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Høberg A, Solberg BS, Hegvik TA, Haavik J. Using polygenic scores in combination with symptom rating scales to identify attention-deficit/hyperactivity disorder. BMC Psychiatry 2024; 24:471. [PMID: 38937684 PMCID: PMC11210094 DOI: 10.1186/s12888-024-05925-7] [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: 11/30/2023] [Accepted: 06/20/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The inclusion of biomarkers could improve diagnostic accuracy of attention-deficit/hyperactivity disorder (ADHD). One potential biomarker is the ADHD polygenic score (PGS), a measure of genetic liability for ADHD. This study aimed to investigate if the ADHD PGS can provide additional information alongside ADHD rating scales and examination of family history of ADHD to distinguish between ADHD cases and controls. METHODS Polygenic scores were calculated for 576 adults with ADHD and 530 ethnically matched controls. ADHD PGS was used alongside scores from the Wender-Utah Rating Scale (WURS) and the Adult ADHD Self-Report Scale (ASRS) as predictors of ADHD diagnosis in a set of nested logistic regression models. These models were compared by likelihood ratio (LR) tests, Akaike information criterion corrected for small samples (AICc), and Lee R². These analyses were repeated with family history of ADHD as a covariate in all models. RESULTS The ADHD PGS increased the variance explained of the ASRS by 0.58% points (pp) (R2ASRS = 61.11%, R2ASRS + PGS=61.69%), the WURS by 0.61pp (R2WURS = 77.33%, R2WURS + PGS= 77.94%), of ASRS and WURS together by 0.57pp (R2ASRS + WURS=80.84%, R2ASRS + WURS+PGS=81.40%), and of self-reported family history by 1.40pp (R2family = 28.06%, R2family + PGS=29.46%). These increases were statistically significant, as measured by LR tests and AICc. CONCLUSION We found that the ADHD PGS contributed additional information to common diagnostic aids. However, the increase in variance explained was small, suggesting that the ADHD PGS is currently not a clinically useful diagnostic aid. Future studies should examine the utility of ADHD PGS in ADHD prediction alongside non-genetic risk factors, and the diagnostic utility of the ADHD PGS should be evaluated as more genetic data is accumulated and computational tools are further refined.
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Affiliation(s)
- André Høberg
- Department of Biomedicine, University of Bergen, Bergen, 5009, Norway.
| | - Berit Skretting Solberg
- Department of Biomedicine, University of Bergen, Bergen, 5009, Norway
- Child- and adolescent psychiatric outpatient unit, Hospital Betanien, Bergen, Norway
| | - Tor-Arne Hegvik
- Clinic of Surgery, St. Olavs Hospital, Trondheim, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, 5009, Norway
- Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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2
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Caroline S SS, Sudhir PM, Mehta UM, Kandasamy A, Thennarasu K, Benegal V. Assessing Adult ADHD: An Updated Review of Rating Scales for Adult Attention Deficit Hyperactivity Disorder (ADHD). J Atten Disord 2024; 28:1045-1062. [PMID: 38369740 DOI: 10.1177/10870547241226654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
METHOD Scholarly articles on adult ADHD between 1996 and 2022 were reviewed using the PRISMA guidelines. ADHD rating scales with multiple citations were selected and their psychometric properties and symptom coverage were analyzed. RESULTS Ten rating scales, with sound psychometric properties, were identified. Out of those reviewed two (BADDS and BAARS-IV) load on the inattentive domain of ADHD, while the rest focus on a comprehensive assessment of ADHD. Only one scale (BARRS-IV) incorporates an assessment of functional impairment. Some scales though widely utilized have not been adequately examined for their sensitivity. CONCLUSIONS Rating scales are reliable and valid, in the assessment of adult ADHD. We present a review of recent scales, with an expanded focus, to help clinicians make informed decisions on diagnosis, identifying targets and planning interventions accordingly.
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Affiliation(s)
- Sharon Suganthi Caroline S
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Paulomi M Sudhir
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Arun Kandasamy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - K Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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3
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Bergamaschi EDNC, Machado G, Rodrigues GM, Lin K. Self-reported attention and hyperactivity symptoms among adults with epilepsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-7. [PMID: 38286432 PMCID: PMC10824590 DOI: 10.1055/s-0044-1779298] [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: 01/04/2023] [Accepted: 10/24/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Patients with epilepsy (PWE) frequently have comorbid psychiatric disorders, the most common of which are depression and anxiety. Attention deficit disorder with hyperactivity (ADHD) is also more frequent among PWE, though that condition has been scarcely studied among the adult PWE population. OBJECTIVE This study aimed to compare the presence of ADHD symptoms between adult PWE and the general population. METHODS This was an observational case-control study. Ninety-five adult PWE from a tertiary center in southern Brazil were compared with 100 healthy controls. All subjects were submitted to three structured scales: 1) the World Health Organization Adult ADHD Self-Report Scale version 1.1 (ASRS); 2) the Hospital Anxiety and Depression Scale (HADS); and 3) the Adverse Events Profile (AEP). Dichotomic variables were analyzed through chi-square test and Fisher's exact test, as appropriate, and non-parametric variables were analyzed through the Mann-Whitney U test. RESULTS Medians and interquartile ranges (IR) were: 1) ASRS: 26.00 (IR: 18 to 38) among PWE versus 17.00 (IR: 11 to 24) among controls, p < 0.001; 2) HADS: 14.00 (IR: 8 to 21) among PWE versus 11.00 (IR: 8 to 16) among controls, p = 0.007; 3) AEP: 3800 (IR: 31 to 49) among PWE versus 33.00 (IR: 23 to 43) among controls, p = 0.001. CONCLUSION PWE showed a higher burden of symptoms of ADHD, depression, and anxiety when compared with controls, which replicates in the Brazilian population the findings of current literature that point toward a higher prevalence of such disorders among PWE.
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Affiliation(s)
| | - Gabriela Machado
- Universidade Federal de Santa Catarina, Florianópolis SC, Brazil.
| | | | - Katia Lin
- Universidade Federal de Santa Catarina, Florianópolis SC, Brazil.
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4
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Soler-Gutiérrez AM, Pérez-González JC, Mayas J. Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLoS One 2023; 18:e0280131. [PMID: 36608036 PMCID: PMC9821724 DOI: 10.1371/journal.pone.0280131] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder, with an onset in childhood, that accompanies the person throughout their life, with prevalence between 3 and 5% in adults. Recent studies point towards a fourth core symptom of the disorder related to the emotional information processing that would explain the repercussions that ADHD has on the social, academic, and professional life of the people affected. This review aims to describe emotion dysregulation features as well as the brain activity associated in adults with ADHD. A search of the scientific literature was launched in specialized databases: PsycInfo, Medline, Eric, PsycArticle, Psicodoc and Scopus, following PRISMA guidelines. Twenty-two articles met the inclusion criteria: (a) an ADHD clinical diagnosis, (b) participants over 18 years old, (c) emotion regulation measurement, (d) empirical studies, and (c) in English. Due to the heterogeneity of the studies included, they were classified into three sections: measures and features of emotion regulation (ER) in people with ADHD, neurological and psychophysiological activity related to ER, and treatments. The studies found that meet the selection criteria are scarce and very heterogeneous both in aims and in sample features. Adults with ADHD show a more frequent use of non-adaptive emotion regulation strategies compared to people without ADHD symptoms. Moreover, emotion dysregulation was associated with symptom severity, executive functioning, psychiatric comorbidities, and even with criminal conviction. Different patterns of brain activity were observed when people with and without ADHD were compared. These results may suggest that psychopharmacological treatments as well as behavioral therapies could be useful tools for improving emotional difficulties in adult ADHD.
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Affiliation(s)
- Ana-María Soler-Gutiérrez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Julia Mayas
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- * E-mail:
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5
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Zlomuzica A, Plank L, Dere E. A new path to mental disorders: Through gap junction channels and hemichannels. Neurosci Biobehav Rev 2022; 142:104877. [PMID: 36116574 DOI: 10.1016/j.neubiorev.2022.104877] [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: 01/31/2022] [Revised: 08/20/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022]
Abstract
Behavioral disturbances related to emotional regulation, reward processing, cognition, sleep-wake regulation and activity/movement represent core symptoms of most common mental disorders. Increasing empirical and theoretical evidence suggests that normal functioning of these behavioral domains relies on fine graded coordination of neural and glial networks which are maintained and modulated by intercellular gap junction channels and unapposed pannexin or connexin hemichannels. Dysfunctions in these networks might contribute to the development and maintenance of psychopathological and neurobiological features associated with mental disorders. Here we review and discuss the evidence indicating a prominent role of gap junction channel and hemichannel dysfunction in core symptoms of mental disorders. We further discuss how the increasing knowledge on intercellular gap junction channels and unapposed pannexin or connexin hemichannels in the brain might lead to deeper mechanistic insight in common mental disorders and to the development of novel treatment approaches. We further attempt to exemplify what type of future research on this topic could be integrated into multidimensional approaches to understand and cure mental disorders.
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Affiliation(s)
- Armin Zlomuzica
- Department of Behavioral and Clinical Neuroscience, Ruhr-University Bochum (RUB), Massenbergstraße 9-13, D-44787 Bochum, Germany.
| | - Laurin Plank
- Department of Behavioral and Clinical Neuroscience, Ruhr-University Bochum (RUB), Massenbergstraße 9-13, D-44787 Bochum, Germany
| | - Ekrem Dere
- Department of Behavioral and Clinical Neuroscience, Ruhr-University Bochum (RUB), Massenbergstraße 9-13, D-44787 Bochum, Germany; Sorbonne Université. Institut de Biologie Paris-Seine, (IBPS), Département UMR 8256: Adaptation Biologique et Vieillissement, UFR des Sciences de la Vie, Campus Pierre et Marie Curie, Bâtiment B, 9 quai Saint Bernard, F-75005 Paris, France.
