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Vajsz K, Paulina LR, Trejo S, Andaverde-Vega AA, Swanson JM, Miklósi M. Psychometric properties of the self-report version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale in a sample of Hungarian adolescents and young adults. Front Psychiatry 2024; 15:1330716. [PMID: 39026526 PMCID: PMC11255780 DOI: 10.3389/fpsyt.2024.1330716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
The Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale (SWAN) measures the full spectrum of attention and activity symptoms, not just the negative end of the distribution. Previous studies revealed strong psychometric properties of the parent and teacher report versions; however, there is little research on the new self-report form of the SWAN. Therefore, our research aimed to explore the psychometric characteristics of the SWAN self-report. A non-clinical sample of young women (N = 664, mean age: 20.01 years, SD: 3.08 years) completed the SWAN self-report, the Strengths and Difficulties Questionnaire (SDQ) and the Mental Health Continuum Short Form (MHC-SF). We tested several models using confirmatory factor analyses to assess the factorial validity of the SWAN self-report. Distributional characteristics, convergent, and predictive validity were assessed. A bifactor model with a general factor and a specific inattention factor (bifactor-1) provided the best fit in our data (CFI = 0.977, TLI/NFI = 0.972, RMSEA = 0.053 [90% CI: 0.047 - 0.059], SRMR = 0.061, ω = 0.90). The reliability of the general ADHD factor was good (ωh = 0.87), and the specific inattention factor was acceptable (ωh = 0.73). The distribution of the SWAN self-report scores did not differ from the normal distribution. A strong correlation between the SWAN and the SDQ Hyperactivity subscale was found. The analyses revealed good predictive validity. Our results suggest that the SWAN self-report is a valuable tool for assessing symptoms of ADHD in adolescents and young adults.
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Affiliation(s)
- Kornél Vajsz
- Department of Clinical Psychology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Developmental and Clinical Child Psychology, Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Laura R. Paulina
- Department of Clinical Psychology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Salvador Trejo
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana, Mexico
| | - Adrián A. Andaverde-Vega
- Unidad Académica de Trabajo Social y Ciencias para el Desarrollo Humano, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Mexico
| | - James M. Swanson
- Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
| | - Mónika Miklósi
- Department of Clinical Psychology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Developmental and Clinical Child Psychology, Psychological Institute, Eötvös Loránd University, Budapest, Hungary
- Centre of Mental Health, Heim Pál National Pediatric Institute, Budapest, Hungary
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Zeides Taubin D, Maeir A. "I wish it wasn't all on me": women's experiences living with a partner with ADHD. Disabil Rehabil 2024; 46:3017-3025. [PMID: 37496495 DOI: 10.1080/09638288.2023.2239158] [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: 03/13/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Grounded in the socio-ecological model of health, this study aims to understand the broader impact of adult attention deficit hyperactivity disorder (ADHD) on the family system. With a notable gap in knowledge concerning the impact of adult ADHD on spouses' well-being, this research explores the lived experiences of women in relationships with partners diagnosed with ADHD. MATERIAL AND METHODS Using a descriptive qualitative phenomenological approach, we conducted semi-structured interviews with thirteen women without ADHD, to gain insights into their experiences. RESULTS Three main themes were identified- ADHD in Everyday Life, Burden Experience, and Women's Coping Strategies for managing ADHD within relationships. The findings suggest that partners' ADHD symptoms involve a burden on women. In response, women developed coping strategies such as learning about ADHD, setting limits, and cultivating partnership by creating bridges to compensate for ADHD-related barriers. CONCLUSIONS This study highlights the substantial burden experienced by women in a relationship with partners diagnosed with ADHD, suggesting they should be recognized as caregivers and a potentially vulnerable group at risk. However, the homogeneous nature of our sample, focusing on white, heterosexual women, underlines the need for further research to better understand the impact of adult ADHD on diverse partners' functioning and health, as well as pathways to support them.
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Affiliation(s)
| | - Adina Maeir
- School of Occupational Therapy, Hebrew University, Jerusalem, Israel
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Perez-Beltran M, Roldán-Merino J, Russi ME, Rolandi MG, Colome Roura R, Sampaio F, Del Campo MD, Farres-Tarafa M, Pardos BH, Alda Díez JÁ. The Development and Content Validation of a Clinical Screening Scale to Identify Attention-Deficit Hyperactivity Disorder Cases Based on the Gender Perspective: An e-Delphi Study. Healthcare (Basel) 2024; 12:1282. [PMID: 38998817 PMCID: PMC11241727 DOI: 10.3390/healthcare12131282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/11/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Although many studies analyse gender differences in the clinical expression of Attention-Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls with ADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls with ADHD. OBJECTIVE The objective of this study is to develop a self-report early detection instrument for boys and girls with ADHD aged 7 to 16, which includes the gender perspective and is sensitive to the detection of girls with ADHD. METHODS The scale was developed and the items that comprised it were created from the thematic analysis of ADHD and its evaluation in children based on the diagnostic criteria of the DSM-5-TR. A modified e-Delphi method involving a three-round web survey was used to establish a consensus on the content of the scale. Ten experts were recruited to form a professional panel. The panel members were asked to assess the differential symptomatology of ADHD in boys and girls, the dimensions to be evaluated, and the importance of scale items to evaluate the content. RESULTS A consensus was reached regarding 13 total items distributed in three dimensions: inattention; hyperactivity/impulsivity; and, a third dimension, internalisation, which includes symptoms most present in the expression of ADHD in girls. CONCLUSIONS To the best of our knowledge, the development of this scale using the Delphi method is the first specific scale used for identifying ADHD that also addresses the gender perspective and the differential symptomatology between boys and girls. However, we must proceed to the analysis of psychometric properties, as the scale requires an exhaustive study of its reliability and validity. We can anticipate that this scale will provide relevant and reliable information that can be used for the identification of ADHD in both boys and girls.
