 18-24), compared to adults in stratum I, those in stratum IV had odds ratios ranging from 2.16 (lifetime suicide ideation) to 3.68 (past 12-month suicide attempt). LIMITATIONS ADHD and suicide data came from self-reports which may have been affected by socially desirable responding. CONCLUSIONS ADHD symptoms were linked to suicidal behavior after controlling for comorbid conditions. Health care professionals should be alerted to the increased suicide risk among adults with ADHD symptoms.
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Affiliation(s)
- Andrew Stickley
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center for 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 Pujades, 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, 28029 Madrid, Spain
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala S-751 85, Sweden; Child Study Center, Yale University Medical School, New Haven, CT 06520, USA; Säter Forensic Psychiatric Clinic, Säter S-783 27, Sweden
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center for Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
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Camodeca L, Micoulaud-Franchi JA, Gabelle A, Dauvilliers Y, Lopez R. Que deviennent nos vieux hyperactifs ? Le trouble déficit de l’attention/hyperactivité chez la personne âgée. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.npg.2015.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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García Murillo L, Cortese S, Anderson D, Di Martino A, Castellanos FX. Locomotor activity measures in the diagnosis of attention deficit hyperactivity disorder: Meta-analyses and new findings. J Neurosci Methods 2015; 252:14-26. [PMID: 25770940 PMCID: PMC4522351 DOI: 10.1016/j.jneumeth.2015.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 02/19/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Our aim was to assess differences in movement measures in attention-deficit/hyperactivity disorder (ADHD) vs. typically developing (TD) controls. METHODS We performed meta-analyses of published studies on motion measures contrasting ADHD with controls. We also conducted a case-control study with children/adolescents (n = 61 TD, n = 62 ADHD) and adults (n = 30 TD, n = 19 ADHD) using the McLean motion activity test, semi-structured diagnostic interviews and the behavior rating inventory of executive function and Conners (parent, teacher; self) rating scales. RESULTS Meta-analyses revealed medium-to-large effect sizes for actigraph (standardized mean difference [SMD]: 0.64, 95% confidence interval (CI): 0.43, 0.85) and motion tracking systems (SDM: 0.92, 95% CI: 0.65, 1.20) measures in differentiating individuals with ADHD from controls. Effects sizes were similar in studies of children/adolescents ([SMD]: 0.75, 95% CI: 0.50, 1.01) and of adults ([SMD]: 0.73, 95% CI: 0.46, 1.00). In our sample, ADHD groups differed significantly in number of head movements (p = 0.02 in children; p = 0.002 in adults), displacement (p = 0.009/p < 0.001), head area (p = 0.03/p < 0.001), spatial complexity (p = 0.06/p = 0.02) and temporal scaling (p = 0.05/p = 0.04). Mean effect sizes were non-significantly larger (d = 0.83, 95% CI: 0.20, 1.45) in adults vs. children/adolescents with ADHD (d = 0.45, 95% CI: 0.08, 0.82). In the concurrent go/no-go task, reaction time variability was significantly greater in ADHD (p < 0.05 in both age groups) than controls. CONCLUSIONS Locomotor hyperactivity remains core to the construct of ADHD even in adults. Our results suggest that objective locomotion measures may be particularly useful in evaluating adults with possible ADHD.
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Affiliation(s)
| | - Samuele Cortese
- The Child Study Center at NYU Langone Medical Center, New York, USA; Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK; School of Medicine, University of Nottingham, UK; Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK
| | - David Anderson
- The Child Study Center at NYU Langone Medical Center, New York, USA; Child Mind Institute, New York, NY, USA
| | | | - Francisco Xavier Castellanos
- The Child Study Center at NYU Langone Medical Center, New York, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
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Jenkins R, Othieno C, Ongeri L, Ogutu B, Sifuna P, Mboroki J, Omollo R. Attention deficit hyperactivity disorder symptom self-report in adults in Kenya and its associated risk factors, an analysis from a household survey in a demographic surveillance site. Glob Ment Health (Camb) 2015; 2:e14. [PMID: 28596862 PMCID: PMC5269634 DOI: 10.1017/gmh.2015.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 05/18/2015] [Accepted: 06/06/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There have been no household surveys of adult attention deficit and hyperactivity disorder (ADHD) in Kenya, and only one in sub-Saharan Africa. METHODS Data on ADHD was used from a household survey of mental disorders and their associated risk factors conducted in Maseno area (population 70 805), near Lake Victoria in Kenya, using a demographic surveillance site as the sample frame, as part of a wider survey of mental health, malaria and immunity A total of 1190 households were selected, and 1158 adult participants consented to the study while 32 refused to participate in the study interviews, giving a response rate of 97.3%. ADHD symptoms were assessed with the WHO Adult ADHD Self-Report Scale (ASRS) Screener. RESULTS This survey found that the overall prevalence of ADHD using the ASRS was 13.1%. This suggests a high level of ADHD in the Kenyan population which needs to be further investigated for its impact on adult mental health. In the adjusted analysis, increased odds ratios (ORs) were found in those with higher assets (OR 1.7, p = 0.023), those with life events (OR 2.4, p = 0.001 for those with 2-3 life events and OR 2.6, p < 0.001 for those with 4 or more life events), and those with common mental disorders (OR 2.3, p = 0.001). CONCLUSION The study demonstrates the magnitude of ADHD symptoms as a public health issue, relevant for health worker training, and the importance of further research into its prevalence in adults and associated risk factors.
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Affiliation(s)
- R. Jenkins
- Health Services and Population Research Department, Institute of Psychiatry, Kings College London, UK
| | - C. Othieno
- Departmenet Psychiatry, University of Nairobi, Nairobi, Kenya
| | - L. Ongeri
- Kenya Medical Research Institute, Centre for Clinical Research, Nairobi, Kenya
| | - B. Ogutu
- Kenya Medical Research Institute, Centre for Clinical Research, Nairobi, Kenya
| | - P. Sifuna
- Kombewa Health and Demographic Surveillance Site, Kisumu, Kenya
| | - J. Mboroki
- Kenya Medical Training Centre, Mental Health, Nairobi, Kenya
| | - R. Omollo
- Kenya Medical Research Institute, Centre for Clinical Research, Nairobi, Kenya
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