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6
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Mestre-Bach G, Granero R, Fernández-Aranda F, Potenza MN, Jiménez-Murcia S. Exploring the pathways model in a sample of patients with gambling disorder. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2029527] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gemma Mestre-Bach
- Facultat de ciencias de la salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Roser Granero
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, and CIBERobn, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn/ Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Spain
| | - Marc N. Potenza
- Department of psychiatry, Yale School of Medicine, Connecticut Mental Health Center and Connecticut Council on Problem Gambling
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn/ Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Spain
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7
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Mestre-Bach G, Steward T, Potenza MN, Granero R, Fernández-Aranda F, Mena-Moreno T, Magaña P, Vintró-Alcaraz C, Del Pino-Gutiérrez A, Menchón JM, Jiménez-Murcia S. The Role of ADHD Symptomatology and Emotion Dysregulation in Gambling Disorder. J Atten Disord 2021; 25:1230-1239. [PMID: 31884864 DOI: 10.1177/1087054719894378] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: Although emotion regulation deficits have been implicated in gambling disorder and ADHD, the interplay between these factors has yet to be systematically studied. We examined relationships between ADHD symptoms, emotion regulation, and gambling disorder severity in a sample of treatment-seeking gambling disorder patients (n = 98). We also examined clinical differences between patients with and without ADHD symptomatology. Method: Structural equation modeling (SEM) evaluated direct and indirect effects of ADHD and emotion regulation on gambling disorder severity. Results: Significant correlations between ADHD symptomatology and emotion regulation and between emotion regulation and gambling disorder severity were identified. Differences in emotion regulation were found between gambling disorder patients with and without ADHD symptomatology. Path analysis revealed emotion regulation to be a mediator between ADHD and gambling disorder. Conclusion: Our findings indicate the presence of ADHD symptomatology to be associated with greater severity of gambling disorder and greater emotional dysregulation.
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Affiliation(s)
- Gemma Mestre-Bach
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Yale School of Medicine, New Haven, CT, USA
| | - Trevor Steward
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,The University of Melbourne, Parkville, Victoria, Australia
| | - Marc N Potenza
- Yale School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, USA.,Connecticut Mental Health Center, New Haven, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Universitat Autònoma de Barcelona, Spain
| | - Fernando Fernández-Aranda
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,University of Barcelona, Spain
| | - Teresa Mena-Moreno
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo Magaña
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | | | - José M Menchón
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,University of Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,University of Barcelona, Spain
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8
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Camp A, Pastrano A, Gomez V, Stephenson K, Delatte W, Perez B, Syas H, Guiseppi-Elie A. Understanding ADHD: Toward an Innovative Therapeutic Intervention. Bioengineering (Basel) 2021; 8:56. [PMID: 34062853 PMCID: PMC8147268 DOI: 10.3390/bioengineering8050056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a pervasive condition affecting persons across all age groups, although it is primarily diagnosed in children. This neurological condition affects behavior, learning, and social adjustment and requires specific symptomatic criteria to be fulfilled for diagnosis. ADHD may be treated with a combination of psychological or psychiatric therapeutic interventions, but it often goes unattended. People with ADHD face societal bias challenges that impact how they manage the disorder and how they view themselves. This paper summarizes the present state of understanding of this disorder, with particular attention to early diagnosis and innovative therapeutic intervention. Contemporary understanding of the mind-brain duality allows for innovative therapeutic interventions based on neurological stimulation. This paper introduces the concept of neurostimulation as a therapeutic intervention for ADHD and poses the question of the relationship between patient adherence to self-administered therapy and the aesthetic design features of the neurostimulation device. By fabricating devices that go beyond safety and efficacy to embrace the aesthetic preferences of the patient, it is proposed that there will be improvements in patient adherence to a device intended to address ADHD.
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Affiliation(s)
- Allyson Camp
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Amanda Pastrano
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Valeria Gomez
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Kathleen Stephenson
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - William Delatte
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Brianna Perez
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Hunter Syas
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Anthony Guiseppi-Elie
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
- Houston Methodist Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Ave., Houston, TX 77030, USA
- Department of Electrical and Computer Engineering, College of Engineering, Anderson University, Anderson, SC 29621, USA
- ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA 23219, USA
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9
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Coelho RM, Drummond C, Mota NB, Erthal P, Bernardes G, Lima G, Molina R, Sudo FK, Tannock R, Mattos P. Network analysis of narrative discourse and attention-deficit hyperactivity symptoms in adults. PLoS One 2021; 16:e0245113. [PMID: 33826632 PMCID: PMC8026017 DOI: 10.1371/journal.pone.0245113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022] Open
Abstract
Previous research investigating language in attention-deficit hyperactivity disorder (ADHD) has demonstrated several deficits in many aspects. However, no previous study employed quantitative methodology providing objective measures that could be compared among different studies with diverse samples. To fill this gap, we used network analysis to investigate how ADHD symptomatology impacts narrative discourse, a complex linguistic task considered to be an ecological measure of language. Fifty-eight adults (34 females and 24 males) with a mean age of 26 years old and a mean of 17 years of educational level were administered the Adult Self-Rating Scale for ADHD symptomatology. They also completed the State-Trait Anxiety Inventory, the Beck Depression Inventory and the Urgency, Premeditation, Perseverance, Sensation Seeking Behavior Scale. Intelligence quotient was calculated. Individuals were asked to tell a story based on a wordless picture book. Speech was recorded and transcribed as an input to SpeechGraphs software. Parameters were total number of words (TNW), number of loops of one node (L1), repeated edges (RE), largest strongly connected component (LSC) and average shortest path (ASP). Verbosity was controlled. Statistical analysis was corrected for multiples comparisons and partial correlations were performed for confounding variables. After controlling for anxiety, depression, IQ, and impulsiveness ADHD symptomatology was positively correlated with L1 and negatively correlated with LSC. TNW was positively correlated with ADHD symptoms. In a subdomain analysis, both inattention and hyperactivity-impulsivity were negatively correlated with LSC. Only hyperactivity-impulsivity positively correlated with TNW and L1. Results indicated a correlation between ADHD symptoms and lower connectedness in narrative discourse (as indicated by higher L1 and lower LSC), as well as higher total number of words (TNW). Our results suggest that the higher the number of ADHD symptoms, the less connectivity among words, and a higher number of words in narrative discourse.
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Affiliation(s)
| | - Cláudia Drummond
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil.,Department of speech and hearing pathology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Pilar Erthal
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Gabriel Bernardes
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Gabriel Lima
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Raquel Molina
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Felipe Kenji Sudo
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Rosemary Tannock
- Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Paulo Mattos
- Institute D'Or for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil.,Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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10
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Walhovd KB, Amlien I, Schrantee A, Rohani DA, Groote I, Bjørnerud A, Fjell AM, Reneman L. Methylphenidate Effects on Cortical Thickness in Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial. AJNR Am J Neuroradiol 2020; 41:758-765. [PMID: 32414901 DOI: 10.3174/ajnr.a6560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/08/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although methylphenidate is frequently used to treat children with attention-deficit/hyperactivity disorder, it is currently unknown how methylphenidate affects brain development. In a randomized controlled trial, we investigated whether the cortical effects of methylphenidate are modulated by age. MATERIALS AND METHODS Between June 1, 2011, and June 15, 2015, we conducted a randomized, double-blind, placebo-controlled trial (Effects of Psychotropic Drugs on Developing Brain-Methylphenidate) in 99 males with attention-deficit/hyperactivity disorder (according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria) from referral centers in the greater Amsterdam area in the Netherlands. The trial was registered on March 24, 2011 (identifier NL34509.000.10) and subsequently at the Netherlands National Trial Register (identifier NTR3103). Participants (first enrolled October 13, 2011) were 10-12 years or 23-40 years of age and randomized to treatment with either methylphenidate or a placebo for 16 weeks. Our main outcome was a change in cortical thickness in predefined ROIs as measured by MR imaging pre- and posttreatment. RESULTS We observed a time × medication × age interaction (F[1,88.825] = 4.316, P < .05) for the right medial cortex ROI, where methylphenidate treatment yielded less cortical thinning in children, but not in adults or the placebo groups. CONCLUSIONS Our finding that the effects of methylphenidate on right medial cortical thickness differ between children and adults infers that the drug affects gray matter development in this brain region. This warrants replication in larger groups with longer follow-up to determine whether this effect can also be observed in other cortical brain regions and whether it may have long-term consequences.
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Affiliation(s)
- K B Walhovd
- From the Department of Psychology (K.B.W., I.A., D.A.R., A.B., A.M.F.), Center for Lifespan Changes in Brain and Cognition.,Departments of Radiology and Nuclear Medicine (K.B.W., A.M.F.)
| | - I Amlien
- From the Department of Psychology (K.B.W., I.A., D.A.R., A.B., A.M.F.), Center for Lifespan Changes in Brain and Cognition
| | - A Schrantee
- Department of Radiology and Nuclear Medicine (A.S., A.B., L.R.), Amsterdam UMC, Academic Medical Center, Amsterdam, the Netherlands
| | - D A Rohani
- From the Department of Psychology (K.B.W., I.A., D.A.R., A.B., A.M.F.), Center for Lifespan Changes in Brain and Cognition
| | - I Groote
- Diagnostic Physics (I.G., A.B.), Oslo University Hospital, Oslo, Norway
| | - A Bjørnerud
- From the Department of Psychology (K.B.W., I.A., D.A.R., A.B., A.M.F.), Center for Lifespan Changes in Brain and Cognition.,Institute of Physics (A.B.), Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.,Diagnostic Physics (I.G., A.B.), Oslo University Hospital, Oslo, Norway.,Department of Radiology and Nuclear Medicine (A.S., A.B., L.R.), Amsterdam UMC, Academic Medical Center, Amsterdam, the Netherlands
| | - A M Fjell
- From the Department of Psychology (K.B.W., I.A., D.A.R., A.B., A.M.F.), Center for Lifespan Changes in Brain and Cognition.,Departments of Radiology and Nuclear Medicine (K.B.W., A.M.F.)
| | - L Reneman
- Department of Radiology and Nuclear Medicine (A.S., A.B., L.R.), Amsterdam UMC, Academic Medical Center, Amsterdam, the Netherlands.