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Affiliation(s)
- Meritxell Perez-Beltran
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Facultat de Psicología, University of Barcelona, Pg. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
- Neuropsychologist at Avan Neurology Center, Carrer Estrella, 10, Sabadell, 08201 Barcelona, Spain
| | - Juan Roldán-Merino
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Mental Health, Psychosocial and Complex Nursing Care Research Group (NURSEARCH), University of Barcelona, Gran Via de les Corts Catalanes, 585, 08007 Barcelona, Spain
| | - Maria Eugenia Russi
- Neuropediatrician in the Pediatric Neurology Service, Sant Joan de Déu Hospital, Pg. de Sant Joan de Déu, 2, 08950 Barcelona, Spain
| | - Maria Garau Rolandi
- Neurology Service and in the Learning Disorders Unit (UTAE), Sant Joan de Deu Hospital, 08950 Barcelona, Spain
- Psychology and Neurotherapy Centers, Carrer de Gresolet, 14, Sarrià-Sant Gervasi, 08034 Barcelona, Spain
| | - Roser Colome Roura
- Neurology Service and in the Learning Disorders Unit (UTAE), Sant Joan de Deu Hospital, 08950 Barcelona, Spain
| | - Francisco Sampaio
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, 4200-072 Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - Marta Domínguez Del Campo
- Parc Sanitari Sant Joan de Déu-Research Center, Carrer del Camí Vell de la Colònia, 25, 08830 Barcelona, Spain
| | - Mariona Farres-Tarafa
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Barbara Hurtado Pardos
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - José Ángel Alda Díez
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Pg. de Sant Joan de Déu, 2, 08950 Barcelona, Spain
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 08830 Esplugues de Llobregat, Spain
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Siddiqui U, Conover MM, Voss EA, Kern DM, Litvak M, Antunes J. Sex Differences in Diagnosis and Treatment Timing of Comorbid Depression/Anxiety and Disease Subtypes in Patients With ADHD: A Database Study. J Atten Disord 2024:10870547241251738. [PMID: 38756010 DOI: 10.1177/10870547241251738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Our study examined the impact of sex, ADHD subtype, and comorbid illnesses (depression/anxiety) on the timing of diagnosis and treatment for ADHD. METHOD To analyze ADHD patients, four health databases were used to assess subtype, comorbid mood, and antidepressant or anxiolytic drug exposure. Analyses were stratified by sex and age. Standardized mean differences measured intergroup differences. RESULTS Females with ADHD were identified at older ages and had higher rates of depression and anxiety diagnoses and treatments before and after their initial ADHD diagnosis. Predominantly inattentive ADHD patients were diagnosed later and more likely to receive mood disorder diagnosis and treatment than hyperactive impulsive ADHD patients. CONCLUSIONS Results suggest a more complex ADHD presentation in females, potentially causing late diagnosis and delayed treatment.
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Affiliation(s)
- Uzma Siddiqui
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | | | - Erica A Voss
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - David M Kern
- Janssen Research & Development, LLC, Titusville, NJ, USA
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Lin YJ, Lai MC, Yang LK, Gau SSF. Sex-differential patterns of neuropsychological functioning in adults with attention-deficit/hyperactivity disorder. Compr Psychiatry 2024; 131:152464. [PMID: 38394925 DOI: 10.1016/j.comppsych.2024.152464] [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] [Received: 10/30/2023] [Revised: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The sex-differential prevalence of attention-deficit/hyperactivity disorder (ADHD) varies across the lifespan, but little is known about sex differences in executive functions in adults with ADHD. METHODS We assessed 261 adults, aged 18-40 years, diagnosed with ADHD (170 males [assigned at birth], aged 25.81 ± 5.49; 91 females, aged 27.76 ± 5.42) and 308 neurotypical adults (176 males, aged 24.62 ± 5.14; 132 female, aged 25.37 ± 5.42) via psychiatric interviews to confirm ADHD and other psychiatric diagnoses. They were assessed by the Cambridge Neuropsychological Testing Automated Battery (CANTAB) on Reaction Time (arousal/processing speed), Rapid Visual Information Processing (sustained attention), Spatial Span (spatial memory), Spatial Working Memory, Intradimentional/Extradimensional Shift (set-shifting), and Stocking of Cambridge (spatial planning). The primary analyses were adjusted for age, full-scale IQ, and co-occurring psychiatric conditions. RESULTS Adults with ADHD had various co-occurring psychiatric conditions without sex differences in ADHD-neurotypical differences. Both adult males and females with ADHD performed poorer in all CANTAB tasks than same-sex neurotypical adults. Significant sex-moderating effects were observed in neuropsychological performance, including greater ADHD-neurotypical differences in arousal for females than males and in location memory for spatial tasks in males than females. CONCLUSION There were no sex-moderating effects in the presence of co-occurring psychiatric conditions in adult ADHD. However, there were sex-moderating effects on how ADHD related to neuropsychological functioning in adulthood. ADHD was associated with more challenges in arousal/processing speed in females and more challenges in strategy use or inhibition in spatial memory in males.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Psychiatry and Child Development Center, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Meng-Chuan Lai
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Li-Kuang Yang
- Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Loy JK, Klam J, Dötsch J, Frank J, Bender S. Exploring adolescent mental health during the COVID-19 crisis - strengths and difficulties. Front Public Health 2024; 12:1357766. [PMID: 38638467 PMCID: PMC11024382 DOI: 10.3389/fpubh.2024.1357766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/08/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction The SARS-CoV-2 pandemic has significantly impacted children and adolescents, leading to mental health challenges. Knowledge on their resources and difficulties is crucial and there is a need for valid instruments to assess their psychosocial condition especially in this exceptional situation. We assessed psychopathological symptoms using the SDQ during the pandemic, comparing to pre-pandemic data. Our study aims to understand adolescents' strengths and difficulties amidst COVID-19, evaluating the SDQ's utility in crisis settings. Methods Within the German school-based surveillance study ("B-Fast"), we assessed behavioral strengths and difficulties in 664 adolescents aged 11-17 years during the peak of the German COVID-19 pandemic using the validated Strengths and Difficulties Questionnaire (SDQ) for both external and self-assessed data collection. Data were collected between November 2020 and April 2021. We compared self-assessed SDQ-scores to pre-pandemic data from a comparable sample and examined adolescent classification as "normal" or "borderline/abnormal" based on both external and self-assessed SDQ subscale scores using established cut-off values. Additionally, we conducted sex and rater-based score comparisons. Results In our study, we observed a significant worsening of "Emotional Symptoms" compared to pre-pandemic levels, while "Conduct Problems" and "Prosocial Behavior" showed improvement. Variations in classification to "normal" and "abnormal" emerged when applying German versus British cut-off values. Females scored higher on "Emotional Symptoms" while males scored higher on "Hyperactivity Symptoms." Correlations between external and self-assessed SDQ ratings ranged from 0.43 (p < 0.001) for "Prosocial Behavior" among girls to 0.62 (p < 0.001) for "Peer Problems" among boys, indicating moderate to high consistency. Discussion/conclusion Our study contributes to understanding the psychosocial impact of the COVID-19 pandemic on German adolescents. Compared to other symptoms, we observed a particular worsening in "Emotional Symptoms" based on our data. Despite the moderate correlation between parental and self-reported evaluations, there appears to be a certain discrepancy in the perception of adolescent quality of life. Therefore, it seems prudent to assess both the external and self-reported evaluations and amalgamate the results from both parties to obtain a comprehensive problem profile of the individual. These findings underscore the importance of using country-specific cutoff values and reaffirm the utility of the SDQ as a valuable assessment tool, even within the unique circumstances posed by a pandemic.
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Affiliation(s)
- Johanna K. Loy
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Janina Klam
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatric and Adolescent Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Frank
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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de Jong M, Wynchank DSMR, Michielsen M, Beekman ATF, Kooij JJS. A Female-Specific Treatment Group for ADHD-Description of the Programme and Qualitative Analysis of First Experiences. J Clin Med 2024; 13:2106. [PMID: 38610871 PMCID: PMC11012758 DOI: 10.3390/jcm13072106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The diagnostics and treatment of attention-deficit/hyperactivity disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period, and (peri)menopause are neglected, even though they impact ADHD symptoms and associated mood disorders. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. Methods: We describe the group programme and underlying rationale, offering a qualitative analysis of the participants' evaluation. Results: The seven bi-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25-47 years) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable, and the structure suited them well. Completing the premenstrual calendar augmented the awareness and recognition of individual cyclical symptoms. A lifespan approach increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care. Conclusions: Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD.
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Affiliation(s)
- M de Jong
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
- Department of Psychiatry, AmsterdamUMC/VUmc, 1081 HJ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VU Medical Centre, 1081 HV Amsterdam, The Netherlands
| | - D S M R Wynchank
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
| | - M Michielsen
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
- Antes Older Adults Outpatient Treatment, 3079 DZ Rotterdam, The Netherlands
| | - A T F Beekman
- Department of Psychiatry, AmsterdamUMC/VUmc, 1081 HJ Amsterdam, The Netherlands
- GGZ inGeest, 1062 NP Amsterdam, The Netherlands
| | - J J S Kooij
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
- Department of Psychiatry, AmsterdamUMC/VUmc, 1081 HJ Amsterdam, The Netherlands
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Babinski DE. Sex Differences in ADHD: Review and Priorities for Future Research. Curr Psychiatry Rep 2024; 26:151-156. [PMID: 38324203 DOI: 10.1007/s11920-024-01492-6] [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] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW In childhood, attention-deficit/hyperactivity disorder (ADHD) is diagnosed three to 16 times more frequently in males compared to females, yet in adulthood, nearly equivalent numbers of males and females are diagnosed with ADHD. Relatively few studies have prioritized examination of sex differences in ADHD even though sex differences may have critical implications for the identification and treatment of ADHD in females and males. This review highlights current research on sex differences in ADHD across the lifespan that has emerged from cross-sectional and prospective longitudinal studies of youth, adult-ascertained samples, and registry studies. RECENT FINDINGS Accumulating research suggests that both males and females with ADHD experience widespread impairment across the lifespan. Some evidence of sex differences emerged, although effects have generally been modest in size. Continued research that includes females and males with ADHD is needed to clarify the nature of sex differences in ADHD. Research that focuses on equitable identification of ADHD in males and females, disentangles the effects of sex and gender, probes underlying mechanisms of sex differences, and addresses the clinical impact of sex differences in ADHD must be prioritized.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 22 Northeast Drive, Hershey, PA, 17033, USA.
