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Güleç A, Güler HA, Türkoğlu S. Relationship between Traumatic Experiences, Circadian Preference and ADHD Symptoms in Adolescents with ADHD Residing in Institutional Care: A Controlled Study. Chronobiol Int 2024; 41:495-503. [PMID: 38375810 DOI: 10.1080/07420528.2024.2319218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Circadian preference, describes biological and behavioural characteristics that influence the ability to plan daily activities according to optimal waking times. It is divided into three main categories: morning, evening and intermediate. In particular, the evening chronotype is associated with conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Post Traumatic Stress Disorder (PTSD). This study was conducted in three groups aged 14-18 years: The first group consisted of 34 adolescents diagnosed with ADHD who had been in institutional care for at least two years and had not used medication in the last six months. The second group included 29 adolescents with ADHD living with their families who had not used medication in the last six months. The third control group consisted of 32 healthy adolescents. The study utilized sociodemographic data forms, the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) to measure ADHD symptoms, the Childhood Chronotype Questionnaire (CCQ), and the Childhood Trauma Questionnaire (CTQ). In institutionalized adolescents with diagnosed ADHD, ADHD and disruptive behavior symptoms were more severe. Increased trauma scores were associated with higher ADHD and disruptive behaviour symptom severity and evening chronotype. In the conducted mediation analysis, evening chronotype was identified as a full mediator in the relationship between trauma symptoms and ADHD symptoms, while it was determined as a partial mediator in the relationship between trauma symptoms and PTSD symptoms. In conclusion, traumatic experiences in institutionalized adolescents with diagnosed ADHD may exacerbate ADHD and disruptive behavior symptoms. Evening chronotype is associated with ADHD and disruptive behavior symptoms, and therefore, the chronotypes of these adolescents should be assessed. Chronotherapeutic interventions may assist in reducing inattention, hyperactivity, and behavioral problems.
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Affiliation(s)
- Ahmet Güleç
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selçuk University, Konya, Türkiye
| | - Hasan Ali Güler
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selçuk University, Konya, Türkiye
| | - Serhat Türkoğlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selçuk University, Konya, Türkiye
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Song Y, Zhao Y, Baranova A, Cao H, Yue W, Zhang F. Causal association of attention-deficit/hyperactivity disorder and autism spectrum disorder with post-traumatic stress disorder. Psychiatr Genet 2024; 34:37-42. [PMID: 38288984 PMCID: PMC10919267 DOI: 10.1097/ypg.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/16/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are two neurodevelopmental disorders that often result in individuals experiencing traumatic events. However, little is known about the connection between ADHD/ASD and post-traumatic stress disorder (PTSD). This study aimed to investigate the genetic associations between these disorders. METHODS Genetic correlation analysis was used to examine the genetic components shared between ADHD (38 691 cases and 275 986 controls), ASD (18 381 cases and 27 969 controls) and PTSD (23 212 cases and 151 447 controls). Two-sample Mendelian randomization analyses were employed to explore the bidirectional causal relationships between ADHD/ASD and PTSD. RESULTS The results of the genetic correlation analysis revealed significant positive correlations of PTSD with ADHD(r g = 0.70) and ASD (r g = 0.34). Furthermore, the Mendelian randomization analysis revealed that genetic liabilities to ADHD [odds ratio (OR) = 1.14; 95% confidence interval (CI), 1.06-1.24; P = 7.88 × 10 -4 ] and ASD (OR = 1.04; CI, 1.01-1.08; P = 0.014) were associated with an increased risk of developing PTSD later in life. However, no evidence supported that genetic liability to PTSD could elevate the risk of ADHD or ASD. CONCLUSION The findings of this study supported that ADHD and ASD may increase the risk of PTSD, but not vice versa.
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Affiliation(s)
- Yuqing Song
- Peking University Sixth Hospital/Institute of Mental Health, Beijing
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing
| | - Yi Zhao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ancha Baranova
- School of Systems Biology, George Mason University, Manassas, USA
- Research Centre for Medical Genetics, Moscow, Russia
| | - Hongbao Cao
- School of Systems Biology, George Mason University, Manassas, USA
| | - Weihua Yue
- Peking University Sixth Hospital/Institute of Mental Health, Beijing
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing
- Chinese Institute for Brain Research, Beijing
| | - Fuquan Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Li ST, Chien WC, Chung CH, Tzeng NS. Increased risk of acute stress disorder and post-traumatic stress disorder in children and adolescents with autism spectrum disorder: a nation-wide cohort study in Taiwan. Front Psychiatry 2024; 15:1329836. [PMID: 38356908 PMCID: PMC10864464 DOI: 10.3389/fpsyt.2024.1329836] [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: 10/30/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Children and adolescents with autism spectrum disorder (ASD) may be particularly vulnerable to the impact of traumatic events, yet the association between ASD and the risk of developing acute stress disorder and post-traumatic stress disorder (PTSD) remains uncertain. This study aims to investigate this association, addressing the gap in large-scale evidence on the subject. Methods Conducted as a retrospective and matched cohort study, data was sourced from the National Health Insurance Research Database (NHIRD) in Taiwan, spanning from January 1, 2000, to December 31, 2015. The study included patients aged 18 years or under newly diagnosed with ASD (n=15,200) and compared them with a matched control group (n=45,600). The Cox proportional regression model was employed to assess the risk of acute stress disorder and PTSD. Results Over the 15-year follow-up period, a total of 132 participants developed either acute stress disorder or PTSD. Among them, 105 cases (0.691% or 64.90 per 100,000 person-years) were in the ASD group, while 27 cases (0.059% or 5.38 per 100,000 person-years) were in the control group. The adjusted hazard ratio for the ASD group was significantly higher compared to the control group (25.661 with 95% CI = 15.913-41.232; P < .001). Discussion This study provides compelling evidence that individuals with ASD face an elevated risk of developing acute stress disorder and PTSD. The findings underscore the importance of clinicians recognizing and addressing this vulnerability in ASD individuals exposed to traumatic events. This emphasizes the need for heightened attention to the risk of PTSD and acute stress disorder in the ASD population.
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Affiliation(s)
- Sung-Tao Li
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Psychiatry, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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Yu Y, Hou L, Wu Y, Yu Y, Liu X, Wu S, He Y, Ge Y, Wei Y, Qian F, Luo Q, Feng Y, Cheng X, Yu T, Li H, Xue F. Causal associations between female reproductive behaviors and psychiatric disorders: a lifecourse Mendelian randomization study. BMC Psychiatry 2023; 23:799. [PMID: 37915018 PMCID: PMC10621101 DOI: 10.1186/s12888-023-05203-y] [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: 05/11/2023] [Accepted: 09/18/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The timings of reproductive life events have been examined to be associated with various psychiatric disorders. However, studies have not considered the causal pathways from reproductive behaviors to different psychiatric disorders. This study aimed to investigate the nature of the relationships between five reproductive behaviors and twelve psychiatric disorders. METHODS Firstly, we calculated genetic correlations between reproductive factors and psychiatric disorders. Then two-sample Mendelian randomization (MR) was conducted to estimate the causal associations among five reproductive behaviors, and these reproductive behaviors on twelve psychiatric disorders, using genome-wide association study (GWAS) summary data from genetic consortia. Multivariable MR was then applied to evaluate the direct effect of reproductive behaviors on these psychiatric disorders whilst accounting for other reproductive factors at different life periods. RESULTS Univariable MR analyses provide evidence that age at menarche, age at first sexual intercourse and age at first birth have effects on one (depression), seven (anxiety disorder, ADHD, bipolar disorder, bipolar disorder II, depression, PTSD and schizophrenia) and three psychiatric disorders (ADHD, depression and PTSD) (based on p<7.14×10-4), respectively. However, after performing multivariable MR, only age at first sexual intercourse has direct effects on five psychiatric disorders (Depression, Attention deficit or hyperactivity disorder, Bipolar disorder, Posttraumatic stress disorder and schizophrenia) when accounting for other reproductive behaviors with significant effects in univariable analyses. CONCLUSION Our findings suggest that reproductive behaviors predominantly exert their detrimental effects on psychiatric disorders and age at first sexual intercourse has direct effects on psychiatric disorders.
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Affiliation(s)
- Yifan Yu
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Lei Hou
- Beijing International Center for Mathematical Research, Peking University, Beijing, People's Republic of China
| | - Yutong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yuanyuan Yu
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Xinhui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Sijia Wu
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yina He
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yilei Ge
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yun Wei
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Fengtong Qian
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Qingxin Luo
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yue Feng
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Xiaojing Cheng
- Shandong Mental Health Center, Shandong Province, Jinan, China
| | - Tiangui Yu
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
| | - Hongkai Li
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China.
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
| | - Fuzhong Xue
- Department of Epidemiology and Health Statistics, School of Public Health, , Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province, China.
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
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Gelner H, Karska J, Gawęda Ł, Samochowiec J, Misiak B. Effects of the interaction between PTSD and ADHD symptoms on the level of reporting psychotic-like experiences: findings from a non-clinical population. Front Psychiatry 2023; 14:1232606. [PMID: 37867761 PMCID: PMC10587572 DOI: 10.3389/fpsyt.2023.1232606] [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: 05/31/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Psychotic-like experiences (PLEs) are increasingly being recognized as subclinical phenomena that might predict the development of various mental disorders that are not limited to the psychosis spectrum. Accumulating evidence suggests that attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are highly comorbid mental disorders. However, their interactive effect on the occurrence of PLEs has not been investigated so far. Therefore, in the present study we aimed to investigate the effect of interaction between ADHD and PTSD symptoms on the level of psychotic-like experiences (PLEs) in the non-clinical sample. Methods The study included 3,000 individuals aged 18-35 years with a negative history of psychiatric treatment. The symptoms of ADHD and PTSD were assessed using self-reports. Results There was a significant association of the interaction between ADHD and PTSD with the level of reporting PLEs. This association remained significant after adjustment for age, gender, the level of education, the current vocational situation, lifetime history of problematic substance use, and depressive symptoms. Post-hoc tests demonstrated significantly higher levels of reporting PLEs in participants with positive screening for both ADHD and PTSD compared to other subgroups of participants. Also, individuals with positive screening for one vulnerability (either ADHD or PTSD) reported significantly higher levels of reporting PLEs compared to those with a negative screening for ADHD and PTSD. In turn, no significant differences between individuals reporting one vulnerability, i.e., between those with positive screening for ADHD and those with positive screening for PTSD, were observed. Conclusion Findings from the present study imply that both PTSD and ADHD symptoms the interaction effect on the level of reporting PLEs that might be of importance for early intervention strategies. However, observed associations require replication in clinical samples.