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Pan MR, Zhao MJ, Liu L, Li HM, Wang YF, Qian QJ. Cognitive behavioural therapy in groups for medicated adults with attention deficit hyperactivity disorder: protocol for a randomised controlled trial. BMJ Open 2020; 10:e037514. [PMID: 33020094 PMCID: PMC7537466 DOI: 10.1136/bmjopen-2020-037514] [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] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Cognitive behavioural therapy (CBT) is an evidence-based treatment for adults with attention deficit hyperactivity disorder (ADHD). However, it is still inconsistent whether a combination of CBT would have additive effects in medicated ADHD in adulthood. And if CBT would have additional effects, what kind and which dimension would CBT play a part? This study estimates the efficacy of CBT in stable medicated adult ADHD, using long-term outcomes and multidimensional evaluations. METHODS AND ANALYSIS It is a two-armed, randomised controlled trial on the superiority of the efficacy of 12 weeks of CBT on medicated adult ADHD. We compare the short-term and long-term outcomes between CBT combined with medication (CBT+M) group and the medication-only (M) group, including ADHD core symptoms, emotional symptoms, executive function, self-esteem, life quality and brain function using functional near-infrared spectroscopy data. Participants are outpatients of the Peking University Sixth Hospital and those recruited online, diagnosed as adult ADHD and with stable medication treatment. We estimate ADHD core symptoms and combined symptoms at baseline (T1) and week 12 (T2), week 24 (T3), week 36 (T4) and week 48 (T5). ETHICS AND DISSEMINATION This trial has been approved by the Ethics and Clinical Research Committees of Peking University Sixth Hospital and will be performed under the Declaration of Helsinki with the Medical Research Involving Human Subjects Act (WMO). The results will be disseminated in a peer-reviewed journal and a conference presentation. TRIAL REGISTRATION NUMBER ChiCTR (ChiCTR1900021705).
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Affiliation(s)
- Mei-Rong Pan
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Meng-Jie Zhao
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hai-Mei Li
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yu-Feng Wang
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qiu-Jin Qian
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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12
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Fontes RM, Marinho V, Carvalho V, Rocha K, Magalhães F, Moura I, Ribeiro P, Velasques B, Cagy M, Gupta DS, Bastos VH, Teles AS, Teixeira S. Time estimation exposure modifies cognitive aspects and cortical activity of attention deficit hyperactivity disorder adults. Int J Neurosci 2020; 130:999-1014. [DOI: 10.1080/00207454.2020.1715394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rhailana Medeiros Fontes
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Marinho
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Valécia Carvalho
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Kaline Rocha
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Francisco Magalhães
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Iris Moura
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
| | - Pedro Ribeiro
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Bruna Velasques
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Mauricio Cagy
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Daya S. Gupta
- Department of Biology, Camden County College, Blackwood, NJ, USA
| | - Victor Hugo Bastos
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
- Brain Mapping and Functionality Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Ariel Soares Teles
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
- Federal Institute of Maranhão, Maranhão, Brazil
| | - Silmar Teixeira
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
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13
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Muit JJ, Bothof N, Kan CC. Pharmacotherapy of ADHD in Adults With Autism Spectrum Disorder: Effectiveness and Side Effects. J Atten Disord 2020; 24:215-225. [PMID: 31625426 PMCID: PMC6939322 DOI: 10.1177/1087054719866255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective: Symptoms of ADHD are expected to be more difficult to treat in patients with a combination of ADHD and autism spectrum disorder (ASD) as opposed to only ADHD. Little evidence is available on the influence of ASD on the effects of pharmacotherapy in adults with ADHD. This study addresses this gap. Method: 60 adults with ADHD and comorbid ASD were selected from an outpatient clinic and compared with 226 adults from the same clinic with only ADHD. Similar treatment regimens were received. Results: Significant decreases in symptoms of ADHD were found in both groups. A diagnosis of ASD did not affect the reduction in symptoms of ADHD. No significant group differences in side effects or vital signs were found. Conclusion: Results show that medication for ADHD can effectively and safely be prescribed to patients with ADHD and comorbid ASD. Suggestions for future research are discussed.
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Affiliation(s)
- J. J. Muit
- Radboud University Medical Center, Nijmegen, The Netherlands,J. J. Muit, Department of Psychiatry, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - N. Bothof
- GGZ Oost Brabant, Boekel, The Netherlands
| | - C. C. Kan
- Radboud University Medical Center, Nijmegen, The Netherlands
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14
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Nickel K, Maier S, Endres D, Joos A, Maier V, Tebartz van Elst L, Zeeck A. Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Front Psychiatry 2019; 10:708. [PMID: 31649563 PMCID: PMC6796791 DOI: 10.3389/fpsyt.2019.00708] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 09/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Links between eating disorders (EDs) [e.g., anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED)] and the major neurodevelopmental disorders of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have been repeatedly highlighted. In both ASD and ADHD, these links range from an elevated risk for EDs to common symptomatic overlaps and etiological commonalities with EDs. Methods: We performed a systematic literature search (through July 2019) with Medline via Ovid for epidemiological data on EDs (AN, BN, and BED) in combination with both ASD and ADHD. Results: The reviewed studies showed that, on average, 4.7% of patients with certain ED diagnoses (AN, BN, or BED) received an ASD diagnosis. Reliable data on the prevalence of EDs in ASD samples are still scarce. Comorbid ASD is most commonly diagnosed in patients with AN. The prevalence of ADHD in EDs ranged between 1.6% and 18%. Comorbid ADHD was more often reported in the AN-binge eating/purging subtype and BN than in the AN restrictive subtype. The prevalence of EDs in ADHD ranged between no association and a lifetime prevalence of 21.8% of developing an ED in women with ADHD. Conclusions: Studies on the prevalence rates of EDs in ADHD and ASD and vice versa are heterogeneous, but they indicate frequent association. While there is growing evidence of clinical overlaps between the three disorders, it remains difficult to determine whether overlapping characteristics (e.g., social withdrawal) are due to common comorbidities (e.g., depression) or are instead primarily associated with EDs and neurodevelopmental disorders. Furthermore, prospective studies are required to better understand how these disorders are related and whether ADHD and ASD could be either specific or nonspecific predisposing factors for the development of EDs.
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Affiliation(s)
- Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon Maier
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Joos
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Psychotherapeutic Neurology, Kliniken Schmieder, Gailingen, Germany
| | - Viktoria Maier
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Almut Zeeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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15
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Pantoni MM, Carmack SA, Hammam L, Anagnostaras SG. Dopamine and norepinephrine transporter inhibition for long-term fear memory enhancement. Behav Brain Res 2019; 378:112266. [PMID: 31580915 DOI: 10.1016/j.bbr.2019.112266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 12/25/2022]
Abstract
Psychostimulants are highly effective cognitive-enhancing therapeutics yet have a significant potential for abuse and addiction. While psychostimulants likely exert their rewarding and addictive properties through dopamine transporter (DAT) inhibition, the mechanisms of their procognitive effects are less certain. By one prevalent view, psychostimulants exert their procognitive effects exclusively through norepinephrine transporter (NET) inhibition, however increasing evidence suggests that DAT also plays a critical role in their cognitive-enhancing properties, including long-term memory enhancement. The present experiments test the hypothesis that combined strong NET and weak DAT inhibition will mimic the fear memory-enhancing but not the addiction-related effects of psychostimulants in mice. We examined the effects of the high affinity NET inhibitors atomoxetine or nisoxetine and the low affinity DAT inhibitor bupropion, either alone or in combination, on short- and long-term memory of Pavlovian fear conditioning. We also examined the addiction-related effects of combined strong NET and weak DAT inhibition using conditioned place preference and a locomotor activity test. While atomoxetine or nisoxetine alone enhanced short-term fear memory, the addition of bupropion was required to significantly enhance long-term fear memory. Additionally, combined atomoxetine and bupropion did not produce substantial motor stimulation or place preference. These findings suggest that combining strong NET and weak DAT inhibition could lead to the development of a highly effective cognitive enhancer that lacks the potential for addiction.
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Affiliation(s)
- Madeline M Pantoni
- Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA 92093-0109, USA.
| | - Stephanie A Carmack
- Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA 92093-0109, USA
| | - Leen Hammam
- Division of Biology, University of California San Diego, La Jolla, CA 92093-0109, USA
| | - Stephan G Anagnostaras
- Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA 92093-0109, USA; Program in Neurosciences, University of California San Diego, La Jolla, CA 92093-0109, USA
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16
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Södersten P, Brodin U, Zandian M, Bergh CEK. Verifying Feighner's Hypothesis; Anorexia Nervosa Is Not a Psychiatric Disorder. Front Psychol 2019; 10:2110. [PMID: 31607977 PMCID: PMC6756277 DOI: 10.3389/fpsyg.2019.02110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/30/2019] [Indexed: 12/17/2022] Open
Abstract
Mental causation takes explanatory priority over evolutionary biology in most accounts of eating disorders. The evolutionary threat of starvation has produced a brain that assists us in the search for food and mental change emerges as a consequence. The major mental causation hypothesis: anxiety causes eating disorders, has been extensively tested and falsified. The subsidiary hypothesis: anxiety and eating disorders are caused by the same genotype, generates inconsistent results because the phenotypes are not traits, but vary along dimensions. Challenging the mental causation hypothesis in Feighner et al. (1972) noted that anorexic patients are physically hyperactive, hoarding for food, and they are rewarded for maintaining a low body weight. In 1996, Feighner's hypothesis was formalized, relating the patients' behavioral phenotype to the brain mechanisms of reward and attention (Bergh and Södersten, 1996), and in 2002, the hypothesis was clinically verified by training patients how to eat normally, thus improving outcomes (Bergh et al., 2002). Seventeen years later we provide evidence supporting Feighner's hypothesis by demonstrating that in 2012, 20 out of 37 patients who were referred by a psychiatrist, had a psychiatric diagnosis that differed from the diagnosis indicated by the SCID-I. Out of the 174 patients who were admitted in 2012, most through self-referral, there was significant disagreement between the outcomes of the SCID-I interview and the patient's subjective experience of a psychiatric problem in 110 of the cases. In addition, 358 anorexic patients treated to remission scored high on the Comprehensive Psychopathological Rating Scale, but an item response analysis indicated one (unknown) underlying dimension, rather than the three dimensions the scale can dissociate in patients with psychiatric disorders. These results indicate that psychiatric diagnoses, which are reliable and valid in patients with psychiatric disorders, are less well suited for patients with anorexia. The results are in accord with the hypothesis of the present Research Topic, that eating disorders are not always caused by disturbed psychological processes, and support the alternative, clinically relevant hypothesis that the behavioral phenotype of the patients should be addressed directly.