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Miklósi M, Kovács B, Janovicz J, Lelki F, Kassai R. Adult attention-deficit/hyperactivity symptoms and parental cognitions: a meta-analysis. Front Psychiatry 2024; 14:1321078. [PMID: 38268568 PMCID: PMC10807045 DOI: 10.3389/fpsyt.2023.1321078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/27/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Attention-deficit/hyperactivity disorder (ADHD) symptoms in adults interfere with parental functioning. Dysfunctional parental cognitions may play a role in this impairment. Despite the importance of parental cognitions on parents and children's outcomes, up to now, no systematic review or meta-analysis of these findings is available. To fill this gap, this meta-analysis aimed to evaluate the relationship between adult ADHD symptoms and parental cognitions. Methods We conducted searches in Web of Science, PubMed, and ProQuest from January 2000 to June 2023. Studies were included if they provided data on the relationship between parental ADHD symptoms and parental cognitions by means of a row correlational coefficient, or means and standard deviation were reported for each study group. A random-effects model was used. Publication bias was assessed by funnel plot and Rosenthal's fail-safe N. Moderator analyses were conducted by means of subgroup analysis and meta-regression analyses. Results Fifteen published papers were included (N = 2851), and 51 effect sizes were analysed. The weighted mean effect size was small but significant (Fisher's Z = 0.186, k = 15, 95% CI [0.120 - 0.252], z = 5.539, p < 0.001), indicating that ADHD symptoms in adults are associated with more negative and less positive parental cognitions. The Fail-Safe N analysis suggested a robust effect. Tweedie's trim and fill results suggested that five studies were missing; after five missing studies had been imputed, the mean overall effect size dropped to 0.116 (0.080 - 0.152). There was significant heterogeneity among effect sizes. The methodology of the study was found to be a significant moderator. Meta-regression analyses revealed that the lower age of the parent and the child were related to more negative parental cognitions. Discussion Though the analysis might be inflated by publication bias, our results suggest a significant association between ADHD symptom level and dysfunctional parental cognitions. Biased negative perceptions of the parental role, the child and co-parenting may play a central mediator role between parental ADHD and parent and child outcomes. Given the familiar nature of ADHD, targeting dysfunctional parental cognitions in parent training programs is warranted. Systematic review registration osf.io/pnur7.
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Affiliation(s)
- Mónika Miklósi
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
- Centre of Mental Health, Heim Pál National Paediatric Institute, Budapest, Hungary
| | - Barbara Kovács
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Júlia Janovicz
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Franciska Lelki
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Réka Kassai
- School of Doctoral Studies, Eötvös Loránd University, Budapest, Hungary
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Metcalfe KB, McFeaters CD, Voyer D. Time-Perception Deficits in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. Dev Neuropsychol 2024; 49:1-24. [PMID: 38145491 DOI: 10.1080/87565641.2023.2293712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/07/2023] [Indexed: 12/27/2023]
Abstract
The present meta-analysis quantified the deficit in time perception in Attention-Deficit/Hyperactivity Disorder (ADHD) throughout the lifespan and examined potential moderators of this deficit. Our sample of 824 effect sizes showed a mean g of 0.688 that was moderated by the age of the sample and working memory. Separate moderator analyses for samples below or above the age of 18 showed that the link with working memory only applied to the samples below the age of 18, whereas an effect of ADHD subtype only applied to samples 18 and above. The discussion highlights the implications for remediation and avenues for future research.
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Affiliation(s)
- Kate B Metcalfe
- Department of Psychology, University of New Brunswick, Fredericton, Canada
| | | | - Daniel Voyer
- Department of Psychology, University of New Brunswick, Fredericton, Canada
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Chutko LS, Surushkina SY, Yakovenko EA, Cherednichenko DV. [Attention deficit hyperactivity disorder in adults]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:97-102. [PMID: 38465816 DOI: 10.17116/jnevro202412402197] [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] [Indexed: 03/12/2024]
Abstract
The article presents a review of scientific publications devoted to the study of the characteristics of the clinical picture and the dynamics of the main symptoms in adult patients with attention deficit hyperactivity disorder (ADHD). The authors present current data on the prevalence of this disease, leading clinical manifestations and the most common comorbid pathology. Research data on the impact of ADHD in adulthood on educational and professional activities are presented, and the economic and criminological aspects of ADHD are considered. The main methods of psychotherapeutic correction and pharmacological therapy are presented.
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Affiliation(s)
- L S Chutko
- N.P. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - S Yu Surushkina
- N.P. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - E A Yakovenko
- N.P. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - D V Cherednichenko
- N.P. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
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Chatterjee M, Saha S, Shom S, Dutta N, Sinha S, Mukhopadhyay K. Glutamate receptor genetic variants affected peripheral glutamatergic transmission and treatment induced improvement of Indian ADHD probands. Sci Rep 2023; 13:19922. [PMID: 37964012 PMCID: PMC10645851 DOI: 10.1038/s41598-023-47117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/09/2023] [Indexed: 11/16/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD), a childhood-onset neurobehavioral disorder, often perturbs scholastic achievement and peer-relationship. The pivotal role of glutamate (Glu) in learning and memory indicated an influence of Glu in ADHD, leading to the exploration of Glu in different brain regions of ADHD subjects. We for the first time analyzed GluR genetic variations, Glu levels, as well as expression of Glu receptors (GluR) in the peripheral blood of eastern Indian ADHD probands to find out the relevance of Glu in ADHD prognosis. After obtaining informed written consent for participation, peripheral blood was collected for analyzing the genetic variants, Glu level, and expression of target genes. Since ADHD probands are often treated with methylphenidate or atomoxetine for providing symptomatic remediation, we have also tested post-therapeutic improvement in the ADHD trait scores in the presence of different GluR genotypes. Two variants, GRM7 rs3749380 "T" and GRIA1 rs2195450 "C", exhibited associations with ADHD (P ≤ 0.05). A few GluR genetic variants showed significant association with higher trait severity, low IQ, lower plasma Glu level, down-regulated GluR mRNA expression, and poor response to medications. This indicates that down-regulated glutamatergic system may have an effect on ADHD etiology and treatment efficacy warranting further in-depth investigation.