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Affiliation(s)
- Hanna Gelner
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Julia Karska
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Kasahara S, Takahashi M, Morita T, Matsudaira K, Sato N, Momose T, Niwa SI, Uchida K. Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder. Front Psychiatry 2023; 14:1221694. [PMID: 37608999 PMCID: PMC10441107 DOI: 10.3389/fpsyt.2023.1221694] [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: 05/12/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background It is known that patients reporting chronic pain often experience trauma or post-traumatic stress disorder (PTSD) and tend to be more difficult to treat. Attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder, is frequently associated with chronic pain. Furthermore, patients diagnosed with ADHD are more likely to encounter trauma and develop PTSD because of their inattentive and impulsive tendencies. There are reports stating that atomoxetine (ATX), a selective noradrenaline reuptake inhibitor for ADHD, is effective in patients diagnosed with PTSD and ADHD. However, there have been no reports on cases of comorbid PTSD and ADHD with chronic pain, and ATX's potential in improving chronic pain coexisting PTSD. Furthermore, no reports have evaluated patient cerebral blood flow in conjunction with the course of treatment with ATX for chronic pain. Case report In this study, we reported a case where ATX improved chronic pain with PTSD and improved cerebral blood flow. The patient was a 56-year-old woman exhibiting chronic pain with PTSD, resulting from 6 years of severe domestic violence from her common-law husband. She had no history of ADHD diagnosis, but through aggressive screening, comorbid ADHD was diagnosed. When treated with ATX, there were significant improvements in her pain, quality of life, anxiety, depression, catastrophic thoughts, and cerebral blood flow. As a result, she could resume work after 11 years. Conclusion The study showed that chronic pain with PTSD may be comorbid with ADHD. Moreover, we found that ATX can improve chronic pain with PTSD and cerebral blood flow. Aggressive screening of ADHD is important because once the diagnosis of comorbidity is confirmed, an ideal ADHD treatment can be selected. Therefore, based on the results of this study, ATX may be a candidate for treatment for cases of chronic pain with PTSD and ADHD.
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Affiliation(s)
- Satoshi Kasahara
- Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Miwako Takahashi
- Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Taito Morita
- Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Ko Matsudaira
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naoko Sato
- Nursing Department, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshimitsu Momose
- Institute of Engineering Innovation, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Shin-Ichi Niwa
- Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Kanji Uchida
- Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan
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Meisinger C, Freuer D. Understanding the causal relationships of attention-deficit/hyperactivity disorder with mental disorders and suicide attempt: a network Mendelian randomisation study. BMJ MENTAL HEALTH 2023; 26:e300642. [PMID: 37669871 DOI: 10.1136/bmjment-2022-300642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/09/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a lifespan neurodevelopmental condition resulting from complex interactions between genetic and environmental risk factors. There is evidence that ADHD is associated with other mental disorders, but it remains unclear whether and in what way a causal relationship exists. OBJECTIVE To investigate the direct and indirect causal paths between ADHD and seven common mental disorders. METHODS Two-sample network Mendelian randomisation analysis was performed to identify psychiatric disorders causally related to ADHD. Total and direct effects were estimated in an univariable and multivariable setting, respectively. Robustness of results was ensured in three ways: a range of pleiotropy-robust methods, an iterative approach identifying and excluding outliers, and use of up to two genome-wide association studies per outcome to replicate results and calculate subsequently pooled meta-estimates. RESULTS Genetic liability to ADHD was independently associated with the risk of anorexia nervosa (OR 1.28 (95% CI 1.11 to 1.47); p=0.001). A bidirectional association was found with major depressive disorder (OR 1.09 (95% CI 1.03 to 1.15); p=0.003 in the forward direction and OR 1.76 (95% CI 1.50 to 2.06); p=4×10-12 in the reverse direction). Moreover, after adjustment for major depression disorder, a direct association with both suicide attempt (OR 1.30 (95% CI 1.16 to 1.547); p=2×10-5) and post-traumatic stress disorder (OR 1.18 (95% CI 1.05 to 1.33); p=0.007) was observed. There was no evidence of a relationship with anxiety, bipolar disorder or schizophrenia. CONCLUSIONS This study suggests that ADHD is an independent risk factor for a number of common psychiatric disorders. CLINICAL IMPLICATIONS The risk of comorbid psychiatric disorders in individuals with ADHD needs to be considered both in diagnosis and treatment.
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Affiliation(s)
- Christa Meisinger
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Dennis Freuer
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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Paulino A, Kuja-Halkola R, Fazel S, Sariaslan A, Rietz ED, Lichtenstein P, Brikell I. Post-traumatic stress disorder and the risk of violent crime conviction in Sweden: a nationwide, register-based cohort study. Lancet Public Health 2023; 8:e432-e441. [PMID: 37244673 DOI: 10.1016/s2468-2667(23)00075-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) has been linked to violent crime in veteran populations. However, whether there is a link between PTSD and violent crime in the general population is not known. This study aimed to investigate the hypothesised association between PTSD and violent crime in the Swedish general population and to investigate the extent to which familial factors might explain this association using unaffected sibling control individuals. METHODS This nationwide, register-based cohort study assessed individuals born in Sweden in 1958-93 for eligibility for inclusion. Individuals who died or emigrated before their 15th birthday, were adopted, were twins, or whose biological parents could not be identified were excluded. Participants were identified and included from the National Patient Register (1973-2013), the Multi-Generation Register (1932-2013), the Total Population Register (1947-2013), and the National Crime Register (1973-2013). Participants with PTSD were matched (1:10) with randomly selected control individuals from the population without PTSD by birth year, sex, and county of residence in the year of PTSD diagnosis for the matched individual. Each participant was followed up from the date of matching (ie, the index person's first PTSD diagnosis) until violent crime conviction or until being censored at emigration, death, or Dec 31, 2013, whichever occurred first. Stratified Cox regressions were used to estimate the hazard ratio of time to violent crime conviction ascertained from national registers in individuals with PTSD compared with control individuals. To account for familial confounding, sibling analyses were conducted, comparing the risk of violent crime in a subsample of individuals with PTSD with their unaffected full biological siblings. FINDINGS Of 3 890 765 eligible individuals, 13 119 had a PTSD diagnosis (9856 [75·1%] of whom were female and 3263 [24·9%] of whom were male), were matched with 131 190 individuals who did not, and were included in the matched cohort. 9114 individuals with PTSD and 14 613 full biological siblings without PTSD were also included in the sibling cohort. In the sibling cohort, 6956 (76·3%) of 9114 participants were female and 2158 (23·7%) were male. Cumulative incidence of violent crime convictions after 5 years was 5·0% (95% CI 4·6-5·5) in individuals diagnosed with PTSD versus 0·7% (0·6-0·7) in individuals without PTSD. At the end of follow-up (median follow-up time 4·2 years, IQR 2·0-7·6), cumulative incidence was 13·5% (11·3-16·6) versus 2·3% (1·9-2·6). Individuals with PTSD had a significantly higher risk of violent crime than the matched control population in the fully-adjusted model (hazard ratio [HR] 6·4, 95% CI 5·7-7·2). In the sibling cohort, the risk of violent crime was also significantly higher in the siblings with PTSD (3·2, 2·6-4·0). INTERPRETATION PTSD was associated with increased risk of violent crime conviction, even after controlling for familial effects shared by siblings and in the absence of SUD or a history of violent crime. Although our results might not be generalisable to less severe or undetected PTSD, our study could inform interventions that aim to reduce violent crime in this vulnerable population. FUNDING None.
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Affiliation(s)
- Anabelle Paulino
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Amir Sariaslan
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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9
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Langevin R, Marshall C, Wallace A, Gagné ME, Kingsland E, Temcheff C. Disentangling the Associations Between Attention Deficit Hyperactivity Disorder and Child Sexual Abuse: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:369-389. [PMID: 34238078 PMCID: PMC10009485 DOI: 10.1177/15248380211030234] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND An association between child sexual abuse (CSA) and attention deficit hyperactivity disorder (ADHD) has been documented. However, the temporal relationship between these problems and the roles of trauma-related symptoms or other forms of maltreatment remain unclear. This review aims to synthesize available research on CSA and ADHD, assess the methodological quality of the available research, and recommend future areas of inquiry. METHODS Studies were searched in five databases including Medline and PsycINFO. Following a title and abstract screening, 151 full texts were reviewed and 28 were included. Inclusion criteria were sexual abuse occurred before 18 years old, published quantitative studies documenting at least a bivariate association between CSA and ADHD, and published in the past 5 years for dissertations/theses, in French or English. The methodological quality of studies was systematically assessed. RESULTS Most studies identified a significant association between CSA and ADHD; most studies conceptualized CSA as a precursor of ADHD, but only one study had a longitudinal design. The quality of the studies varied greatly with main limitations being the lack of (i) longitudinal designs, (ii) rigorous multimethod/ multiinformant assessments of CSA and ADHD, and (iii) control for two major confounders: trauma-related symptoms and other forms of child maltreatment. DISCUSSION Given the lack of longitudinal studies, the directionality of the association remains unclear. The confounding role of other maltreatment forms and trauma-related symptoms also remains mostly unaddressed. Rigorous studies are needed to untangle the association between CSA and ADHD.