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Affiliation(s)
- Per Södersten
- Karolinska Institutet, Mandometer Clinics, Huddinge, Sweden
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17
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A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with attention-deficit/hyperactivity disorder (ADHD). Psychiatry Res 2019; 279:23-33. [PMID: 31280035 DOI: 10.1016/j.psychres.2019.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/11/2022]
Abstract
The study aimed to explore whether cognitive behavioral therapy (CBT) combined with medication is superior to CBT alone in core symptoms, emotional symptoms, self-esteem as well as social and cognitive functions of adult attention-deficit/hyperactivity disorder (ADHD) patients. Samples from a previous RCT study and outpatient participants were all included. A total of 124 patients received 12 weeks of manualized CBT sessions, either with (n = 57) or without (n = 67) medication. Efficacy variables were evaluated at baseline and each week. Mixed linear models (MLM) were used to compare differences between the two groups in all of the above domains. Within-group comparisons showed that both groups had robust improvements in core ADHD symptoms, emotional symptoms and social functional outcomes. The CBT + M group presented more domains of improvement in executive functions than the CBT group. However, comparisons between groups didn't indicate the superiority of CBT + M in core symptoms, emotional symptoms and self-esteem. Instead, the CBT group showed a greater improvement in the physical domain of the WHOQOL-BREF than the CBT + M group. This study further indicated that CBT is an effective treatment for adults with ADHD. A combination of CBT and medication presented broader improvements in executive functions, but not in clinical symptoms, than CBT alone.
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18
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Huang F, Tang YL, Zhao M, Wang Y, Pan M, Wang Y, Qian Q. Cognitive-Behavioral Therapy for Adult ADHD: A Randomized Clinical Trial in China. J Atten Disord 2019; 23:1035-1046. [PMID: 28866911 DOI: 10.1177/1087054717725874] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Cognitive-behavioral therapy (CBT) is effective for adult ADHD, and booster sessions may improve long-term outcome. This study was designed to investigate the effects of group CBT and its booster sessions for Chinese adult patients with ADHD. METHOD There were CBT only group ( n = 43), CBT +booster group ( n = 43), and control group with patients on the waiting list ( n = 22). The primary outcome was the score of the ADHD-Rating Scale (ADHD-RS). Secondary outcomes included emotion, executive function (EF), impulsivity, self-esteem, and life quality at 12th and 24th week. RESULTS At 12th week, the score of ADHD-RS, EF, and impulsivity showed significant improvement in CBT +booster group comparing with control group. At 24th week, differences between CBT only group and CBT +booster group were not significant. CONCLUSION CBT was effective for Chinese adult patients with ADHD. Booster sessions do not appear to provide additional benefits.
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Affiliation(s)
- Fang Huang
- 1 Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,2 Key Laboratory of Mental Health, Ministry of Health(Peking University), Beijing, China
| | - Yi-Lang Tang
- 3 Emory University, School of Medicine, Atlanta, GA, USA.,4 Atlanta VA Medical Center, Decatur, GA, USA
| | - Mengjie Zhao
- 1 Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,2 Key Laboratory of Mental Health, Ministry of Health(Peking University), Beijing, China
| | - Yanfei Wang
- 1 Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,2 Key Laboratory of Mental Health, Ministry of Health(Peking University), Beijing, China
| | - Meirong Pan
- 1 Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,2 Key Laboratory of Mental Health, Ministry of Health(Peking University), Beijing, China
| | - Yufeng Wang
- 1 Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,2 Key Laboratory of Mental Health, Ministry of Health(Peking University), Beijing, China
| | - Qiujin Qian
- 1 Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,2 Key Laboratory of Mental Health, Ministry of Health(Peking University), Beijing, China
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19
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Association of symptoms of attention deficit-hyperactivity disorder and impulsive-aggression with severity of suicidal behavior in adult attempters. Sci Rep 2019; 9:4593. [PMID: 30872743 PMCID: PMC6418227 DOI: 10.1038/s41598-019-41046-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/19/2019] [Indexed: 01/28/2023] Open
Abstract
Literature emphasizes the relationship between attention deficit-hyperactivity disorder (ADHD) and suicidal behavior (SB). However, the link between ADHD and the severity of SB is yet to be determined. We investigated the association between a probable diagnosis of ADHD and the severity of SB in 539 hospitalized suicide attempters, and determined the role of comorbid psychiatric diagnoses. The severity of SB was defined as the number of suicide attempts, age at first suicide attempt, seriousness and violence of suicide attempts. A diagnosis of probable adult ADHD (probable ADHD) was defined as the presence of both current ADHD symptoms and ADHD symptoms in childhood. We evaluated the combined effect of high impulsive-aggression levels and probable ADHD. Probable ADHD was not associated with early or frequent suicide attempts after adjustment for psychiatric disorders and treatment intake. High levels of impulsive-aggression increased the risk of an early suicide attempt, particularly in patients with ADHD symptoms, and independently of other clinical factors. The association between serious suicide attempts and probable ADHD remained significant after adjustment. Although ADHD is involved in suicidal vulnerability, psychiatric comorbidities and impulsive-aggression appear to largely explain the severity of SB in adult attempters with ADHD symptoms.
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20
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Trejo S, Matute E, de Lourdes Ramírez-Dueñas M, Mendizabal-Ruiz AP, Chamorro Y, Morales JA. "Like parent, like child": Attention deficit hyperactivity disorder-like characteristics in parents of ADHD cases. Am J Med Genet B Neuropsychiatr Genet 2018; 177:676-684. [PMID: 30338900 DOI: 10.1002/ajmg.b.32676] [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: 02/27/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 11/06/2022]
Abstract
The objective of this study was to characterize an attention deficit hyperactivity disorder (ADHD) endophenotype in non-affected parents of adolescents with a history of ADHD, based on the relationship between performance on a sustained attention test (continuous performance task, or CPT) and polymorphisms of the DRD4 gene. In a sample of 25 non-affected parents of adolescents with ADHD history obtained from a longitudinal study of a nonclinical population, and 25 non-affected parents of adolescents with no ADHD history, four groups were evaluated with respect to the presence or absence of the long allele polymorphism of the DRD4 gene (i.e., over seven repeats). Comparisons of CPT performance among the four study groups included the number of commission errors, the number of omission errors, mean reaction time on correct responses (MRT), and reaction time (RT) variability (mean standard deviation of RT in each block [SDRT, as variability], and the sigma and tau components of the ex-Gaussian approach). The group of non-affected parents of adolescents with ADHD history and at least one long allele of the DRD4 gene showed greater RT variability (measured by SDRT), which is best explained by the greater frequency of abnormally slow responses (measured by tau). An association between the presence of the long allele of the DRD4 gene polymorphism and ADHD-like failure in CPT performance was evident in the non-affected parents of adolescents with ADHD in childhood. These findings suggest that certain traits of CPT performance could be considered an ADHD endophenotype.
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Affiliation(s)
- Salvador Trejo
- Laboratorio de Neuropsicología y Neurolingüística, Instituto de Neurociencias CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Esmeralda Matute
- Laboratorio de Neuropsicología y Neurolingüística, Instituto de Neurociencias CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - María de Lourdes Ramírez-Dueñas
- Laboratorio de Neuropsicología y Neurolingüística, Instituto de Neurociencias CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Adriana P Mendizabal-Ruiz
- Laboratorio de Neuropsicología y Neurolingüística, Instituto de Neurociencias CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.,Departamento de Farmacobiología y Departamento de Ciencias Computacionales, CUCEI, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Yaira Chamorro
- Laboratorio de Neuropsicología y Neurolingüística, Instituto de Neurociencias CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - José A Morales
- Laboratorio de Neuropsicología y Neurolingüística, Instituto de Neurociencias CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.,Departamento de Farmacobiología y Departamento de Ciencias Computacionales, CUCEI, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
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21
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Paz Y, Friedwald K, Levkovitz Y, Zangen A, Alyagon U, Nitzan U, Segev A, Maoz H, Koubi M, Bloch Y. Randomised sham-controlled study of high-frequency bilateral deep transcranial magnetic stimulation (dTMS) to treat adult attention hyperactive disorder (ADHD): Negative results. World J Biol Psychiatry 2018; 19:561-566. [PMID: 28090806 DOI: 10.1080/15622975.2017.1282170] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Recent studies support the possible effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a treatment for attention deficit hyperactivity disorder (ADHD). The objective of this study was to evaluate the safety and possible efficacy of bilateral prefrontal deep rTMS for the treatment of adult ADHD. METHODS Twenty-six adult ADHD patients were randomised blindly to sham or actual deep TMS (dTMS). Twenty daily sessions were conducted using the bilateral H5 dTMS coil (Brainsway, IL) in order to stimulate the prefrontal cortex at 120% of the motor threshold at high frequency. For assessment, Conners' Adult ADHD Rating Scale questionnaire and a computerised continuous performance test, Test of Variables of Attention, were used. RESULTS No differences in clinical outcomes were detected between the actual dTMS and sham groups. CONCLUSIONS The presented evidence does not support the utility of bilateral prefrontal stimulation to treat adult ADHD. Due to the small sample size, caution must be exercised in interpreting our preliminary findings.