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Affiliation(s)
- Mahasweta Chatterjee
- Manovikas Biomedical Research and Diagnostic Centre, Manovikas Kendra, 482 Madudah, Plot I-24, Sector J, EM Bypass, Kolkata, West Bengal, 700107, India
| | - Sharmistha Saha
- Manovikas Biomedical Research and Diagnostic Centre, Manovikas Kendra, 482 Madudah, Plot I-24, Sector J, EM Bypass, Kolkata, West Bengal, 700107, India
| | - Sayanti Shom
- Manovikas Biomedical Research and Diagnostic Centre, Manovikas Kendra, 482 Madudah, Plot I-24, Sector J, EM Bypass, Kolkata, West Bengal, 700107, India
| | - Nilanjana Dutta
- Manovikas Biomedical Research and Diagnostic Centre, Manovikas Kendra, 482 Madudah, Plot I-24, Sector J, EM Bypass, Kolkata, West Bengal, 700107, India
| | - Swagata Sinha
- Manovikas Biomedical Research and Diagnostic Centre, Manovikas Kendra, 482 Madudah, Plot I-24, Sector J, EM Bypass, Kolkata, West Bengal, 700107, India
| | - Kanchan Mukhopadhyay
- Manovikas Biomedical Research and Diagnostic Centre, Manovikas Kendra, 482 Madudah, Plot I-24, Sector J, EM Bypass, Kolkata, West Bengal, 700107, India.
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Lowthian E, Bedston S, Kristensen SM, Akbari A, Fry R, Huxley K, Johnson R, Kim HS, Owen RK, Taylor C, Griffiths L. Maternal Mental Health and Children's Problem Behaviours: A Bi-directional Relationship? Res Child Adolesc Psychopathol 2023; 51:1611-1626. [PMID: 37400731 PMCID: PMC10628040 DOI: 10.1007/s10802-023-01086-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 07/05/2023]
Abstract
Transactional theory and the coercive family process model have illustrated how the parent-child relationship is reciprocal. Emerging research using advanced statistical methods has examined these theories, but further investigations are necessary. In this study, we utilised linked health data on maternal mental health disorders and explored their relationship with child problem behaviours via the Strengths and Difficulties Questionnaire for over 13 years. We accessed data from the Millennium Cohort Study, linked to anonymised individual-level population-scale health and administrative data within the Secure Anonymised Information Linkage (SAIL) Databank. We used Bayesian Structural Equation Modelling, specifically Random-Intercept Cross-Lagged Panel Models, to analyse the relationships between mothers and their children. We then explored these models with the addition of time-invariant covariates. We found that a mother's mental health was strongly associated over time, as were children's problem behaviours. We found mixed evidence for bi-directional relationships, with only emotional problems showing bi-directional associations in mid to late childhood. Only child-to-mother pathways were identified for the overall problem behaviour score and peer problems; no associations were found for conduct problems or hyperactivity. All models had strong between-effects and clear socioeconomic and sex differences. We encourage the use of whole family-based support for mental health and problem behaviours, and recommend that socioeconomic, sex and wider differences should be considered as factors in tailoring family-based interventions and support.
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Affiliation(s)
- Emily Lowthian
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales.
- Department of Education and Childhood Studies, School of Social Sciences, Swansea University, Swansea, SA2 8PP, Wales.
| | - Stuart Bedston
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
| | | | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
| | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
| | - Katy Huxley
- School of Social Sciences, Population Data Science, Swansea University Medical School, Swansea University, Wales, UK
| | - Rhodri Johnson
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
| | - Hyun Sue Kim
- Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA, 24016, United States
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
| | - Chris Taylor
- School of Social Sciences, Population Data Science, Swansea University Medical School, Swansea University, Wales, UK
| | - Lucy Griffiths
- Population Data Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
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Saunders EFH, Brady M, Mukherjee D, Baweja R, Forrest LN, Gomaa H, Babinski D, He F, Pearl AM, Liao D, Waschbusch DA. Gender differences in transdiagnostic domains and function of adults measured by DSM-5 assessment scales at the first clinical visit: a cohort study. BMC Psychiatry 2023; 23:709. [PMID: 37784092 PMCID: PMC10544467 DOI: 10.1186/s12888-023-05207-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Measurement-based care has been called for as best practice in psychiatric care and learning health systems and use of transdiagnostic measures was suggested as part of the DSM-5. Our objective is to examine gender differences in first visit socioeconomic, transdiagnostic, and functional characteristics of a dynamic, real-world measurement-based care cohort. METHODS Transdiagnostic, functional, and clinical measures were collected from 3,556 patients at first visit in an ambulatory psychiatric clinic. All patients were evaluated at the first visit by board-certified psychiatrists or licensed clinical psychologists. Demographic variables and clinical diagnoses were collected from the Electronic Medical Record. Self-report measures were collected that assessed transdiagnostic symptoms (DSM-5 Level 1 Cross-cutting Measure and Level 2 symptom scales), disability, alcohol use, attention deficit hyperactivity disorder (ADHD) symptoms, depression, anxiety, mania, suicidal thoughts and behaviors, and trauma exposure. RESULTS Men and women did not differ in age, BMI, household income, high school graduation rate, race, or ethnicity, but women were more likely to be formerly married and less likely to have commercial insurance. Compared to men, women reported significantly higher overall psychopathology on the transdiagnostic Level 1 Cross-cutting measure and had higher depression, anxiety, sleep, anger, ADHD combined presentation, and suicidality severity. Women also had higher disability scores than men. However, men reported higher alcohol, tobacco and substance use, and more risky behavior than women. Trauma exposure differed significantly by gender; men reported more exposure to accidents, war-related trauma, serious accidents, and major disasters and women reported more unwanted sexual contact. CONCLUSIONS This cross-sectional study of a transdiagnostic, ecologically-valid real-word measurement-based care cohort demonstrates gender differences in socioeconomic factors, trauma exposure, transdiagnostic symptoms, and functioning.