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Affiliation(s)
- Rachel Langevin
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
- Rachel Langevin, McGill University, 3700
McTavish Street, Education Building, Room 614, Montreal, Quebec, Canada H3A 1Y2.
| | - Carley Marshall
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
| | - Aimée Wallace
- Département de sexologie, Université du Québec à Montréal, Quebec,
Canada
| | - Marie-Emma Gagné
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
| | | | - Caroline Temcheff
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
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10
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Karibwende F, Niyonsenga J, Biracyaza E, Nyirinkwaya S, Hitayezu I, Sebatukura GS, Ntete JM, Mutabaruka J. Efficacy of narrative therapy for orphan and abandoned children with anxiety and attention deficit and hyperactivity disorders in Rwanda: A randomized controlled trial. J Behav Ther Exp Psychiatry 2023; 78:101802. [PMID: 36435544 DOI: 10.1016/j.jbtep.2022.101802] [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: 09/06/2021] [Revised: 07/30/2022] [Accepted: 10/29/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Although narrative therapy (NT) is globally practiced for alleviating psychological disorders, studies of its efficacy for vulnerable children are still scarce, especially in African post-conflict settings. Thus, this study was aimed at assessing the efficacy of NT for Rwandan Orphans and abandoned children (OAC) with ADHD and anxiety disorders. METHOD This study was a parallel randomized controlled trial in which participants (n = 72) were recruited from SOS Children's Villages. A half of participants (n = 36) were randomly allocated to either the NT group or the waitlist control group (WCG). Outcomes were collected at baseline before randomization and 10 weeks post-randomization. RESULTS ANOVA results indicated a significant main effect of time for anxiety disorders (p < .001, ηp2= 0.176), and the main effects of group were significant for anxiety disorders (p < .001, ηp2= 0.254) and ADHD disorders (p < .001, ηp2= 0.260). There was a significant time by group interaction effect for anxiety disorders (p < .001, ηp2= 0.328) and for ADHD (p < .001, ηp2= 0.193). Between group analyses showed that the difference in symptoms was significant for anxiety disorders (p < .001, Cohen's d = 1.28) and for ADHD (p < .001, Cohen's d = 1.6) during the posttest, and the effect sizes were large. LIMITATION The long-term effects of the intervention for the current sample were not assessed in this study. CONCLUSION Despite its limitations, this study provides initial support for the safety, efficacy, and usefulness of NT among Rwandan OAC with ADHD and anxiety disorders. Health professionals must implement the new intervention as an everyday tool.
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Affiliation(s)
- Françoise Karibwende
- Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Japhet Niyonsenga
- Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; Mental Health & Behaviour Research Group, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | | | - Serge Nyirinkwaya
- Acting National Director and Psychosocial Support, SOS Children's Village, Kigali, Rwanda
| | | | - Gitimbwa Simeon Sebatukura
- Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jeanne Marie Ntete
- Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Mutabaruka
- Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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11
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Punski-Hoogervorst JL, Engel-Yeger B, Avital A. Attention deficits as a key player in the symptomatology of posttraumatic stress disorder: A review. J Neurosci Res 2023; 101:1068-1085. [PMID: 36807926 DOI: 10.1002/jnr.25177] [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: 09/06/2022] [Revised: 01/05/2023] [Accepted: 01/28/2023] [Indexed: 02/22/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder characterized by symptoms such as re-experiencing of the psychotrauma and hyperarousal. Although current literature mainly discusses the emotionally related aspects of these symptoms, studies also highlight the relation between re-experiencing, hyperarousability, and attention deficits, which are associated with poorer daily function and reduced quality of life. This review provides a comprehensive analysis of the existing research on attention deficits among adults with PTSD. A systematic search through five databases resulted in the inclusion of 48 peer-reviewed, English-language articles, describing 49 distinct studies. Using a total of 47 different attentional assessment tools, the majority of studies investigated sustained (n = 40), divided (n = 16), or selective (n = 14) attention. A total of 30 studies (61.2%) found significant correlations between PTSD symptoms and attention deficits, and 10 studies (20.4%) found that higher levels of attention deficits were predictive of worse PTSD symptoms. Moreover, neuroimaging results of six (f)MRI and three EEG studies identified various potential neurobiological pathways involved, including (pre)frontal attention networks. Together, the body of research shows that attention deficits in individuals with PTSD are common and occur in surroundings with emotionally neutral stimuli. Nonetheless, current treatment strategies do not target these attentional difficulties. We propose a novel perspective to PTSD diagnosis and treatment strategies based on attention deficits and their relation with top-down regulation of re-experiencing and subsequent other PTSD symptoms.
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Affiliation(s)
- Janne L Punski-Hoogervorst
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Avi Avital
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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12
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Analysis of the Relationship of Attention-Deficit/Hyperactivity Disorder With Posttraumatic Stress Disorder Clarifies Relationship Directionality. Biol Psychiatry 2023; 93:e11-e12. [PMID: 36653108 DOI: 10.1016/j.biopsych.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 01/18/2023]
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13
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Wendt FR, Garcia-Argibay M, Cabrera-Mendoza B, Valdimarsdóttir UA, Gelernter J, Stein MB, Nivard MG, Maihofer AX, Nievergelt CM, Larsson H, Mattheisen M, Polimanti R, Meier SM. The Relationship of Attention-Deficit/Hyperactivity Disorder With Posttraumatic Stress Disorder: A Two-Sample Mendelian Randomization and Population-Based Sibling Comparison Study. Biol Psychiatry 2023; 93:362-369. [PMID: 36335070 PMCID: PMC10496427 DOI: 10.1016/j.biopsych.2022.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are associated, but it is unclear if this is a causal relationship or confounding. We used genetic analyses and sibling comparisons to clarify the direction of this relationship. METHODS Linkage disequilibrium score regression and 2-sample Mendelian randomization were used to test for genetic correlation (rg) and bidirectional causal effects using European ancestry genome-wide association studies of ADHD (20,183 cases and 35,191 controls) and 6 PTSD definitions (up to 320,369 individuals). Several additional variables were included in the analysis to verify the independence of the ADHD-PTSD relationship. In a population-based sibling comparison (N = 2,082,118 individuals), Cox regression models were fitted to account for time at risk, a range of sociodemographic factors, and unmeasured familial confounders (via sibling comparisons). RESULTS ADHD and PTSD had consistent rg (rg range, 0.43-0.52; p < .001). ADHD genetic liability was causally linked with increased risk for PTSD (β = 0.367; 95% CI, 0.186-0.552; p = 7.68 × 10-5). This result was not affected by heterogeneity, horizontal pleiotropy (Mendelian randomization Egger intercept = 4.34 × 10-4, p = .961), or other phenotypes and was consistent across PTSD datasets. However, we found no consistent associations between PTSD genetic liability and ADHD risk. Individuals diagnosed with ADHD were at a higher risk for developing PTSD than their undiagnosed sibling (hazard ratio = 2.37; 95% CI, 1.98-3.53). CONCLUSIONS Our findings add novel evidence supporting the need for early and effective treatment of ADHD, as patients with this diagnosis are at significantly higher risk to develop PTSD later in life.
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Affiliation(s)
- Frank R Wendt
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut; Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | | | - Brenda Cabrera-Mendoza
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Unnur A Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Murray B Stein
- Department of Psychiatry, UC San Diego School of Medicine, University of California, San Diego, La Jolla, California; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Michel G Nivard
- Department of Biological Psychology, Faculty of Behaviour and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Adam X Maihofer
- Department of Psychiatry, UC San Diego School of Medicine, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California; Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Caroline M Nievergelt
- Department of Psychiatry, UC San Diego School of Medicine, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California; Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Mattheisen
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany; Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Renato Polimanti
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
| | - Sandra M Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada.
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14
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Weiss F, Tidona S, Carli M, Perugi G, Scarselli M. Triple Diagnosis of Attention-Deficit/Hyperactivity Disorder with Coexisting Bipolar and Alcohol Use Disorders: Clinical Aspects and Pharmacological Treatments. Curr Neuropharmacol 2023; 21:1467-1476. [PMID: 36306451 PMCID: PMC10472804 DOI: 10.2174/1570159x20666220830154002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/13/2022] [Accepted: 08/03/2022] [Indexed: 11/22/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD), Bipolar Disorder (BD) and Alcohol Use Disorder (AUD) are common medical conditions often coexisting and exerting mutual influence on disease course and pharmacological treatment response. Each disorder, when considered separately, relies on different therapeutic approaches, making it crucial to detect the plausible association between them. Treating solely the emerging condition (e.g., alcoholism) and disregarding the patient's whole psychopathological ground often leads to treatment failure and relapse. Clinical experience and scientific evidence rather show that tailoring treatments for these three conditions considering their co-occurrence as a sole complex disorder yields more fulfilling and durable clinical outcomes. In light of the above considerations, the purpose of the present review is to critically discuss the pharmacological strategies in the personalized treatment of complex conditions defined by ADHD-bipolarityalcoholism coexistence.
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Affiliation(s)
- Francesco Weiss
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Simone Tidona
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Marco Carli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa 56126, Italy
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Marco Scarselli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa 56126, Italy
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15
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Brewerton TD. Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span. J Eat Disord 2022; 10:162. [PMID: 36372878 PMCID: PMC9661783 DOI: 10.1186/s40337-022-00696-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Multiple published sources from around the world have confirmed an association between an array of adverse childhood experiences (ACEs) and other traumatic events with eating disorders (EDs) and related adverse outcomes, including higher morbidity and mortality. METHODS In keeping with this Special Issue's goals, this narrative review focuses on the ACEs pyramid and its purported mechanisms through which child maltreatment and other forms of violence toward human beings influence the health and well-being of individuals who develop EDs throughout the life span. Relevant literature on posttraumatic stress disorder (PTSD) is highlighted when applicable. RESULTS At every level of the pyramid, it is shown that EDs interact with each of these proclaimed escalating mechanisms in a bidirectional manner that contributes to the predisposition, precipitation and perpetuation of EDs and related medical and psychiatric comorbidities, which then predispose to early death. The levels and their interactions that are discussed include the contribution of generational embodiment (genetics) and historical trauma (epigenetics), social conditions and local context, the ACEs and other traumas themselves, the resultant disrupted neurodevelopment, subsequent social, emotional and cognitive impairment, the adoption of health risk behaviors, and the development of disease, disability and social problems, all resulting in premature mortality by means of fatal complications and/or suicide. CONCLUSIONS The implications of these cascading, evolving, and intertwined perspectives have important implications for the assessment and treatment of EDs using trauma-informed care and trauma-focused integrated treatment approaches. This overview offers multiple opportunities at every level for the palliation and prevention of EDs and other associated trauma-related conditions, including PTSD.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
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16
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Boodoo R, Lagman JG, Jairath B, Baweja R. A Review of ADHD and Childhood Trauma: Treatment Challenges and Clinical Guidance. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2022. [DOI: 10.1007/s40474-022-00256-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Hogg B, Gardoki-Souto I, Valiente-Gómez A, Rosa AR, Fortea L, Radua J, Amann BL, Moreno-Alcázar A. Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta-analysis. Eur Arch Psychiatry Clin Neurosci 2022; 273:397-410. [PMID: 36208317 DOI: 10.1007/s00406-022-01495-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/27/2022] [Indexed: 01/08/2023]
Abstract
This umbrella review is the first to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions. We searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classified the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-effects p value, the 95% confidence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study effect, and excess significance bias. Additional outcomes were the association between specific trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines. Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across different diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR = 2.92) and between childhood trauma and any mental disorder (OR = 2.90). Regarding specific trauma types, convincing evidence linked physical abuse (OR = 2.36) and highly suggestive evidence linked sexual abuse (OR = 3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR = 3.05); there were no data for emotional abuse with other disorders. These findings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Valiente-Gómez
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Adriane Ribeiro Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Department of Pharmacology, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil.,Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Lydia Fortea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Joaquim Radua
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK.,Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain. .,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain. .,Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain. .,Department of Psychiatry and Psychotherapy, Klinikum Der Universität München, Munich, Germany.