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Affiliation(s)
- Yaniv Paz
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
| | - Keren Friedwald
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
| | - Yeheal Levkovitz
- c Beer-Yaakov Mental Health Center, Ministry of Health, Sackler Faculty of Medicine , Tel Aviv University , Beer-Yaakov , Israel
| | - Abraham Zangen
- d Department of Life Sciences and the Zlotowski Center for Neuroscience , Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Uri Alyagon
- d Department of Life Sciences and the Zlotowski Center for Neuroscience , Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Uri Nitzan
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
| | - Aviv Segev
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
| | - Hagai Maoz
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
| | - May Koubi
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
| | - Yuval Bloch
- a Shalvata Mental Health Care Center , Hod-Hasharon , Israel.,b Sackler School of Medicine , Tel Aviv University, Ramat Aviv , Tel Aviv , Israel
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Mathews CL, Morrell HER, Molle JE. Video game addiction, ADHD symptomatology, and video game reinforcement. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:67-76. [PMID: 29874473 DOI: 10.1080/00952990.2018.1472269] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Up to 23% of people who play video games report symptoms of addiction. Individuals with attention deficit hyperactivity disorder (ADHD) may be at increased risk for video game addiction, especially when playing games with more reinforcing properties. OBJECTIVES The current study tested whether level of video game reinforcement (type of game) places individuals with greater ADHD symptom severity at higher risk for developing video game addiction. METHODS Adult video game players (N = 2,801; Mean age = 22.43, SD = 4.70; 93.30% male; 82.80% Caucasian) completed an online survey. Hierarchical multiple linear regression analyses were used to test type of game, ADHD symptom severity, and the interaction between type of game and ADHD symptomatology as predictors of video game addiction severity, after controlling for age, gender, and weekly time spent playing video games. RESULTS ADHD symptom severity was positively associated with increased addiction severity (b = .73 and .68, ps < 0.001). Type of game played or preferred the most was not associated with addiction severity, ps > .05. The relationship between ADHD symptom severity and addiction severity did not depend on the type of video game played or preferred most, ps > .05. CONCLUSION Gamers who have greater ADHD symptom severity may be at greater risk for developing symptoms of video game addiction and its negative consequences, regardless of type of video game played or preferred most. Individuals who report ADHD symptomatology and also identify as gamers may benefit from psychoeducation about the potential risk for problematic play.
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Affiliation(s)
| | - Holly E R Morrell
- a Department of Psychology , Loma Linda University, Loma Linda, CA, USA
| | - Jon E Molle
- b Department of Computer Science and Engineering , University of California, Riverside, CA, USA
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23
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Lee HJ, Tran DD, Morrell HER. Smoking, ADHD, and Problematic Video Game Use: A Structural Modeling Approach. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 21:281-286. [PMID: 29652524 DOI: 10.1089/cyber.2017.0429] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Problematic video game use (PVGU), or addiction-like use of video games, is associated with physical and mental health problems and problems in social and occupational functioning. Possible correlates of PVGU include frequency of play, cigarette smoking, and attention deficit hyperactivity disorder (ADHD). The aim of the current study was to explore simultaneously the relationships among these variables as well as test whether two separate measures of PVGU measure the same construct, using a structural modeling approach. Secondary data analysis was conducted on 2,801 video game users (Mage = 22.43 years, standard deviation [SD]age = 4.7; 93 percent male) who completed an online survey. The full model fit the data well: χ2 (2) = 2.017, p > 0.05; root mean square error of approximation (RMSEA) = 0.002 (90% CI [0.000-0.038]); comparative fit index (CFI) = 1.000; standardized root mean square residual (SRMR) = 0.004; and all standardized residuals <|0.1|. All freely estimated paths were statistically significant. ADHD symptomatology, smoking behavior, and hours of video game use explained 41.8 percent of variance in PVGU. Tracking these variables may be useful for PVGU prevention and assessment. Young's Internet Addiction Scale, adapted for video game use, and the Problem Videogame Playing Scale both loaded strongly onto a PVGU factor, suggesting that they measure the same construct, that studies using either measure may be compared to each other, and that both measures may be used as a screener of PVGU.
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Affiliation(s)
- Hyo Jin Lee
- Department of Psychology, Loma Linda University , Loma Linda, California
| | - Denise D Tran
- Department of Psychology, Loma Linda University , Loma Linda, California
| | - Holly E R Morrell
- Department of Psychology, Loma Linda University , Loma Linda, California
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24
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Corbisiero S, Bitto H, Newark P, Abt-Mörstedt B, Elsässer M, Buchli-Kammermann J, Künne S, Nyberg E, Hofecker-Fallahpour M, Stieglitz RD. A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)-A Randomized Controlled Trial. Front Psychiatry 2018; 9:571. [PMID: 30505283 PMCID: PMC6250816 DOI: 10.3389/fpsyt.2018.00571] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/19/2018] [Indexed: 11/13/2022] Open
Abstract
In the treatment of adult attention-deficit/hyperactivity disorder (ADHD) the importance of psychological interventions in combination with pharmacotherapy is widely accepted in contemporary clinical routine. The natural course of the disorder seems to justify additional psychological interventions because even in patients who are highly compliant to pharmacotherapy full remission is not always achieved. The aim of the present study was to analyze the contribution of psychotherapy to the treatment of adult ADHD patients. In a randomized controlled study, the efficacy of a combined treatment of psychotherapy with pharmacotherapy is compared to pharmacological intervention alone. After initiation and stabilization of treatment with methylphenidate (MPH) in all subjects randomization to the two different treatment conditions was done. Afterwards both groups underwent treatment for about 10-12 weeks, the experimental group receiving sessions of cognitive-behavioral therapy (CBT) whereas the control group only received medication and standard clinical management (SCM). ADHD symptoms differed statistically during time but not between the two different treatment conditions. This result was the same for the single ADHD symptoms-inattention, hyperactivity, impulsivity, and emotional symptoms-and also for impairment. Individual standardized ADHD specific CBT program was not able to outperform SCM.
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Affiliation(s)
- Salvatore Corbisiero
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Hannes Bitto
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Patricia Newark
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Beatrice Abt-Mörstedt
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Marina Elsässer
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Jacqueline Buchli-Kammermann
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Sven Künne
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Elisabeth Nyberg
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Maria Hofecker-Fallahpour
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Rolf-Dieter Stieglitz
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland.,Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
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25
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Bottelier MA, Schrantee A, Ferguson B, Tamminga HGH, Bouziane C, Kooij JJS, de Ruiter MB, Reneman L. Age-dependent effects of acute methylphenidate on amygdala reactivity in stimulant treatment-naive patients with Attention Deficit/Hyperactivity Disorder. Psychiatry Res Neuroimaging 2017; 269:36-42. [PMID: 28938219 DOI: 10.1016/j.pscychresns.2017.09.009] [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: 11/15/2016] [Revised: 09/06/2017] [Accepted: 09/10/2017] [Indexed: 11/18/2022]
Abstract
In the present study, we investigate whether methylphenidate (MPH) affects emotional processing and whether this effect is modulated by age. We measured amygdala reactivity with functional Magnetic Resonance Imaging (fMRI) during processing of angry and fearful facial expressions in male stimulant treatment-naive patients with ADHD (N = 35 boys; N = 46 men) and 23 healthy control subjects (N = 11 boys; N = 12 men). In ADHD patients, we also measured amygdala reactivity 90min after an acute oral challenge with MPH (0.5mg/kg). Mean amygdala reactivity was analyzed for all subjects using a repeated measures analysis of variance (ANOVA). Whole-brain maps were analyzed for the patients only. At baseline, we found a age*diagnosis effect approaching significance (p = 0.05) in the right amygdala due to lower reactivity in children with Attention Deficit/Hyperactivity Disorder (ADHD) vs. controls (-31%), but higher reactivity in adults with ADHD vs. controls (+31%). MPH significantly reduced right amygdala reactivity in all patients, resulting in further reductions in children. In the left amygdala, reduction of amygdala reactivity was confined to adult ADHD patients whereas there was no change in children with ADHD. MPH-induced decrease of amygdala reactivity in adults might be a promising avenue for managing emotional dysregulation when replicated for chronic MPH treatment.
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Affiliation(s)
- Marco A Bottelier
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Child, and Adolescent Psychiatry, Triversum, Alkmaar, The Netherlands
| | - Anouk Schrantee
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Bart Ferguson
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Center Rudolph Magnus, Department of Psychiatry, University Medical Center, Utrecht, The Netherlands
| | - Hyke G H Tamminga
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Dutch Autism and ADHD research center, University of Amsterdam, Amsterdam, The Netherlands
| | - Cheima Bouziane
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J J Sandra Kooij
- PsyQ, psycho-medical programs, Expertise Center Adult ADHD, Den Haag, The Netherlands
| | - Michiel B de Ruiter
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Liesbeth Reneman
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.
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26
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Kim EJ, Kim Y, Seo WS, Lee SH, Park EJ, Bae SM, Shin D. The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (I) - Clinical Presentation and Comorbidity -. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.2.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Eun Jin Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Yunsin Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Wan Seok Seo
- Department of Psychiatry, Yeungnam University School of Medicine, Daegu, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
| | - Eun Jin Park
- Department of Psychiatry, Inje University School of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Seung-Min Bae
- Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea
| | - Dongwon Shin
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
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Abstract
OBJECTIVE Attention-deficit hyperactivity disorder (ADHD) has been associated with various manifestations of impulsivity in adults, including elevated rates of other impulsive disorders, substance use, questionnaire-based impulsivity scores, and inhibitory dysregulation on neurocognitive tests. The relationship between ADHD and all these other forms of impulsivity has yet to be explored within the context of a single comprehensive study. METHODS A total of 423 young adults, who gambled ≥5 times in the preceding year, were recruited using media advertisements and undertook detailed assessment including structured psychiatric interview, questionnaires, and neurocognitive tests. Participants with ADHD symptoms were identified using the Adult ADHD Self-Report Scale Screener (ASRS-V1.1) and were compared to controls using multivariate analysis of variance (MANOVA). RESULTS ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity questionnaire scores, more problematic Internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times. Of these variables, stop-signal reaction times and Barratt attentional impulsiveness were the strongest predictors of group classification. CONCLUSIONS ADHD symptoms are common and under-diagnosed in young adults who gamble, and are most strongly linked with certain other types of impulsivity (questionnaire- and cognitive-based measures) and with emotional dysregulation, suggesting that these are each important considerations in understanding the pathophysiology of the disorder, but also potential treatment targets. It is necessary to question whether treatment for adult ADHD could be enhanced by considering self-esteem, emotional reactivity, and impaired inhibitory control as specific treatment targets, in addition to the core diagnostic symptoms of the disorder.