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Affiliation(s)
- Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
| | - Megan Brady
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dahlia Mukherjee
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Ritika Baweja
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Lauren N Forrest
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Hassaan Gomaa
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Dara Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Fan He
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Amanda M Pearl
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
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Shebl EM, Abu Bakr Elsaid NM, Hassan HA, Kamal D, Araby E. Attention-deficit hyperactivity disorder in Egyptian medical students and how it relates to their academic performance. J Family Community Med 2023; 30:287-294. [PMID: 38044975 PMCID: PMC10688586 DOI: 10.4103/jfcm.jfcm_59_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/08/2023] [Accepted: 07/31/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND The neurobehavioral disorder, known as attention-deficit hyperactivity disorder (ADHD), is characterized by impulsivity, hyperactivity, and a lack of focus. In addition, it is connected to poor academic performance. The purpose of this study was to determine the prevalence of ADHD and its effect on their academic performance among medical students. MATERIALS AND METHODS This web-based cross-sectional study was conducted among medical students of four medical colleges during December 2021 and April 2022. Data was collected using a self-administered questionnaire comprising Wender Utah Rating Scale and adult ADHD Self-Report Scale [ASRS]. The link to Google Form survey was distributed to students through academic emails and WhatsApp. Data analyzed using SPSS; Chisquare test or Fisher's exact test as appropriate, were used to determine statistical significance. RESULTS A total of 990 students filled online questionnaire; 54.7% were females.. The estimated prevalence of ADHD in Egyptian medical students was 11%. Students who had childhood ADHD were significantly linked with the present ADHD (r = 0.54, P < 0.001). There was a negative correlation between the ASRS score for ADHD and students' GPA (r = 0.2, P < 0.001). No statistically significant association was observed between ADHD and sex, type of university, and academic level. of the students. CONCLUSION ADHD is prevalent among medical students. Since most of our students with adult ADHD also had preexisting childhood ADHD, it is crucial that the primary care services, especially school health services, have appropriate standards for the early identification and management of ADHD. Health authorities should conduct a comprehensive health education campaign to raise public awareness of ADHD and its risk factors, the clinical picture, and the burden.
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Affiliation(s)
- Eman M. Shebl
- Department of Public Health and Community Medicine, Benha University, Benha, Egypt
| | - Noha M. Abu Bakr Elsaid
- Department of Public Health, Community, Environmental and Occupational Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Department of Basic Medical Sciences, Faculty of Medicine, King Salman International University, South Sinai, Egypt
| | - Hend A. Hassan
- Department of Public Health and Community Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Doaa Kamal
- Department of Medical Education, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Eman Araby
- Department of Public Health and Community Medicine, Benha University, Egypt
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16
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Frare C, Pitt SK, Hewett SJ. Sex- and age-dependent contribution of System x c- to cognitive, sensory, and social behaviors revealed by comprehensive behavioral analyses of System x c- null mice. Front Behav Neurosci 2023; 17:1238349. [PMID: 37649973 PMCID: PMC10462982 DOI: 10.3389/fnbeh.2023.1238349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Background System xc- (Sxc-) is an important heteromeric amino acid cystine/glutamate exchanger that plays a pivotal role in the CNS by importing cystine into cells while exporting glutamate. Although certain behaviors have been identified as altered in Sxc- null mutant mice, our understanding of the comprehensive impact of Sxc- on behavior remains incomplete. Methods To address this gap, we compared motor, sensory and social behaviors of male and female mice in mice null for Sxc- (SLC7A11sut/sut) with wildtype littermates (SLC7A11+/+) in a comprehensive and systematic manner to determine effects of genotype, sex, age, and their potential interactions. Results Motor performance was not affected by loss of Sxc- in both males and females, although it was impacted negatively by age. Motor learning was specifically disrupted in female mice lacking Sxc- at both 2 and 6 months of age. Further, female SLC7A11sut/sut mice at both ages exhibited impaired sociability, but normal spatial and recognition memory, as well as sensorimotor gating. Finally, pronounced open-space anxiety was displayed by female SLC7A11sut/sut when they were young. In contrast, young SLC7A11sut/sut male mice demonstrated normal sociability, delayed spatial learning, increased open-space anxiety and heightened sensitivity to noise. As they aged, anxiety and noise sensitivity abated but hyperactivity emerged. Discussion We find that the behavioral phenotypes of female SLC7A11sut/sut are similar to those observed in mouse models of autism spectrum disorder, while behaviors of male SLC7A11sut/sut resemble those seen in mouse models of attention deficit hyperactivity disorder. These results underscore the need for further investigation of SLC7A11 in neurodevelopment. By expanding our understanding of the potential involvement of Sxc-, we may gain additional insights into the mechanisms underlying complex neurodevelopmental conditions.
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Affiliation(s)
| | | | - Sandra J. Hewett
- Department of Biology, Program in Neuroscience, Syracuse University, Syracuse, NY, United States
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Vizgaitis AL, Bottini S, Polizzi CP, Barden E, Krantweiss AR. Self-Reported Adult ADHD Symptoms: Evidence Supporting Cautious Use in an Assessment-Seeking Sample. J Atten Disord 2023:10870547231172764. [PMID: 37158158 DOI: 10.1177/10870547231172764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Self-report symptom inventories are commonly used in adult ADHD assessment, and research indicates they should be interpreted with caution. This study investigated one self-report symptom inventory for adult ADHD in a clinical sample. METHOD Archival data were used to evaluate diagnostic utility of the Conners Adult ADHD Rating Scale-Self-Report: Long Version (CAARS-S:L) in a sample of 122 adults seeking ADHD assessment. RESULTS Overall, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) estimates for the ADHD Index and other CAARS-S:L scales demonstrated weak accuracy. Anxiety and depression were the most common diagnoses present when a false positive on the ADHD Index was observed. PPV and specificity for the ADHD Index were higher in males compared to females. CONCLUSION The CAARS-S:L may be useful for screening purposes in some cases, but should not be the main method used for diagnostic purposes. Clinical implications of findings are discussed.