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
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18
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Schuler BR, Vazquez CE, Kobulsky JM, Dumenci L. Adversity and child body mass index in Fragile Families over 15 years: Do type and timing matter? SSM Popul Health 2022; 19:101197. [PMID: 36033351 PMCID: PMC9399528 DOI: 10.1016/j.ssmph.2022.101197] [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: 06/01/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Weight status has been linked to adverse childhood experiences. Existing research, however, is limited to unidimensional assessments of cumulative risk and does not account for the complex nature of adversity experienced by children in high-risk settings. We fill existing gaps by assessing how four subtypes of adversity across two primary dimensions of threat and deprivation-based adversity are associated with changes in body mass index (BMI) across child ages 3 through 15 years. Method U.S. mothers and fathers (n = 2412) in the Fragile Families and Child Wellbeing Study were interviewed when children were born, and again at ages 1, 3, 5, 9, and 15 years. Independent variables include interpersonal (e.g., domestic violence), family (e.g., mental health), economic (e.g., housing insecurity), and community (e.g., witness/victim of violence) adversity from ages 1 through 9 years. Path analysis regressed changes in BMIz from ages 3 through 15 on past adversity exposures. Results Increased interpersonal and community adversity subtypes from ages 3 to 5 were associated with decreased BMIz from ages 5–9 years. Increased economic adversity from age 3 to 5 was associated with increased BMIz from ages 5 to 9, adjusted for mother age, race, and education. Conclusion Findings highlight the differential influence of past adversity type and timing on child BMI. Interpersonal and community adversity were associated with decreased BMIz, and economic adversity with increased BMIz. Differences in directionality of associations suggest research should capture multiple dimensions of adversity in early childhood and possible positive and negative trends in effects on child weight as children grow from early to mid-childhood. We found positive and negative trends in BMIz, depending on adversity type. Interpersonal and community adversity types were associated with decrease BMIz. Economic adversity was associated with increased BMIz. BMIz from ages 5 to 9 was sensitive to adversity exposure from ages 3–5 years.
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Affiliation(s)
- Brittany R Schuler
- School of Social Work, College of Public Health, Temple University, 1311 Cecil B Moore Ave., Ritter Annex 5th floor, Philadelphia, PA, 19122, USA
| | - Christian E Vazquez
- School of Social Work, The University of Texas at Arlington, Arlington, TX, 6019, USA
| | - Julia M Kobulsky
- School of Social Work, College of Public Health, Temple University, 1311 Cecil B Moore Ave., Ritter Annex 5th floor, Philadelphia, PA, 19122, USA
| | - Levent Dumenci
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, 19122, USA
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19
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Khoury NM, Radonjić NV, Albert AB, Faraone SV. From Structural Disparities to Neuropharmacology: A Review of Adult Attention-Deficit/Hyperactivity Disorder Medication Treatment. Child Adolesc Psychiatr Clin N Am 2022; 31:343-361. [PMID: 35697389 DOI: 10.1016/j.chc.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Adult attention-deficit/hyperactivity disorder (ADHD) is an early-onset disorder with many functional impairments and psychiatric comorbidities. Although no treatment fully mitigates impairments associated with ADHD, effective management is possible with pharmacologic and nonpharmacologic treatments. The etiology and pathophysiology of ADHD are remarkably complex and the disorder is continuously distributed in the population. While these findings have been well documented in studies with predominantly white samples, ADHD may affect racial and ethnic minorities differentially, given diagnostic and treatment disparities. This review provides an updated overview of the epidemiology, etiology, neurobiology, and neuropharmacology of ADHD, addressing racial and ethnic disparities whereby data are available.
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Affiliation(s)
- Nayla M Khoury
- Department of Psychiatry and Behavioral Sciences, Upstate Medical University, Syracuse, NY, USA
| | - Nevena V Radonjić
- Department of Psychiatry and Behavioral Sciences, Upstate Medical University, Syracuse, NY, USA
| | - Avery B Albert
- Clinical Psychology, Syracuse University, Syracuse, NY, USA
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Science, SUNY Upstate Medical University, Institute for Human Performance, Room 3707, 505 Irving Avenue, Syracuse, NY 13210, USA; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Institute for Human Performance, Room 3707, 505 Irving Avenue, Syracuse, NY 13210, USA.
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20
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Peleikis DE, Fredriksen M, Faraone SV. Childhood trauma in adults with ADHD is associated with comorbid anxiety disorders and functional impairment. Nord J Psychiatry 2022; 76:272-279. [PMID: 34392781 DOI: 10.1080/08039488.2021.1962973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Child and adolescent psychological trauma exposure is associated with psychopathology in the adult population in general, but literature on childhood trauma (CT) in adults with ADHD is scarce. AIMS To determine the prevalence of CT among adult patients with ADHD, and whether a history of CT implies different adult outcomes of psychiatric comorbidities, and functional impairment than without. METHOD Previously unmedicated adult outpatients with ADHD (n = 250, median age 32 years) entered the study. Participants were diagnosed with ADHD using the Diagnostic Interview for ADHD in Adults, second edition (DIVA 2.0), and were assessed by historical data, validated questionnaires, and structured clinical interviews for CT and mental disorders including post-traumatic stress disorder (PTSD) and functional impairment. Analyses compared ADHD patients with and without CT. RESULTS Prevalence of CT was 44%. Of those with PTSD (n = 21), many had CT (85%, p < 0.001). In binary logistic regression analyses, CT was linked to an increased likelihood of concomitant panic disorder (unadjusted odds ratio, OR = 3.0, p < 0.001, and adjusted OR = 2.7, p < 0.01) and any anxiety disorders and two or more comorbid psychiatric disorders (adjusted OR = 1.9, p < 0.05 and OR = 1.7, p < 0.05, respectively), and was associated with significant functional impairment. CONCLUSIONS These findings suggest that awareness of child and adolescent trauma is clinically relevant among young to middle-aged adult ADHD patients, and implications for earlier detection of CT and treatment warrant further studies.
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Affiliation(s)
- Dawn E Peleikis
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Asker DPS, Drammen, Norway
| | - Mats Fredriksen
- Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.,Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
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21
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Kern DM, Teneralli RE, Flores CM, Wittenberg GM, Gilbert JP, Cepeda MS. Revealing Unknown Benefits of Existing Medications to Aid the Discovery of New Treatments for Post‐Traumatic Stress Disorder. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2022; 4:12-20. [PMID: 36101715 PMCID: PMC9175795 DOI: 10.1176/appi.prcp.20210019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/13/2021] [Accepted: 11/20/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To systematically identify novel pharmacological strategies for preventing or treating post‐traumatic stress disorder (PTSD) by leveraging large‐scale analysis of real‐world observational data. Methods Using a self‐controlled study design, the association between 1399 medications and the incidence of PTSD across four US insurance claims databases covering commercially insured, Medicare eligible, and Medicaid patients was examined. A validated algorithm for identifying PTSD in claims data was used, and medications were identified by their RxNorm ingredient. Medications used to treat PTSD or its symptoms (e.g., antidepressants, antipsychotics) were excluded. Medications associated with ≥30% reduction in risk of PTSD in ≥2 databases were identified. Results A total of 137,182,179 individuals were included in the analysis. Fifteen medications met the threshold criteria for a potential protective effect on PTSD; six were categorized as “primary signals” while the remaining nine were considered “potential signals”. The primary signals include a beta blocker that has been previously studied for PTSD, and five medications used to treat attention‐deficit/hyperactivity disorder. The potential signals include four medications used to treat substance use disorders and five medications used to treat sleep disorders. Discussion The medications identified in this analysis provide targets for further research in studies that are designed to examine specific hypotheses regarding these medications and the incidence of PTSD. This work may aid in discovering novel therapeutic approaches to treat PTSD, wherein new and effective treatments are badly needed. Four large US‐based administrative claims databases were used to analyze the association between all marketed prescription medications and the outcome of incident post‐traumatic stress disorder (PTSD) Of the 1399 medications examined, there were 15 that met the strict filtering criteria for showing consistent, moderate‐to‐strong, protective effects against the outcome Medications fell into four main classes: (1) a beta blocker (propranolol), (2) five medications used to treat attention‐deficit/hyperactivity disorder (ADHD), (3) four medications used to treat substance use disorders and (4) five medications used to treat sleep disorders These findings identify rational starting points for future hypothesis‐driven research to explore these associations in greater detail
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Affiliation(s)
- David M. Kern
- Janssen Research & Development, Titusville, NJ (D. M. Kern, R. E. Teneralli, G. M. Wittenberg, J. P. Gilbert, M. S. Cepeda); Janssen Research & Development, San Diego (C. M. Flores)
| | - Rachel E. Teneralli
- Janssen Research & Development, Titusville, NJ (D. M. Kern, R. E. Teneralli, G. M. Wittenberg, J. P. Gilbert, M. S. Cepeda); Janssen Research & Development, San Diego (C. M. Flores)
| | - Christopher M. Flores
- Janssen Research & Development, Titusville, NJ (D. M. Kern, R. E. Teneralli, G. M. Wittenberg, J. P. Gilbert, M. S. Cepeda); Janssen Research & Development, San Diego (C. M. Flores)
| | - Gayle M. Wittenberg
- Janssen Research & Development, Titusville, NJ (D. M. Kern, R. E. Teneralli, G. M. Wittenberg, J. P. Gilbert, M. S. Cepeda); Janssen Research & Development, San Diego (C. M. Flores)
| | - James P. Gilbert
- Janssen Research & Development, Titusville, NJ (D. M. Kern, R. E. Teneralli, G. M. Wittenberg, J. P. Gilbert, M. S. Cepeda); Janssen Research & Development, San Diego (C. M. Flores)
| | - M. Soledad Cepeda
- Janssen Research & Development, Titusville, NJ (D. M. Kern, R. E. Teneralli, G. M. Wittenberg, J. P. Gilbert, M. S. Cepeda); Janssen Research & Development, San Diego (C. M. Flores)
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22
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Cao H, Wang J, Baranova A, Zhang F. Classifying major mental disorders genetically. Prog Neuropsychopharmacol Biol Psychiatry 2022; 112:110410. [PMID: 34339760 DOI: 10.1016/j.pnpbp.2021.110410] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/24/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023]
Abstract
Typically, mental disorders are defined and classified based on clinical symptoms and syndromes. Although clinically useful, current diagnostic systems for psychiatry cause concerns due to the lack of biological mechanisms. Deciphering the relationships among psychiatric traits according to their genetic basis may facilitate understanding the biological mechanisms of psychiatric disorders. Ten mental disorders were classified by genomic structural equation modeling (SEM), which leverages summary results of genome-wide association studies. Attention-deficit/hyperactivity disorder (ADHD), anorexia nervosa (AN), anxiety disorder (ANX), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), schizophrenia (SZ), and Tourette syndrome (TS) were included. The analysis indicates that they are genetically inter-correlated with one another and can be separated based on their general psychopathology. Most disorders have a close partner, forming pairs of traits; only TS is a relatively distinctive condition. At a higher level, MDD, ANX, ADHD, ASD, and PTSD cluster together, while OCD, AN, and TS cluster together. Together, the ten traits constitute a hierarchical classificatory system. This study allows inference of genetically determined classification of the ten mental disorders, which may biologically inform the current diagnostic framework and treatment regimens for mental disorders.