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28
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Diagnosis of developmental learning and attention disorders in adults: A review of clinical modalities. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.npbr.2016.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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29
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Lee S, Choi JW, Kim KM, Kim JW, Kim S, Kang T, Kim JI, Lee YS, Kim B, Han DH, Cheong JH, Lee SI, Hyun GJ, Kim BN. The Guideline of Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder: Developed by ADHD Translational Research Center. Soa Chongsonyon Chongsin Uihak 2016. [DOI: 10.5765/jkacap.2016.27.4.236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sumin Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Won Choi
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung-Min Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sooyeon Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | | | - Johanna Inhyang Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Young Sik Lee
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Bongseog Kim
- Department of Psychiatry, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Jae Hoon Cheong
- Uimyung Research Institute for Neuroscience, Sahmyook University, Seoul, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea
| | - Gi Jung Hyun
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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30
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Wéry A, Vogelaere K, Challet-Bouju G, Poudat FX, Caillon J, Lever D, Billieux J, Grall-Bronnec M. Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic. J Behav Addict 2016; 5:623-630. [PMID: 27774812 PMCID: PMC5370367 DOI: 10.1556/2006.5.2016.071] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background and aims Research on sexual addiction flourished during the last decade, promoted by the development of an increased number of online sexual activities. Despite the accumulation of studies, however, evidence collected in clinical samples of treatment-seeking people remains scarce. The aim of this study was to describe the characteristics (socio-demographics, sexual habits, and comorbidities) of self-identified "sexual addicts." Methods The sample was composed of 72 patients who consulted an outpatient treatment center regarding their sexual behaviors. Data were collected through a combination of structured interviewing and self-report measures. Results Most patients were males (94.4%) aged 20-76 years (mean 40.3 ± 10.9). Endorsement of sexual addiction diagnosis varied from 56.9% to 95.8% depending on the criteria used. The sexual behaviors reported to have the highest degree of functional impairment were having multiple sexual partners (56%), having unprotected sexual intercourse (51.9%), and using cybersex (43.6%). Ninety percent of patients endorsed a comorbid psychiatric diagnosis, and 60.6% presented at least one paraphilia. Conclusions Results showed highly different profiles in terms of sexual preferences and behaviors, as well as comorbidities involved. These findings highlight the need to develop tailored psychotherapeutic interventions by taking into account the complexity and heterogeneity of the disorder.
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Affiliation(s)
- Aline Wéry
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium,Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium,Corresponding authors: Aline Wéry; Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place du Cardinal Mercier, 10, B-1348 Louvain-la-Neuve, Belgium; Phone: +32 (0)10 47 45 46; Fax: +32 (0)10 47 37 74; E-mail: ; Marie Grall-Bronnec; CHU de Nantes, Department of Addictology and Psychiatry, Hôpital Saint-Jacques, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; Phone: +33 (0)2 40 84 61 16; Fax: +33 (0)2 40 84 61 18; E-mail:
| | - Kim Vogelaere
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Gaëlle Challet-Bouju
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France,Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France
| | - François-Xavier Poudat
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France
| | - Julie Caillon
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France,Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France
| | - Delphine Lever
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France
| | - Joël Billieux
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium,Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marie Grall-Bronnec
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France,Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France,Corresponding authors: Aline Wéry; Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place du Cardinal Mercier, 10, B-1348 Louvain-la-Neuve, Belgium; Phone: +32 (0)10 47 45 46; Fax: +32 (0)10 47 37 74; E-mail: ; Marie Grall-Bronnec; CHU de Nantes, Department of Addictology and Psychiatry, Hôpital Saint-Jacques, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; Phone: +33 (0)2 40 84 61 16; Fax: +33 (0)2 40 84 61 18; E-mail:
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Mörstedt B, Corbisiero S, Stieglitz RD. Normierung der Adult ADHD Self-Report-Scale-V1.1 und der ADHS Selbstbeurteilungsskala an einer repräsentativen deutschsprachigen Stichprobe. DIAGNOSTICA 2016. [DOI: 10.1026/0012-1924/a000154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Zusammenfassung. Die beiden Verfahren Adult ADHD Self-Report-Scale-V1.1 (ASRS-V1.1) und ADHS-Selbstbeurteilungsskala (ADHS-SB) sind häufig eingesetzte Instrumente zur Diagnostik einer adulten ADHS. Für beide Verfahren steht allerdings eine Normierung für die deutschsprachige Allgemeinbevölkerung bisher aus. Zur Erstellung von repräsentativen Normwerten der Skalen für die Allgemeinbevölkerung wurden N = 640 Personen (300 Männer, 340 Frauen) in der deutschsprachigen Schweiz rekrutiert. Mit Hilfe von Varianzanalysen mit den Haupteffekten Geschlecht und Alter wurde ermittelt, dass altersspezifische Normen sinnvoll sind. Es wurden daher für beide Selbstbeurteilungsverfahren Normierungen für die Gesamtbevölkerung, als auch für verschiedene Altersränge (18 – 19; 20 – 39; 40 – 64 und über 64) bestimmt. Für beide Selbstbeurteilungsverfahren wurden Prozentränge und Stanine-Werte berechnet. Infolgedessen wurden kritische Werte entwickelt, bei deren Erreichen unbedingt eine genaue ADHS Abklärung stattfinden sollte.
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Gerasch S, Kanaan AS, Jakubovski E, Müller-Vahl KR. Aripiprazole Improves Associated Comorbid Conditions in Addition to Tics in Adult Patients with Gilles de la Tourette Syndrome. Front Neurosci 2016; 10:416. [PMID: 27672358 PMCID: PMC5018494 DOI: 10.3389/fnins.2016.00416] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/26/2016] [Indexed: 12/13/2022] Open
Abstract
Gilles de la Tourette Syndrome (GTS) is characterized by motor and vocal tics, as well as associated comorbid conditions including obsessive-compulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), depression, and anxiety which are present in a substantial number of patients. Although randomized controlled trials including a large number of patients are still missing, aripiprazole is currently considered as a first choice drug for the treatment of tics. The aim of this study was to further investigate efficacy and safety of aripiprazole in a group of drug-free, adult patients. Specifically, we investigated the influence of aripiprazole on tic severity, comorbidities, premonitory urge (PU), and quality of life (QoL). Moreover, we were interested in the factors that influence a patient's decision in electing for-or against- pharmacological treatment. In this prospective uncontrolled open-label study, we included 44 patients and used a number of rating scales to assess tic severity, PU, comorbidities, and QoL at baseline and during treatment with aripiprazole. Eighteen out of fortyfour patients decided for undergoing treatment for their tics with aripiprazole and completed follow-up assessments after 4–6 weeks. Our major findings were (1) aripiprazole resulted in significant reduction of tics, but did not affect PU; (2) aripiprazole significantly improved OCD and showed a trend toward improvement of other comorbidities including depression, anxiety, and ADHD; (3) neither severity of tics, nor PU or QoL influenced patients' decisions for or against treatment of tics with aripiprazole; instead patients with comorbid OCD tended to decide in favor of, while patients with comorbid ADHD tended to decide against tic treatment; (4) most frequently reported adverse effects were sleeping problems; (5) patients' QoL was mostly impaired by comorbid depression. Our results suggest that aripiprazole may improve associated comorbid conditions in addition to tics in patients with GTS. It can be hypothesized that these beneficial effects are related to aripiprazole's adaptive pharmacological profile, which exhibits an influence on the dopaminergic as well as a number of other neurotransmitter systems. For the first time, our data provide evidence that patients' decision making process for or against medical treatment is influenced by other factors than tic severity and QoL.
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Affiliation(s)
- Sarah Gerasch
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Ahmad Seif Kanaan
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical SchoolHannover, Germany; Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
| | - Ewgeni Jakubovski
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School Hannover, Germany
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33
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Association of attention-deficit/hyperactivity disorder with gambling disorder. J Neural Transm (Vienna) 2016; 123:1013-9. [DOI: 10.1007/s00702-016-1566-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 04/30/2016] [Indexed: 12/31/2022]
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34
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Philipp-Wiegmann F, Retz-Junginger P, Retz W, Rösler M. The intraindividual impact of ADHD on the transition of adulthood to old age. Eur Arch Psychiatry Clin Neurosci 2016; 266:367-71. [PMID: 26438010 DOI: 10.1007/s00406-015-0644-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 09/20/2015] [Indexed: 11/24/2022]
Abstract
The aim of the study was to explore whether the individual burden of ADHD is the same in the elderly as in younger ages even though the symptomatological impact of ADHD seems to remain stable over the lifespan. To assess ADHD symptoms and ADHD-associated problems in daily life, standardised questionnaires were conducted. To assess the subjectively experienced course of disease over the lifespan, all participants were interviewed regarding symptoms of ADHD in childhood as well as before and after the fiftieth year of life. In the sample of 296 respondents with a mean age of 69.55 years, 11 fulfilled the criteria of adult ADHD. Retrospectively, the ADHD subjects reported negative impacts due to ADHD-associated behaviour over the life span. These impairments remained stable over time with 18 % of subjects reporting impairments in family life, 46 % in social relationships, 18 % in dealing with money, and 36 % in organisation of daily life in the presence. Thus, the ADHD subjects reported problems with stability over time caused by low self-confidence, being quick-tempered, and due to defiantness. Although this is pilot study, our results reflect the burden of ADHD not only in young and middle adulthood, but also in seniority. The findings indicate the lifelong impact of ADHD as the explored seniors with ADHD reported the negative impact of ADHD remaining stable over the lifespan.