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Affiliation(s)
| | | | | | - Eileen Barden
- Boston University School of Medicine, MA, USA
- State University of New York at Binghamton, NY, USA
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18
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Hartman CA, Chen Q, Solberg BS, Du Rietz E, Klungsøyr K, Cortese S, Dalsgaard S, Haavik J, Ribasés M, Mostert JC, Libutzki B, Kittel-Schneider S, Cormand B, Vos M, Larsson H, Reif A, Faraone SV, Bellato A. Anxiety, mood, and substance use disorders in adult men and women with and without Attention-Deficit/Hyperactivity Disorder: a substantive and methodological overview. Neurosci Biobehav Rev 2023; 151:105209. [PMID: 37149075 DOI: 10.1016/j.neubiorev.2023.105209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]
Abstract
Knowledge on psychiatric comorbidity in adult ADHD is essential for prevention, detection, and treatment of these conditions. This review (1) focuses on large studies (n> 10,000; surveys, claims data, population registries) to identify (a) overall, (b) sex- and (c) age-specific patterns of comorbidity of anxiety disorders (ADs), major depressive disorder (MDD), bipolar disorder (BD) and substance use disorders (SUDs) in adults with ADHD relative to adults without ADHD; and (2) describes methodological challenges relating to establishing comorbidity in ADHD in adults as well as priorities for future research. Meta-analyses (ADHD: n=550,748; no ADHD n=14,546,814) yielded pooled odds ratios of 5.0(CI:3.29-7.46) for AD, 4.5(CI:2.44-8.34) for MDD, 8.7(CI:5.47-13.89) for BD and 4.6(CI:2.72-7.80) for SUDs, indicating strong differences in adults with compared to adults without ADHD. Moderation by sex was not found: high comorbidity held for both men and women with sex-specific patterns as in the general population: higher prevalences of ADs, MDD and BD in women and a higher prevalence of SUDs in men. Insufficient data on different phases of the adult lifespan prevented conclusions on developmental changes in comorbidity. We discuss methodological challenges, knowledge gaps, and future research priorities.
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Affiliation(s)
- Catharina A Hartman
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands.
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Berit Skretting Solberg
- Child- and adolescent psychiatric outpatient unit, Hospital Betanien, Bergen, Norway; Department of Biomedicine, University of Bergen, Norway
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Søren Dalsgaard
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark; CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Norway; Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Marta Ribasés
- Department of Psychiatry, Mental Health and Addictions, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain
| | - Jeanette C Mostert
- Department of Psychiatry, Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Center Nijmegen, the Netherlands; Department of Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Berit Libutzki
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic, University Hospital Würzburg, Würzburg, Germany
| | - Bru Cormand
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Melissa Vos
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt am Main, Germany
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alessio Bellato
- School of Psychology, University of Nottingham, Semenyih, Malaysia
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Associations of UPPS-P negative urgency and positive urgency with ADHD dimensions: Moderation by lack of premeditation and lack of perseverance in men and women. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2023.112125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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20
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Wang H, Liu F, Yu D. Complex network of eye movements during rapid automatized naming. Front Neurosci 2023; 17:1024881. [PMID: 37065911 PMCID: PMC10102513 DOI: 10.3389/fnins.2023.1024881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionAlthough the method of visualizing eye-tracking data as a time-series might enhance performance in the understanding of gaze behavior, it has not yet been thoroughly examined in the context of rapid automated naming (RAN).MethodsThis study attempted, for the first time, to measure gaze behavior during RAN from the perspective of network-domain, which constructed a complex network [referred to as gaze-time-series-based complex network (GCN)] from gaze time-series. Hence, without designating regions of interest, the features of gaze behavior during RAN were extracted by computing topological parameters of GCN. A sample of 98 children (52 males, aged 11.50 ± 0.28 years) was studied. Nine topological parameters (i.e., average degree, network diameter, characteristic path length, clustering coefficient, global efficiency, assortativity coefficient, modularity, community number, and small-worldness) were computed.ResultsFindings showed that GCN in each RAN task was assortative and possessed “small-world” and community architecture. Additionally, observations regarding the influence of RAN task types included that: (i) five topological parameters (i.e., average degree, clustering coefficient, assortativity coefficient, modularity, and community number) could reflect the difference between tasks N-num (i.e., naming of numbers) and N-cha (i.e., naming of Chinese characters); (ii) there was only one topological parameter (i.e., network diameter) which could reflect the difference between tasks N-obj (i.e., naming of objects) and N-col (i.e., naming of colors); and (iii) when compared to GCN in alphanumeric RAN, GCN in non-alphanumeric RAN may have higher average degree, global efficiency, and small-worldness, but lower network diameter, characteristic path length, clustering coefficient, and modularity. Findings also illustrated that most of these topological parameters were largely independent of traditional eye-movement metrics.DiscussionThis article revealed the architecture and topological parameters of GCN as well as the influence of task types on them, and thus brought some new insights into the understanding of RAN from the perspective of complex network.