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Affiliation(s)
- Hongbao Cao
- School of Systems Biology, George Mason University (GMU), Fairfax, VA 22030, USA
| | - Jun Wang
- Department of Clinical Psychology, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, Jiangsu Province 214151, China
| | - Ancha Baranova
- School of Systems Biology, George Mason University (GMU), Fairfax, VA 22030, USA; Research Centre for Medical Genetics, Moscow 115478, Russia
| | - Fuquan Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, China.
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23
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Lafavor T, Gimbel B, Olsen A, Travis A, Weber R. Relationship of parent-rated and objectively evaluated executive function to symptoms of posttraumatic stress and attention-deficit/hyperactivity disorder in homeless youth. Child Neuropsychol 2021; 28:768-790. [PMID: 34957916 DOI: 10.1080/09297049.2021.2016671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Compared to their stably housed peers, homeless, and highly mobile (HHM) youth experience disproportionately greater adversity and risk leading to a wide variety of poor developmental outcomes, and targeted interventions have the potential to mitigate such outcomes. A growing literature highlights the need for accurate diagnosis in high-risk populations given the considerable overlap between posttraumatic symptomology and behaviorally based disorders such as ADHD. Objective testing inferring neurobiological and circuit-based abnormalities in posttraumatic stress disorder (PTSD) and ADHD may provide a useful clinical tool to aid accurate diagnosis and treatment recommendations. This novel, exploratory study examined the relation between executive function (EF) as measured by objective testing and parent ratings with symptoms of posttraumatic stress and ADHD in 86 children (age 9 to 11) living in emergency homeless shelters. Parent-rated EF problems suggested broad impairment associated with ADHD symptoms but specific impairment in emotional/behavioral function associated with posttraumatic stress symptoms. While measures of inhibition and shifting EF were strongly associated with symptomology in bivariate correlations, they explained minimal variance in regression models. Internalizing behavior problems were associated with posttraumatic stress symptoms, while externalizing behavior problems were associated with ADHD symptoms. Implications for clinical practice and future research are discussed.
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Affiliation(s)
- Theresa Lafavor
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Blake Gimbel
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Aarika Olsen
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Alicia Travis
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Rachel Weber
- The Compass Clinic, Vancouver, British Columbia, Canada
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24
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Imai J, Sasayama D, Kuge R, Honda H, Washizuka S. Hyperactive/impulsive symptoms and autistic trait in institutionalized children with maltreatment experience. New Dir Child Adolesc Dev 2021; 2021:29-39. [PMID: 34882945 DOI: 10.1002/cad.20445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The present study examined how maltreatment experience was associated with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) symptoms in children under institutional care. The key caregivers of children and adolescents aged 6 to 18 years who were under institutional care in Nagano prefecture, Japan were asked to answer the background questionnaire, ADHD-Rating Scale, and the Japanese children's version of the Autism-Spectrum Quotient. A total of 378 valid responses were obtained, of which 222 reported maltreatment experience prior to institutionalization. Both hyperactive/impulsive and inattentive scores were significantly higher in the maltreated group. Maltreatment experience was significantly associated with the presence of hyperactive/impulsive symptoms (p = 0.003) and inattentive symptoms (p = 0.027). Particularly, those who had experienced physical abuse were significantly more likely to have hyperactive/impulsive symptoms (p = 0.012) and autistic trait (p = 0.002). Thorough assessment of neurodevelopmental symptoms should be performed when placing children with maltreatment experience into institutional care.
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Affiliation(s)
- Junko Imai
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.,Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, Japan
| | - Daimei Sasayama
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.,Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, Japan.,Department of Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Rie Kuge
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, Japan.,Department of Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hideo Honda
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.,Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, Japan.,Department of Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shinsuke Washizuka
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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25
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Fuller-Thomson E, Lewis DA, Agbeyaka S. Attention-Deficit/Hyperactivity Disorder and Alcohol and Other Substance Use Disorders in Young Adulthood: Findings from a Canadian Nationally Representative Survey. Alcohol Alcohol 2021; 57:385-395. [PMID: 34343246 DOI: 10.1093/alcalc/agab048] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 12/31/2022] Open
Abstract
AIM (a) To document the prevalence and odds of (i) alcohol use disorders, (ii) cannabis use disorders, (iii) other drug use disorders and (iv) any substance use disorder (SUD), among young adults with and without ADHD, and (b) to investigate the degree to which the association between ADHD and SUDs is attenuated by socio-demographics, early adversities and mental health. METHOD Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (CCHS-MH). The sample included 6872 respondents aged 20-39, of whom 270 had ADHD. The survey response rate was 68.9%. MEASUREMENTS Substance Use Disorder: World Health Organization's Composite International Diagnostic Interview criteria, SUDs, were derived from lifetime algorithms for alcohol, cannabis and other substance abuse or dependence. ADHD was based on self-report of a health professional's diagnosis. FINDINGS One in three young adults with ADHD had a lifetime alcohol use disorder (36%) compared to 19% of those without ADHD (P < 0.001). After adjusting for all control variables, those with ADHD had higher odds of developing alcohol use disorders (OR = 1.38, 95% CI: 1.05, 1.81), cannabis use disorders (OR = 1.46, 95% CI: 1.06, 2.00), other drug use disorders (OR = 2.07, 95% CI: 1.46, 2.95) and any SUD (OR = 1.69, 95% CI: 1.28, 2.23). History of depression and anxiety led to the largest attenuation of the ADHD-SUD relationship, followed by childhood adversities and socioeconomic status. CONCLUSIONS Young adults with ADHD have a high prevalence of alcohol and other SUDs. Targeted outreach and interventions for this extremely vulnerable population are warranted.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, Canada.,Department of Family and Community Medicine, 500 University Avenue, 5th Floor University of Toronto, Toronto, Canada.,Institute for Life Course & Aging, University of Toronto, 246 Bloor St. W., Toronto, Canada
| | - Danielle A Lewis
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, Canada
| | - Senyo Agbeyaka
- Toronto General Hospital, 200 Elizabeth St, University Health Network, Toronto, ON, Canada
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26
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Bong SH, Kim KM, Seol KH, Kim JW. Bullying perpetration and victimization in elementary school students diagnosed with attention-deficit/hyperactivity disorder. Asian J Psychiatr 2021; 62:102729. [PMID: 34120014 DOI: 10.1016/j.ajp.2021.102729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/21/2021] [Accepted: 05/30/2021] [Indexed: 12/17/2022]
Abstract
Previous research has found that attention-deficit/hyperactivity disorder (ADHD) in children is related to bullying perpetration. This study examined the correlation between ADHD and bullying perpetration, and aimed to identify which factors, including bullying victimization, predicted bullying. Forty-nine elementary school students, aged 6-12, participated voluntarily in a comparative study between children with ADHD and non-ADHD control children; none of them had previously undergone psychiatric treatment. Both parents' and participants' social demographic information (gender, age) and clinical variables were obtained from self-report questionnaires. The participants' bullying victimization experience, impulsivity, and parents' history of ADHD had significant relationships with bullying. The status of ADHD and other self-reported scales had no significant relationships with bullying. The association between bullying victimization and bullying perpetration was notable among all factors examined. This was consistent with the claims of prior studies that past victimization led to perpetration of bullying. Therefore, it seems that when treating victims of bullying, care should be taken, through proper intervention, to ensure the incident is neither repeated nor replicated. Characteristics associated with ADHD, including impulsivity and parents' history of ADHD, were significantly related to bullying. However, we could not confirm our hypothesis that ADHD itself might be associated with bullying behavior.