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Affiliation(s)
- Florence Philipp-Wiegmann
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421, Homburg, Saar, Germany.
| | - Petra Retz-Junginger
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421, Homburg, Saar, Germany
| | - Wolfgang Retz
- Department of Forensic Psychiatry, University Medical Centre Mainz, Mainz, Germany
| | - Michael Rösler
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421, Homburg, Saar, Germany
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Alexander L, Liljequist L. Determining the Accuracy of Self-Report Versus Informant-Report Using the Conners' Adult ADHD Rating Scale. J Atten Disord 2016; 20:346-52. [PMID: 23503811 DOI: 10.1177/1087054713478652] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The present research examined the validity of self-report versus informant-report in relation to a performance-based indicator of adult ADHD. METHOD Archival data from 118 participants (52 males, 66 females) were used to compare Conners' Adult ADHD Rating Scale-Self-Report: Long Format (CAARS-S:L) and Conners' Adult ADHD Rating Scale-Observer Report: Long Format (CAARS-O:L) with discrepancy scores calculated between the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) Verbal Comprehension Index - Working Memory Index (VCI - WMI) and Perceptual-Organizational Index - Processing Speed Index (POI - PSI) scaled scores. RESULTS Neither the self- nor informant-report formats of the CAARS were better predictors of discrepancies between WAIS-III Index scores. Intercorrelations between the CAARS-S:L and CAARS-O:L revealed generally higher correlations between the same scales of different formats and among scales measuring externally visible symptoms. Furthermore, regression analysis indicated that both the CAARS-S:L and CAARS-O:L clinical scales contributed a significant proportion of variance in WAIS-III VCI - WMI discrepancy scores (14.7% and 16.4%, respectively). CONCLUSION Results did not establish greater accuracy of self-report versus informant-report of ADHD symptomatology, rather demonstrate the need for multimodal assessment of ADHD in adults.
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Lis S, Baer N, Franzen N, Hagenhoff M, Gerlach M, Koppe G, Sammer G, Gallhofer B, Kirsch P. Social Interaction Behavior in ADHD in Adults in a Virtual Trust Game. J Atten Disord 2016; 20:335-45. [PMID: 23564736 DOI: 10.1177/1087054713482581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Social cognitive functions in adults with ADHD were investigated in a virtual social exchange game. METHOD The sample consisted of 40 participants (20 adult ADHD participants, 20 healthy controls). Participants played a multiround trust game with virtual trustees who differed in regard to fairness and presence of emotional facial cues. RESULTS Investments were higher in ADHD participants than in healthy participants except for partners who played fair with constant neutral expressions. ADHD patients did not adapt their behavior to the fairness of the trustee. In the presence of emotional facial cues, ADHD and healthy participants transferred more monetary units to happy rather than angry-looking trustees. Differences in investment behavior were not linked to deficits in emotion-recognition abilities or cognitive dysfunctions. CONCLUSION Alterations in interaction behavior and in the formation of a general attitude toward social partners could be shown in adults with ADHD.
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Affiliation(s)
- Stefanie Lis
- Justus-Liebig University Giessen, Germany Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Nina Baer
- Justus-Liebig University Giessen, Germany
| | | | | | | | - Georgia Koppe
- Justus-Liebig University Giessen, Germany Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | | | | | - Peter Kirsch
- Justus-Liebig University Giessen, Germany Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
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Wyrwich KW, Shaffer S, Gries K, Auguste P, Mooney KH, Prasad S, Bilder DA. Content Validity of the ADHD Rating Scale (ADHD RS-IV) and Adult ADHD Self-Report Scale (ASRS) in Phenylketonuria. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2016. [DOI: 10.1177/2326409816639316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Deborah A. Bilder
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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Kang T, Kim JW, Bahn GH, Song SH, Kim J, Kim JH, Kim YJ, Kim EJ, Kim TH, Yang SJ, Yang J, Lee SI, Park JH, Choi J, Han DH. Development of Korean Adult ADHD Rating Scale. Soa Chongsonyon Chongsin Uihak 2015. [DOI: 10.5765/jkacap.2015.26.4.295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Taewoong Kang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Won Kim
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sook Hyung Song
- Department of Psychiatry, Yong-In Mental Hospital, Yongin, Korea
| | - Junwon Kim
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Ji-Hoon Kim
- Department of Neuropsychiatry, Pusan National University Yangsan Hospital, Busan, Korea
| | | | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University School of Medicine, Seoul, Korea
| | - Tae-Ho Kim
- Department of Psychiatry, College of Medicine, Konkuk University, Chungju, Korea
| | - Su-Jin Yang
- Jeju Special Self-Governing Provincial Office of Education, Jeju, Korea
| | - Jaewon Yang
- KAIST Clinic, Korea Advanced Institute of Science and Technology (KAIST, Daejeon, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Joon-Ho Park
- Department of Industrial and Advertising Psychology, Daejeon University, Daejeon, Korea
| | - Jeewook Choi
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Korea
| | - Doug-Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea
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Adult ADHD: Associations with Personality and Other Psychopathology. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015. [DOI: 10.1007/s10862-015-9519-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Burke A, Vorster A. Prevalence rates of comorbid disorders in attention deficit hyperactivity disorder adults. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2015. [DOI: 10.1177/0081246315602429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although there has been extensive research on attention deficit hyperactivity disorder as a clinical disorder in adulthood, many clinicians remain sceptical about the validity of this disorder. Among the many reasons for this are comorbid conditions which may complicate the disorder. The aim of this study was to determine the prevalence rates of other disorders among a group of adults with attention deficit hyperactivity disorder, based on participants’ scores on the Million Clinical Multiaxial Inventory-III. In order to meet this aim, the Million Clinical Multiaxial Inventory -III results of a group of adults with attention deficit hyperactivity disorder ( n = 51) were analysed. In terms of Cluster B personality disorders, the following prevalence rates were found for the attention deficit hyperactivity disorder group: 23% Borderline, 27.4% Antisocial, 19.6% Histrionic, and 19.6% Narcissistic. As far as comparing prevalence rates of possible comorbid conditions, as found in this study, with those of previous studies, the results compare well to those conditions that are reported as the most prevalent in other studies. However, the wide range of clinical and personality disorders that are associated with attention deficit hyperactivity disorder indicate that there are no typical comorbid disorders.
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Affiliation(s)
- Alban Burke
- Department of Psychology, University of Johannesburg, South Africa
| | - Adri Vorster
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, South Africa
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Liebrenz M, Gamma A, Ivanov I, Buadze A, Eich D. Adult attention-deficit/hyperactivity disorder: Associations between subtype and lifetime substance use - a clinical study. F1000Res 2015; 4:407. [PMID: 27853503 PMCID: PMC5089146 DOI: 10.12688/f1000research.6780.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 11/20/2022] Open
Abstract
ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD). Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.
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Affiliation(s)
- Michael Liebrenz
- Institute of Forensic Medicine, Department of Forensic Psychiatry, University of Bern, Bern, 3012, Switzerland
| | - Alex Gamma
- Institute of Forensic Medicine, Department of Forensic Psychiatry, University of Bern, Bern, 3012, Switzerland
| | - Iliyan Ivanov
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Anna Buadze
- Psychiatric University Hospital, Research Group on ADHD, Zurich, 8032, Switzerland
| | - Dominique Eich
- Psychiatric University Hospital, Research Group on ADHD, Zurich, 8032, Switzerland
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Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder. BIOMED RESEARCH INTERNATIONAL 2015; 2015:965303. [PMID: 26229967 PMCID: PMC4502275 DOI: 10.1155/2015/965303] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022]
Abstract
Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits.
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Babcock T, Ornstein CS. Comorbidity and its Impact in Adult Patients with Attention-Deficit/Hyperactivity Disorder: A Primary Care Perspective. Postgrad Med 2015; 121:73-82. [DOI: 10.3810/pgm.2009.05.2005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Matte B, Anselmi L, Salum GA, Kieling C, Gonçalves H, Menezes A, Grevet EH, Rohde LA. ADHD in DSM-5: a field trial in a large, representative sample of 18- to 19-year-old adults. Psychol Med 2015; 45:361-373. [PMID: 25066615 PMCID: PMC4301194 DOI: 10.1017/s0033291714001470] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/17/2014] [Accepted: 05/24/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND The DSM criteria for adult attention-deficit/hyperactivity disorder (ADHD) have not been tested in American Psychiatric Association (APA) field trials for either DSM-IV or DSM-5. This study aimed to assess: (a) the prevalence of ADHD according to DSM-5 criteria; (b) the factor solution that provides the best fit for ADHD symptoms; (c) the symptoms with the highest predictive value for clinical impairment; and (d) the best symptomatic threshold for each ADHD dimension (inattention and hyperactivity/impulsivity). METHOD Trained psychologists evaluated 4000 young adults from the 1993 Pelotas Birth Cohort Study with an instrument covering all DSM-5 ADHD criteria. A series of confirmatory factor analyses (CFAs) tested the best factor structure. Complex logistic regressions assessed differential contributions of each symptom to clinical impairment. Receiver-operating characteristic (ROC) analyses tested which would be the best symptomatic cut-off in the number of symptoms for predicting impairment. RESULTS The prevalence of DSM-5 ADHD was 3.55% [95% confidence interval (CI) 2.98-4.12]. The estimated prevalence of DSM-IV ADHD was 2.8%. CFA revealed that a bifactor model with a single general factor and two specific factors provided the best fit for DSM-5 symptoms. Inattentive symptoms continued to be the most important predictors of impairment in adults. The best cut-offs were five symptoms of inattention and four symptoms of hyperactivity/impulsivity. CONCLUSIONS Our results, combined with previous findings, suggest a 27% increase in the expected prevalence of ADHD among young adults, comparing DSM-IV to DSM-5 criteria. The DSM-5 symptomatic organization derived a similar factor structure for adults as DSM-IV symptoms. Data using DSM-5 criteria support lowering the symptomatic threshold for diagnosing ADHD in adults.