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Affiliation(s)
- Su Hyun Bong
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Kyoung Min Kim
- Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Ki Ho Seol
- Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
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27
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Luderer M, Ramos Quiroga JA, Faraone SV, Zhang James Y, Reif A. Alcohol use disorders and ADHD. Neurosci Biobehav Rev 2021; 128:648-660. [PMID: 34265320 DOI: 10.1016/j.neubiorev.2021.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/18/2022]
Abstract
Despite a growing literature on the complex bidirectional relationship of ADHD and substance use, reviews specifically focusing on alcohol are scarce. ADHD and AUD show a significant genetic overlap, including genes involved in gluatamatergic and catecholaminergic neurotransmission. ADHD drives risky behavior and negative experiences throughout the lifespan that subsequently enhance a genetically increased risk for Alcohol Use Disorders (AUD). Impulsive decisions and a maladaptive reward system make individuals with ADHD vulnerable for alcohol use and up to 43 % develop an AUD; in adults with AUD, ADHD occurs in about 20 %, but is vastly under-recognized and under-treated. Thus, routine screening and treatment procedures need to be implemented in AUD treatment. Long-acting stimulants or non-stimulants can be used to treat ADHD in individuals with AUD. However, it is crucial to combine medical treatment for ADHD with pharmacotherapy and psychotherapy for AUD, and other comorbid disorders. Identification of individuals at risk for AUD, especially those with ADHD and conduct disorder or oppositional defiant disorder, is a key factor to prevent negative outcomes.
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Affiliation(s)
- Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Frankfurt am Main, Germany.
| | - Josep Antoni Ramos Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatryand Forensic Medicine, Universitat Autònoma deBarcelona, Bellaterra, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Yanli Zhang James
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Frankfurt am Main, Germany
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28
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The role of intraindividual cognitive variability in posttraumatic stress syndromes and cognitive aging: a literature search and proposed research agenda. Int Psychogeriatr 2021; 33:677-687. [PMID: 32172714 DOI: 10.1017/s1041610220000228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Cognitive impairments are directly related to severity of symptoms and are a primary cause for functional impairment. Intraindividual cognitive variability likely plays a role in both risk and resiliency from symptoms. In fact, such cognitive variability may be an earlier marker of cognitive decline and emergent psychiatric symptoms than traditional psychiatric or behavioral symptoms. Here, our objectives were to survey the literature linking intraindividual cognitive variability, trauma, and dementia and to suggest a potential research agenda. DESIGN A wide body of literature suggests that exposure to major stressors is associated with poorer cognitive performance, with intraindividual cognitive variability in particular linked to the development of posttraumatic stress disorder (PTSD) in the aftermath of severe trauma. MEASUREMENTS In this narrative review, we survey the empirical studies to date that evaluate the connection between intraindividual cognitive variability, PTSD, and pathological aging including dementia. RESULTS The literature suggests that reaction time (RT) variability within an individual may predict future cognitive impairment, including premature cognitive aging, and is significantly associated with PTSD symptoms. CONCLUSIONS Based on our findings, we argue that intraindividual RT variability may serve as a common pathological indicator for trauma-related dementia risk and should be investigated in future studies.
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29
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ADHD symptoms as risk factor for PTSD in inpatients treated for alcohol use disorder. Psychiatry Res 2021; 300:113904. [PMID: 33872853 DOI: 10.1016/j.psychres.2021.113904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/27/2021] [Indexed: 12/24/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are more common in alcohol use disorder (AUD) patients than in the general population. Still, there is a lack of knowledge about the relationship between the two conditions in these patients. The main objective of this study was to examine the prevalence of ADHD symptoms, and the relationship between ADHD symptoms and PTSD in AUD inpatients in treatment. Data from 85 AUD patients were collected. The Adult ADHD Self-Report Scale (ASRS) was used to measure ADHD symptoms in all patients. Differences between groups split by PTSD diagnosis and by ASRS clinical cut-off were described, and the relationship between ADHD symptom level and PTSD was tested in a multiple regression model. Almost half the patients scored above ASRS cut-off and 14% had PTSD. Of the patients whose score was above cut-off on the ASRS 23% had PTSD, versus 7% among those below cut-off. Higher ASRS score was associated with PTSD even when age, sex and trauma were adjusted for. This study confirms the high level of ADHD symptoms in AUD patients in treatment. Diagnostic evaluation of PTSD is recommended in patients with ADHD attending inpatient treatment programs for AUD.
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30
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Abstract
This case study displays the successful application of Prolonged Exposure (PE) for a client with diagnoses of Posttraumatic Stress Disorder (PTSD), Attention Deficit Hyperactivity Disorder (ADHD), and Generalized Anxiety Disorder (GAD). To our knowledge ADHD has not been examined as a predictor or moderator of PE outcomes. As such, practitioners have precious little information about how to proceed in such cases, which highlights the importance of careful individual assessment and case conceptualization. There is also a dearth of information on the effects of combining PE (a research-supported psychological intervention for PTSD) with psychostimulant medication (a research-supported pharmacological intervention for ADHD). The present case study illustrates a positive synergy between psychostimulant treatment and PE. The unique adjustments made to deliver services (including in the face of COVID-19) are described as well as what this case suggests about the effects of psychostimulant use on PTSD symptoms and the new learning that occurs during PE.
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31
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Mii AE, McCoy K, Coffey HM, Meidlinger K, Sonnen E, Huit TZ, Flood MF, Hansen DJ. Attention Problems and Comorbid Symptoms following Child Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:924-943. [PMID: 33170112 DOI: 10.1080/10538712.2020.1841353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/30/2020] [Accepted: 09/27/2020] [Indexed: 06/11/2023]
Abstract
Treatment utilization following child sexual abuse (CSA) is essential in combatting the various negative consequences of CSA. Youth may present to treatment for CSA with symptoms that cut across multiple diagnostic presentations that impact their ability to successfully engage in treatment. In particular, children who have difficulties with attention may have unique treatment needs following CSA. The purpose of this study was to examine how attention problems interplay with comorbid symptoms and how these clinical presentations impact treatment outcomes for youth who have been sexually abused. Participants included 323 families presenting to treatment for CSA. Youth were 7 to 19 years old, 78.5% female, and 76.6% identified as Caucasian/White. Results indicated that 22.9% of the youth presented with clinically elevated attention problems as collected through parent-report of the Child Behavior Checklist (CBCL). Results demonstrated that child survivors of CSA who presented with attention problems self-reported more psychological concerns (e.g., symptoms of depression, anxiety, and post-traumatic stress). At post-treatment, attention problems, interpersonal problems, and thought problems were significantly reduced for youth initially presenting with attention problems. Further implications for treatment following CSA and unique needs for youth with attention problems are discussed.
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Affiliation(s)
- Akemi E Mii
- University of Nebraska-Lincoln , Lincoln, USA
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32
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Hess JL, Nguyen NH, Suben J, Meath RM, Albert AB, Van Orman S, Anders KM, Forken PJ, Roe CA, Schulze TG, Faraone SV, Glatt SJ. Gene co-expression networks in peripheral blood capture dimensional measures of emotional and behavioral problems from the Child Behavior Checklist (CBCL). Transl Psychiatry 2020; 10:328. [PMID: 32968041 PMCID: PMC7511314 DOI: 10.1038/s41398-020-01007-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/29/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022] Open
Abstract
The U.S. National Institute of Mental Health (NIMH) introduced the research domain criteria (RDoC) initiative to promote the integration of information across multiple units of analysis (i.e., brain circuits, physiology, behavior, self-reports) to better understand the basic dimensions of behavior and cognitive functioning underlying normal and abnormal mental conditions. Along those lines, this study examined the association between peripheral blood gene expression levels and emotional and behavioral problems in school-age children. Children were chosen from two age- and sex-matched groups: those with or without parental reports of any prior or current psychiatric diagnosis. RNA-sequencing was performed on whole blood from 96 probands aged 6-12 years who were medication-free at the time of assessment. Module eigengenes were derived using weighted gene co-expression network analysis (WGCNA). Associations were tested between module eigengene expression levels and eight syndrome scales from parent ratings on the Child Behavior Checklist (CBCL). Nine out of the 36 modules were significantly associated with at least one syndrome scale measured by the CBCL (i.e., aggression, social problems, attention problems, and/or thought problems) after accounting for covariates and correcting for multiple testing. Our study demonstrates that variation in peripheral blood gene expression relates to emotional and behavioral profiles in children. If replicated and validated, our results may help in identifying problem or at-risk behavior in pediatric populations, and in elucidating the biological pathways that modulate complex human behavior.
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Affiliation(s)
- Jonathan L Hess
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Nicholas H Nguyen
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jesse Suben
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ryan M Meath
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Avery B Albert
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Sarah Van Orman
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kristin M Anders
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Patricia J Forken
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Cheryl A Roe
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, Medical Center of the University of Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Stephen V Faraone
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephen J Glatt
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA.
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, Syracuse, NY, USA.
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Low brain endocannabinoids associated with persistent non-goal directed nighttime hyperactivity after traumatic brain injury in mice. Sci Rep 2020; 10:14929. [PMID: 32913220 PMCID: PMC7483739 DOI: 10.1038/s41598-020-71879-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
Traumatic brain injury (TBI) is a frequent cause of chronic headache, fatigue, insomnia, hyperactivity, memory deficits, irritability and posttraumatic stress disorder. Recent evidence suggests beneficial effects of pro-cannabinoid treatments. We assessed in mice levels of endocannabinoids in association with the occurrence and persistence of comparable sequelae after controlled cortical impact in mice using a set of long-term behavioral observations in IntelliCages, motor and nociception tests in two sequential cohorts of TBI/sham mice. TBI mice maintained lower body weights, and they had persistent low levels of brain ethanolamide endocannabinoids (eCBs: AEA, OEA, PEA) in perilesional and subcortical ipsilateral brain tissue (6 months), but rapidly recovered motor functions (within days), and average nociceptive responses were within normal limits, albeit with high variability, ranging from loss of thermal sensation to hypersensitivity. TBI mice showed persistent non-goal directed nighttime hyperactivity, i.e. they visited rewarding and non-rewarding operant corners with high frequency and random success. On successful visits, they made more licks than sham mice resulting in net over-licking. The lower the eCBs the stronger was the hyperactivity. In reward-based learning and reversal learning tasks, TBI mice were not inferior to sham mice, but avoidance memory was less stable. Hence, the major late behavioral TBI phenotype was non-goal directed nighttime hyperactivity and "over-licking" in association with low ipsilateral brain eCBs. The behavioral phenotype would agree with a "post-TBI hyperactivity disorder". The association with persistently low eCBs in perilesional and subcortical regions suggests that eCB deficiency contribute to the post-TBI psychopathology.