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Affiliation(s)
- B. Matte
- ADHD Out-patient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - L. Anselmi
- ADHD Out-patient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - G. A. Salum
- ADHD Out-patient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - C. Kieling
- ADHD Out-patient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - H. Gonçalves
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - A. Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - E. H. Grevet
- ADHD Out-patient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - L. A. Rohde
- ADHD Out-patient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
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Dalteg A, Zandelin A, Tuninger E, Levander S. Psychosis in adulthood is associated with high rates of ADHD and CD problems during childhood. Nord J Psychiatry 2014; 68:560-6. [PMID: 24620816 DOI: 10.3109/08039488.2014.892151] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patients diagnosed with schizophrenia display poor premorbid adjustment (PPA) in half of the cases. Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common child psychiatric disorders. These two facts have not previously been linked in the literature. AIMS To determine the prevalence of ADHD/CD problems retrospectively among patients with psychoses, and whether and to what extent the high frequency of substance abuse problems among such patients may be linked to ADHD/CD problems. METHOD ADHD and CD problems/diagnoses were retrospectively recorded in one forensic (n = 149) and two non-forensic samples (n = 98 and n = 231) of patients with a psychotic illness: schizophrenia, bipolar or other, excluding drug-induced psychoses. RESULTS ADHD and CD were much more common among the patients than in the general population-the odds ratio was estimated to be greater than 5. There was no significant difference in this respect between forensic and non-forensic patients. Substance abuse was common, but substantially more common among patients with premorbid ADHD/CD problems. CONCLUSIONS Previous views regarding PPA among patients with a psychotic illness may reflect an association between childhood ADHD/CD and later psychosis. The nature of this association remains uncertain: two disorders sharing some generative mechanisms or one disorder with two main clinical manifestations. Childhood ADHD and particularly CD problems contribute to the high frequency of substance abuse in such groups.
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Affiliation(s)
- Arne Dalteg
- Arne Dalteg, Psychiatric Clinic , SE-57228, Oskarshamn , Sweden
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Canu WH, Tabor LS, Michael KD, Bazzini DG, Elmore AL. Young adult romantic couples' conflict resolution and satisfaction varies with partner's attention-deficit/hyperactivity disorder type. JOURNAL OF MARITAL AND FAMILY THERAPY 2014; 40:509-524. [PMID: 24749971 DOI: 10.1111/jmft.12018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has previously been associated with less satisfaction and success in romantic relationships. This study compares conflict resolution and problem-solving behaviors in young adult romantic couples either having one partner with ADHD combined type (C-couples), having one partner identified with ADHD inattentive type (IA-couples), or in which neither partner has an ADHD diagnosis (nondiagnosed [ND] couples). Self-reports of current and childhood ADHD symptoms corroborated diagnostic status and speaker and listener behaviors, coded via the Rapid Couples Interaction Scoring System (Gottman, 1996), were the primary dependent variables. Analyses revealed greater negativity and less positivity in C-couples' behavior during a conflict resolution task, relative to IA and ND couples, and this corresponded with couples' relational satisfaction. IA-couples emitted relational behavior that was largely similar to ND couples. Findings support that relational impairment exists in C-couples, and to some degree, contrast with previous research suggesting that individuals with predominant inattention experience greater social impairment in adulthood than those with other types of ADHD.
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Di Nicola M, Sala L, Romo L, Catalano V, Even C, Dubertret C, Martinotti G, Camardese G, Mazza M, Tedeschi D, Callea A, De Risio L, Guelfi JD, Rouillon F, Janiri L, Gorwood P. Adult attention-deficit/hyperactivity disorder in major depressed and bipolar subjects: role of personality traits and clinical implications. Eur Arch Psychiatry Clin Neurosci 2014; 264:391-400. [PMID: 24077910 DOI: 10.1007/s00406-013-0456-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 09/17/2013] [Indexed: 12/20/2022]
Abstract
A significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and affective disorders has been consistently reported in adults. Less data regarding the role of personality traits and the influence of ADHD co-occurrence on clinical characteristics and outcome of mood disorders are currently available. One hundred and six remitted major depressed, 102 euthymic bipolar subjects, and 120 healthy controls, homogeneous with respect to demographic characteristics, were included in the study. ADHD diagnosis was based on DSM-IV-TR criteria. Childhood and adult ADHD features were measured with the Wender Utah Rating Scale, the Adult ADHD Self-rating Scale, and the Brown Attention-Deficit Disorder Scale. The Revised NEO Personality Inventory was also administered to the clinical groups, in order to investigate personality dimensions. The occurrence of adult ADHD in subjects with bipolar disorders (BD) or major depressive disorder (MDD) was 15.7 and 7.5 %, respectively, compared to 3.3 % in healthy controls (HC). Significant associations (p < .001) between personality traits (neuroticism, conscientiousness, and extraversion) and ADHD features were observed. Logistic regression analysis of all clinical subjects (n = 208) showed that those with lower levels of neuroticism (OR = 1.031; p = .025) had a lower frequency of ADHD comorbidity. The present study emphasizes the close relationship between affective disorders, especially BD, and ADHD in adults. Our findings support the need to assess subjects with mood disorders in the clinical setting for possible coexisting ADHD and to further investigate personality traits to better understand the etiology of affective disorders and ADHD co-occurrence.
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Hallerbäck MU, Lugnegård T, Gillberg C. ADHD and nicotine use in schizophrenia or Asperger syndrome: a controlled study. J Atten Disord 2014; 18:425-33. [PMID: 22498753 DOI: 10.1177/1087054712439099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine ADHD prevalence, rating scales, and relationship to nicotine use in adults with schizophrenia or Asperger syndrome. METHOD Ninety-five individuals, 41 with schizophrenia and 54 with Asperger syndrome, were included. Self-rating of adult ADHD symptoms with the Wender-Reimherr Adult Attention Deficit Diagnostic Rating Scale (WRAADDS), parent rating of proband's ADHD childhood and adult life symptoms using the Swanson, Nolan, and Pelham Questionnaire (SNAP), and report of clinical ADHD diagnosis were included as ADHD measures. Nicotine use data were compared with data from a population sample. RESULTS In all, 10% of the schizophrenia group and 30% of the Asperger syndrome group had a clinical ADHD diagnosis. Nicotine dependency in the whole sample was closely linked to ADHD. CONCLUSION The prevalence of comorbid ADHD was high in schizophrenia and Asperger syndrome. The WRAADDS self-rating scale for ADHD can be one useful tool for assessing comorbid ADHD in these patient groups.
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Affiliation(s)
| | - Tove Lugnegård
- Central Hospital, Karlstad, Sweden University of Gothenburg, Sweden
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Estimating the prevalence of adult ADHD in the psychiatric clinic: a cross-sectional study using the adult ADHD self-report scale (ASRS). Ir J Psychol Med 2014; 27:195-197. [DOI: 10.1017/s079096670000152x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectives: We sought to determine the point prevalence of adult attention deficit/hyperactivity disorder (ADHD) in an out-patient psychiatric population.Methods: Patients (n=243) attending five different outpatient clinics in a largely urban adult psychiatric service completed the Adult ADHD Self-Report Scale, a recently developed instrument by the World Health Organisation. Clinical and demographic data were recorded.Results: There was a high apparent rate of adult ADHD detected (23.9%). Such patients were significantly more likely to have lower educational attainment, ADHD as children, a forensic history and the diagnosis of personality disorder as well as a higher rate of benzodiazepine use. They were no more likely to be dissatisfied with the service, nor to be heavier users of the service.Conclusions: We report a high apparent rate of adult ADHD. Correlates of this high rate indicate individuals with less positive lifestyles than other patients. Screening for this disorder appears warranted, particularly in the light of the emergence of new non-amphetamine-based therapies.
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Liebrenz M, Frei A, Fisher CE, Gamma A, Buadze A, Eich D. Adult attention-deficit/hyperactivity disorder and nicotine use: a qualitative study of patient perceptions. BMC Psychiatry 2014; 14:141. [PMID: 24885526 PMCID: PMC4037284 DOI: 10.1186/1471-244x-14-141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 04/21/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with high rates of comorbid substance use disorders, and cigarette smoking has a particularly high prevalence in this population. However, there is an ongoing debate as to whether this tobacco use is an attempt at "self-medication" or due to behavioral disinhibition. There is a surprising lack of qualitative studies that investigate the subjective perceptions of adults with ADHD regarding cigarette smoking. The present study was designed to fill this gap in the literature. METHODS We recruited twelve adult patients with ADHD and comorbid tobacco use from our ADHD consultation service, an outpatient facility of the Zurich University Psychiatric Hospital. Subjects were interviewed using qualitative methodology, and Mayring's qualitative content analysis was used to evaluate findings. RESULTS We identified two explanatory models linking ADHD and tobacco use: smoking as an attempt at self-medication and "smoking as a social behavior". On one hand, subjects considered tobacco a therapeutic aid, reporting positive effects on "inner tension" and cognitive function, and noted possible antidepressant properties as well. On the other hand, subjects considered smoking to enhance social functioning and to have a positive impact on interpersonal relationships. The majority believed that stimulant medications offered only a transient decrease in patterns of tobacco use because their ability to reduce nicotine cravings wore off quickly. Others believed that stimulants had no effect or even reinforced cigarette use. CONCLUSIONS Participants had different views about the link between cigarette smoking and ADHD. While the majority thought of nicotine as a sort of therapy, viewing smoking as a way to self-medicate symptoms of ADHD, motivations for nicotine use were also related to self-image, desire to belong to a peer-group, and a drive to undermine perceived social norms. Ultimately, these findings can be used by clinicians to improve treatment alliance and collaboration.
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Affiliation(s)
- Michael Liebrenz
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Anja Frei
- Institute for General Practice and Health Services Research, University of Zurich, Pestalozzistrasse 24, 8091 Zurich, Switzerland
| | - Carl Erik Fisher
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Alex Gamma
- Psychiatric University Hospital, Division of ADHD Research, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Anna Buadze
- Psychiatric University Hospital, Division of ADHD Research, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Dominique Eich
- Psychiatric University Hospital, Division of ADHD Research, Lenggstrasse 31, 8032 Zurich, Switzerland
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