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Biederman J, Fried R, DiSalvo M, Driscoll H, Green A, Biederman I, Woodworth KY, Faraone SV. A novel digital health intervention to improve patient engagement to stimulants in adult ADHD in the primary care setting: Preliminary findings from an open label study. Psychiatry Res 2020; 291:113158. [PMID: 32559669 DOI: 10.1016/j.psychres.2020.113158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022]
Abstract
AIMS We piloted the effectiveness and acceptability of a novel text messaging-based (SMS) digital health intervention aimed at addressing the previously documented poor rate of patient engagement in stimulant treatment in the primary care setting. METHODS 117 adults ages 18-55 from primary care and psychiatric practices who were prescribed a stimulant medication for ADHD treatment received the SMS intervention. Comparators were age-, race-, and sex-matched patients from the same health care organization's electronic medical record who had been prescribed stimulant medications over a similar time period. Using documented prescription records, we determined whether patients had timely prescription refills. RESULTS Ninety-six percent (N = 112) of participants completed our a priori metric of patient engagement consisting of 37 days of the SMS program. Eighty-one percent of participants refilled their index prescriptions in a timely manner compared to only 36% of patients receiving treatment as usual (OR=7.54, 95% CI: 4.46, 12.77; p<0.001). We found no significant interaction between prescribing source (non-psychiatry vs. psychiatry) and intervention group (SMS vs. treatment as usual). CONCLUSIONS These data suggest that an ADHD-centric, digital health intervention using text messaging significantly improves patient engagement in stimulant treatment in adults with ADHD.
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Affiliation(s)
- Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Ronna Fried
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Haley Driscoll
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Allison Green
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Itai Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - K Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
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Jennum P, Hastrup LH, Ibsen R, Kjellberg J, Simonsen E. Welfare consequences for people diagnosed with attention deficit hyperactivity disorder (ADHD): A matched nationwide study in Denmark. Eur Neuropsychopharmacol 2020; 37:29-38. [PMID: 32682821 DOI: 10.1016/j.euroneuro.2020.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 03/18/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022]
Abstract
There is insufficient data regarding the excess direct and indirect costs associated with attention deficit hyperactivity disorder (ADHD). Using the Danish National Patient Registry (2002-2016), we identified 83,613 people of any age with a diagnosis of ADHD or who were using central-acting medication against ADHD (primarily methylphenidate, with at least two prescriptions) and matched them to 334,446 control individuals. Additionally, 18,959 partners of patients aged ≥18 years with ADHD were identified, and compared with 74,032 control partners. Direct costs were based on data from the Danish Ministry of Health. Information about the use and costs of drugs were obtained from the Danish Medicines Agency. The frequencies of visits and hospitalizations, and costs of general practice were derived from data from the National Health Security. Indirect costs were obtained from Coherent Social Statistics. The average annual health care costs for people with ADHD and their partners were, respectively, €2636 and €477 higher than those of the matched controls. A greater percentage of people with ADHD and their partners compared with respective control subjects received social services (sick pay or disability pension). Those with ADHD had a lower income from employment than did controls for equivalent periods up to five years before the first diagnosis of ADHD. The additional direct and indirect annual costs (for those aged ≥18 years) including transfers of ADHD compared with controls were €23,072 for people with ADHD and €7,997 for their partners. ADHD has substantial socioeconomic consequences for individual patients, their partners and society.
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Affiliation(s)
- Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet, DK 2600 Glostrup, Copenhagen, Denmark.
| | | | | | - Jakob Kjellberg
- VIVE - The Danish Center for Social Science Research, Copenhagen, Denmark.
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry, Region Zealand, Denmark; Department of Clinical Medicine, Faculty of Medical and health Sciences, University of Copenhagen, Denmark.
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Fried R, DiSalvo M, Kelberman C, Adler A, McCafferty D, Woodworth KY, Green A, Biederman I, Faraone SV, Biederman J. An innovative SMS intervention to improve adherence to stimulants in children with ADHD: Preliminary findings. J Psychopharmacol 2020; 34:883-890. [PMID: 32077768 DOI: 10.1177/0269881120908014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although large datasets document that stimulants decrease the risk for many adverse ADHD-associated outcomes, compliance with stimulants remains poor. AIMS This study examined the effectiveness of a novel ADHD-centric text messaging-based intervention aimed to improve adherence to stimulant medications in children with ADHD. METHODS Subjects were 87 children aged 6-12, who were prescribed a stimulant medication for ADHD treatment. Prescribers gave permission to contact their patients for participation in the study. Subjects were primarily from the primary care setting with a subsample of psychiatrically referred subjects for comparison. Age- and sex-matched comparators were identified (3:1) from the same pool of prescriber-approved subjects that did not participate. Timely prescription refills (within 37 days) were determined from prescription dates documented in patients' electronic medical record. RESULTS Eighty-five percent of SMS intervention patients refilled their prescriptions in a timely manner compared with 62% of patients receiving treatment as usual (OR = 3.46, 95% CI: 1.82, 6.58; p < 0.001). The number needed to treat statistic was computed as five, meaning for every five patients who receive the SMS intervention, we can keep one adherent to their stimulant treatment. CONCLUSIONS These preliminary findings support the potential utility of a readily accessible technology to improve the poor rate of adherence to stimulant treatment in children with ADHD. To the best of our knowledge, this study is the first digital health intervention aimed at improving adherence to stimulant medication for children with ADHD. These results support the need for further examination of this technology through more definitive randomized clinical trials.
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Affiliation(s)
- Ronna Fried
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Caroline Kelberman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Amos Adler
- MemoText Corporation, Toronto, ON, Canada
| | | | - K Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Allison Green
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Itai Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA.,KG Jebsen Center for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Luderer M, Reinhard I, Richter A, Kiefer F, Weber T. ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients. Eur Addict Res 2020; 26:245-253. [PMID: 32653887 DOI: 10.1159/000508918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/25/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Alcohol dependence (AD) is frequently associated with attention-deficit/hyperactivity disorder (ADHD) as well as with posttraumatic stress disorder (PTSD). OBJECTIVE Aim of this study was to investigate whether in patients with AD, ADHD is associated with an increased rate of exposure to potentially traumatic events (PTEs) and PTSD, with increased PTSD severity and higher impact on daily functioning. METHODS Patients with AD were thoroughly assessed for ADHD during long-term residential treatment. Participants also completed the Posttraumatic Diagnostic Scale (PDS). The PDS is a 49-item self-report instrument that assesses exposure to different PTEs, DSM-IV criteria for PTSD, severity of PTSD, and related functional impairment. RESULTS Of 341 patients with AD, 66 were diagnosed with ADHD (19%). ADHD was associated with a more frequent exposure to PTEs (88 vs. 65%, p < 0.001). In patients with PTEs (n = 237), odds for PTSD were higher in ADHD versus no-ADHD patients (OR 8.9, 95% CI 3.9-20.5). Furthermore, PTSD severity and functional impairment were increased in ADHD patients. CONCLUSIONS ADHD in patients with AD is associated with a higher frequency of PTEs and PTSD with more severe and more impairing PTSD symptoms. In alcohol-dependent patients with ADHD, regular screening for PTSD should be considered.
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Affiliation(s)
- Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany, .,Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany,
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | | | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany.,Feuerlein Center of Translational Addiction Medicine, Heidelberg, Germany
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Lafavor T, Langworthy SE, Persaud S, Kalstabakken AW. The Relationship Between Parent and Teacher Perceptions and the Academic Success of Homeless Youth. CHILD & YOUTH CARE FORUM 2019. [DOI: 10.1007/s10566-019-09538-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tortella-Feliu M, Fullana MA, Pérez-Vigil A, Torres X, Chamorro J, Littarelli SA, Solanes A, Ramella-Cravaro V, Vilar A, González-Parra JA, Andero R, Reichenberg A, Mataix-Cols D, Vieta E, Fusar-Poli P, Ioannidis JP, Stein MB, Radua J, Fernández de la Cruz L. Risk factors for posttraumatic stress disorder: An umbrella review of systematic reviews and meta-analyses. Neurosci Biobehav Rev 2019; 107:154-165. [DOI: 10.1016/j.neubiorev.2019.09.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023]
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González RA, Vélez-Pastrana MC, McCrory E, Kallis C, Aguila J, Canino G, Bird H. Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence. Soc Psychiatry Psychiatr Epidemiol 2019; 54:671-682. [PMID: 30903235 DOI: 10.1007/s00127-019-01659-0] [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] [Received: 07/19/2018] [Accepted: 01/17/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE An emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence. METHODS Data were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status. RESULTS Emotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence. CONCLUSIONS Associations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.
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Affiliation(s)
- Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 7th floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK. .,Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.
| | - María C Vélez-Pastrana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.,Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Jivelisse Aguila
- Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan, PR, USA
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Howlett JR, Campbell-Sills L, Jain S, Heeringa SG, Nock MK, Sun X, Ursano RJ, Stein MB. Attention Deficit Hyperactivity Disorder and Risk of Posttraumatic Stress and Related Disorders: A Prospective Longitudinal Evaluation in U.S. Army Soldiers. J Trauma Stress 2018; 31:909-918. [PMID: 30461069 PMCID: PMC6386189 DOI: 10.1002/jts.22347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 07/01/2018] [Accepted: 08/02/2018] [Indexed: 12/13/2022]
Abstract
Cross-sectional associations between attention deficit hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) have been observed, but longitudinal studies assessing this association are lacking. This prospective study evaluated the association between predeployment ADHD and postdeployment PTSD among U.S. Army soldiers. Soldiers who deployed to Afghanistan were surveyed before deployment (T0) and approximately 1 month (T1), 3 months (T2), and 9 months (T3) after their return. Logistic regression was performed to estimate the association between predeployment ADHD and postdeployment (T2 or T3) PTSD among 4,612 soldiers with data at all waves and no record of stimulant medication treatment during the study. To evaluate specificity of the ADHD-PTSD association, we examined associations among predeployment ADHD, postdeployment major depressive episode (MDE), generalized anxiety disorder (GAD), and suicidal ideation. Weighted prevalence of ADHD predeployment was 6.1% (SE = 0.4%). Adjusting for other risk factors, predeployment ADHD was associated with risk of postdeployment PTSD, adjusted odds ratio (AOR) = 2.13, 95% CI [1.51, 3.00], p < .001, including incidence among soldiers with no predeployment history of PTSD, AOR = 2.50, 95% CI [1.69, 3.69], p < .001. ADHD was associated with postdeployment MDE, AOR = 2.80, 95% CI [2.01, 3.91], p < .001, and GAD, AOR = 3.04, 95% CI [2.10, 4.42], p < .001, but not suicidal ideation. Recognition of associations between predeployment ADHD and postdeployment PTSD, MDE, and GAD may inform targeted prevention efforts. Future research should examine whether treatment of ADHD is protective against PTSD and related disorders in trauma-exposed individuals.
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Affiliation(s)
- Jonathon R. Howlett
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Laura Campbell-Sills
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Sonia Jain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Steven G. Heeringa
- University of Michigan, Institute for Social Research, Ann Arbor, Michigan, USA
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Xiaoying Sun
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA,VA San Diego Healthcare System, San Diego, California, USA
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Ohlsson Gotby V, Lichtenstein P, Långström N, Pettersson E. Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study. J Child Psychol Psychiatry 2018; 59:957-965. [PMID: 29570782 DOI: 10.1111/jcpp.12884] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD), Attention-deficit/Hyperactivity disorder (ADHD), and other related neurodevelopmental disorders (NDDs) have, in some previous studies, been shown to increase the risk of being sexually victimized. However, no studies have examined whether the association is driven by a general NDD phenotype versus specific diagnoses, nor the etiology of the association. METHOD Using a genetically informative, prospective design, we examined the association between ASD and ADHD in childhood and coercive sexual victimization up to age 18. A total of 4,500 children participating in the Child and Adolescent Twin Study in Sweden (CATSS) were rated by their parents on NDDs at age 9 or 12 years, and self-reported at age 18 on lifetime experiences of coercive sexual touching and/or coercive sex. First, we regressed sexual victimization on the NDDs. Second, we regressed sexual victimization on general and specific NDD symptoms identified via a bifactor model. Third, we decomposed the observed associations into genetic and environmental parts. RESULTS In females, ASD was associated with an almost threefolded increased risk of coercive sexual victimization, and ADHD with a doubled risk. In males, the risk associated with ASD and ADHD was of the same magnitude but not significant. When controlling for overall NDD symptom load ASD or ADHD, no longer uniquely predicted coercive sexual victimization. The association between the NDD general factor and coercive sexual victimization was due to shared genetics. CONCLUSIONS General NDD symptom load, rather than specific ASD or ADHD symptoms, seems to be a moderate vulnerability factor for coercive sexual victimization. We speculate that an evocative gene-environment correlation might account for this observation, such that sexual perpetrators actively target NDD individuals.
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Affiliation(s)
- Vide Ohlsson Gotby
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Långström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Posttraumatic Stress Disorder and Psychiatric Comorbidity among Adolescent Earthquake Survivors: a Longitudinal Cohort Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 47:671-681. [DOI: 10.1007/s10802-018-0462-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Trauma exposure in children with and without ADHD: prevalence and functional impairment in a community-based study of 6-8-year-old Australian children. Eur Child Adolesc Psychiatry 2018; 27:811-819. [PMID: 29086104 DOI: 10.1007/s00787-017-1067-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Abstract
Both ADHD and trauma exposure are common childhood problems, but there are few empirical data regarding the association between the two conditions. The aims of this study were to compare lifetime prevalence of trauma exposure in children with and without ADHD, and to explore the association between trauma exposure and outcomes in children with ADHD. Children aged 6-8 years with ADHD (n = 179) and controls (n = 212) recruited from 43 schools were assessed for ADHD, trauma exposure and comorbid mental health disorders using the Diagnostic Interview Schedule for Children IV. Outcome data were collected by direct child assessment, parent report and teacher-report, and included ADHD symptom severity, internalizing and externalizing problems, quality of life, and academic functioning. Logistic and linear regression models were used to examine differences adjusted for child and family socio-demographics. Children with ADHD were more likely than controls to have ever experienced a traumatic event (27 vs 16%; OR: 1.99; 95% CI 1.21, 3.27). This difference remained significant in the adjusted model (OR: 1.76, 95% CI 1.03, 3.01) accounting for child factors (age and gender) and family socio-demographic factors (parent age, parent high school completion and single parent status). Among those with ADHD, trauma-exposed children had higher parent-reported ADHD severity and more externalizing problems than non-exposed children, however, this effect attenuated in adjusted model. Children with ADHD were more likely to have experienced a traumatic event than controls. The high prevalence of trauma exposure in our sample suggests that clinicians should evaluate for trauma histories in children presenting with ADHD.
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Fluegge K. Letter to the Editor: Exposure to nitrous oxide and intrusive memory formation in psychological trauma. Psychol Med 2018; 48:874-875. [PMID: 28712366 DOI: 10.1017/s003329171700191x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- K Fluegge
- Institute of Health and Environmental Research,Cleveland,OH,USA
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Uchida M, Spencer TJ, Faraone SV, Biederman J. Adult Outcome of ADHD: An Overview of Results From the MGH Longitudinal Family Studies of Pediatrically and Psychiatrically Referred Youth With and Without ADHD of Both Sexes. J Atten Disord 2018; 22:523-534. [PMID: 26396145 DOI: 10.1177/1087054715604360] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE We aimed to provide an overview of the Massachusetts General Hospital (MGH) Longitudinal Studies of ADHD. METHODS We evaluated and followed samples of boys and girls with and without ADHD ascertained from psychiatric and pediatric sources and their families. RESULTS These studies documented that ADHD in both sexes is associated with high levels of persistence into adulthood, high levels of familiality with ADHD and other psychiatric disorders, a wide range of comorbid psychiatric and cognitive disorders including mood, anxiety, and substance use disorders, learning disabilities, executive function deficits, emotional dysregulation, and autistic traits as well as functional impairments. The MGH studies suggested that stimulant treatment decreased risks of developing comorbid psychiatric disorders, substance use disorders, and functional outcomes. The MGH studies documented the neural basis of persistence of ADHD using neuroimaging. CONCLUSION The MGH studies provided various insights on symptoms, course, functions, comorbidities, and neuroscience of ADHD.
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Affiliation(s)
- Mai Uchida
- 1 Massachusetts General Hospital, Boston, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Thomas J Spencer
- 1 Massachusetts General Hospital, Boston, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Stephen V Faraone
- 3 SUNY Upstate Medical University, Syracuse, USA.,4 University of Bergen, Norway
| | - Joseph Biederman
- 1 Massachusetts General Hospital, Boston, USA.,2 Harvard Medical School, Boston, MA, USA
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Nasıroğlu S, Çeri V, Erkorkmaz Ü, Semerci B. Determinants of psychiatric disorders in children refugees in Turkey’s Yazidi refugee camp. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2017.1422958] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Serhat Nasıroğlu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Sakarya University, Sakarya, Turkey
| | - Veysi Çeri
- Pendik Training and Research Hospital, Department of Child and Adolescent Psychiatry, Medical School of Marmara University, Istanbul, Turkey
| | - Ünal Erkorkmaz
- Faculty of Medicine, Department of Biostatistics, Sakarya University, Sakarya, Turkey
| | - Bengi Semerci
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
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Scarella TM, Franzen JR. Case report: Improvement in dissociative symptoms with mixed amphetamine salts. J Trauma Dissociation 2017; 18:649-662. [PMID: 27841738 DOI: 10.1080/15299732.2016.1259195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Symptoms of dissociation, including dissociative amnesia, depersonalization, and derealization, commonly develop in individuals subject to chronic and repeated trauma during development. This includes the trauma of environmental inability to facilitate development of adequate cognitive strategies for coping with strong negative emotions. Dissociation likely involves dysregulated balance of prefrontal inhibition of limbic structures and inadequate regulation of attentional bias by both prefrontal and limbic systems. There is currently no established psychopharmacologic treatment for dissociative symptoms. Here the case of a woman with severe dissociative symptoms that were markedly improved with the administration of mixed amphetamine salts is discussed. Potential neurobiologic mechanisms for dissociative symptom improvement with psychostimulants are discussed.
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Affiliation(s)
- Timothy M Scarella
- a Department of Psychiatry , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA.,b Harvard Medical School , Boston , Massachusetts , USA
| | - Jamie R Franzen
- a Department of Psychiatry , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA.,b Harvard Medical School , Boston , Massachusetts , USA
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Spencer AE, Marin MF, Milad MR, Spencer TJ, Bogucki OE, Pope AL, Plasencia N, Hughes B, Pace-Schott EF, Fitzgerald M, Uchida M, Biederman J. Abnormal fear circuitry in Attention Deficit Hyperactivity Disorder: A controlled magnetic resonance imaging study. Psychiatry Res Neuroimaging 2017; 262:55-62. [PMID: 28235692 DOI: 10.1016/j.pscychresns.2016.12.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 12/09/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
We examined whether non-traumatized subjects with Attention Deficit Hyperactivity Disorder (ADHD) have dysfunctional activation in brain structures mediating fear extinction, possibly explaining the statistical association between ADHD and other disorders characterized by aberrant fear processing such as PTSD. Medication naïve, non-traumatized young adult subjects with (N=27) and without (N=20) ADHD underwent a 2-day fear conditioning and extinction protocol in a 3T functional magnetic resonance imaging (fMRI) scanner. Skin conductance response (SCR) was recorded as a measure of conditioned response. Compared to healthy controls, ADHD subjects had significantly greater insular cortex activation during early extinction, lesser dorsal anterior cingulate cortex (dACC) activation during late extinction, lesser ventromedial prefrontal cortex (vmPFC) activation during late extinction learning and extinction recall, and greater hippocampal activation during extinction recall. Hippocampal and vmPFC deficits were similar to those documented in PTSD subjects compared to traumatized controls without PTSD. Non-traumatized, medication naive adults with ADHD had abnormalities in fear circuits during extinction learning and extinction recall, and some findings were consistent with those previously documented in subjects with PTSD compared to traumatized controls without PTSD. These findings could explain the significant association between ADHD and PTSD as well as impaired emotion regulation in ADHD.
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Affiliation(s)
- Andrea E Spencer
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Marie-France Marin
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
| | - Mohammed R Milad
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thomas J Spencer
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Olivia E Bogucki
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Amanda L Pope
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Natalie Plasencia
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Brittany Hughes
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Edward F Pace-Schott
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
| | - Maura Fitzgerald
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Mai Uchida
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Joseph Biederman
- Pediatric Psychopharmacology and Adult ADHD Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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