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Affiliation(s)
- Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Fulin Liu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Dongchuan Yu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- *Correspondence: Dongchuan Yu
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Tan EJ, Raut T, Le LKD, Hay P, Ananthapavan J, Lee YY, Mihalopoulos C. The association between eating disorders and mental health: an umbrella review. J Eat Disord 2023; 11:51. [PMID: 36973817 PMCID: PMC10044389 DOI: 10.1186/s40337-022-00725-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/18/2022] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE There have been an increasing number of systematic reviews indicating the association between eating disorders (ED), including its risk factors, with mental health problems such as depression, suicide and anxiety. The objective of this study was to conduct an umbrella review of these reviews and provide a top-level synthesis of the current evidence in this area. METHOD A systematic search was performed using four databases (MEDLINE Complete, APA PyscInfo, CINAHL Complete and EMBASE). The inclusion criteria were systematic reviews (with or without meta-analysis), published in the English language between January 2015 and November 2022. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for use of JBI Systematic reviews. RESULTS A total of 6,537 reviews were identified, of which 18 reviews met the inclusion criteria, including 10 reviews with meta-analysis. The average quality assessment score for the included reviews was moderate. Six reviews investigated the association between ED and three specific mental health problems: (a) depression and anxiety, (b) obsessive-compulsive symptoms and (c) social anxiety. A further 3 reviews focused on the relationship between ED and attention deficit hyperactivity disorder (ADHD) while 2 reviews focused on ED and suicidal-related outcomes. The remaining 7 reviews explored the association between ED and bipolar disorders, personality disorders, and non-suicidal self-injury. Depression, social anxiety and ADHD are likely to have a stronger strength of association with ED relative to other mental health problems. DISCUSSION Mental health problems such as depression, social anxiety and ADHD were found to be more prevalent among people suffering from eating disorders. Further research is necessary to understand the mechanism and health impacts of potential comorbidities of ED.
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Affiliation(s)
- Eng Joo Tan
- School of Public Health and Preventive Medicine, Monash University Health Economics Group (MUHEG), Monash University, Melbourne, VIC, 3004, Australia
| | - Tejeesha Raut
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia
| | - Long Khanh-Dao Le
- School of Public Health and Preventive Medicine, Monash University Health Economics Group (MUHEG), Monash University, Melbourne, VIC, 3004, Australia.
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Camden and Campbelltown Hospital, SWSLHD, Campbelltown, NSW, 2560, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia
| | - Yong Yi Lee
- School of Public Health and Preventive Medicine, Monash University Health Economics Group (MUHEG), Monash University, Melbourne, VIC, 3004, Australia
- School of Public Health, The University of Queensland, QLD, 4006, Herston, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, QLD, 4076, Wacol, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University Health Economics Group (MUHEG), Monash University, Melbourne, VIC, 3004, Australia
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22
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Sex-Specific Neurocognitive Impairment. Neurol Clin 2023; 41:359-369. [PMID: 37030963 DOI: 10.1016/j.ncl.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-specific neurocognitive impairment across a range of medical conditions including neurodegenerative diseases and coronavirus disease-2019.
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23
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Breach MR, Lenz KM. Sex Differences in Neurodevelopmental Disorders: A Key Role for the Immune System. Curr Top Behav Neurosci 2023; 62:165-206. [PMID: 35435643 PMCID: PMC10286778 DOI: 10.1007/7854_2022_308] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Sex differences are prominent defining features of neurodevelopmental disorders. Understanding the sex biases in these disorders can shed light on mechanisms leading to relative risk and resilience for the disorders, as well as more broadly advance our understanding of how sex differences may relate to brain development. The prevalence of neurodevelopmental disorders is increasing, and the two most common neurodevelopmental disorders, Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) exhibit male-biases in prevalence rates and sex differences in symptomology. While the causes of neurodevelopmental disorders and their sex differences remain to be fully understood, increasing evidence suggests that the immune system plays a critical role in shaping development. In this chapter we discuss sex differences in prevalence and symptomology of ASD and ADHD, review sexual differentiation and immune regulation of neurodevelopment, and discuss findings from human and rodent studies of immune dysregulation and perinatal immune perturbation as they relate to potential mechanisms underlying neurodevelopmental disorders. This chapter will give an overview of how understanding sex differences in neuroimmune function in the context of neurodevelopmental disorders could lend insight into their etiologies and better treatment strategies.
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Affiliation(s)
- Michaela R Breach
- Neuroscience Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Kathryn M Lenz
- Department of Psychology, The Ohio State University, Columbus, OH, USA.
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA.
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA.
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24
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Bartoli F, Callovini T, Cavaleri D, Cioni RM, Bachi B, Calabrese A, Moretti F, Canestro A, Morreale M, Nasti C, Palpella D, Piacenti S, Nacinovich R, Riboldi I, Crocamo C, Carrà G. Clinical correlates of comorbid attention deficit hyperactivity disorder in adults suffering from bipolar disorder: A meta-analysis. Aust N Z J Psychiatry 2023; 57:34-48. [PMID: 35786010 DOI: 10.1177/00048674221106669] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder is a frequent comorbid condition in adults with bipolar disorder. We performed a meta-analysis aimed at assessing sociodemographic and clinical correlates of attention deficit hyperactivity disorder in bipolar disorder. METHOD We searched main electronic databases up to June 2021. Random-effects meta-analyses, with relevant meta-regression and quality-based sensitivity analyses, were carried out to estimate the association between attention deficit hyperactivity disorder and putative correlates, grading the quality of evidence. RESULTS We included 43 studies, based on 38 independent samples. Attention deficit hyperactivity disorder participants were more likely to be males (odds ratio = 1.46; p < 0.001) and unemployed (odds ratio = 1.45; p = 0.045), and less likely to be married (odds ratio = 0.62; p = 0.014). They had an earlier onset of bipolar disorder (standardized mean difference = -0.36; p < 0.001); more mood episodes (standardized mean difference = 0.35; p = 0.007), particularly depressive (standardized mean difference = 0.30; p = 0.011) and mixed (standardized mean difference = 0.30; p = 0.031) ones; higher odds of using antidepressants (odds ratio = 1.80; p = 0.024) and attempted suicides (odds ratio = 1.83; p < 0.001) and lower odds of psychotic features (odds ratio = 0.63; p = 0.010). Moreover, they were more likely to have generalized anxiety disorder (odds ratio = 1.50; p = 0.019), panic disorder (odds ratio = 1.89; p < 0.001), social phobia (odds ratio = 1.61; p = 0.017), eating disorders (odds ratio = 1.91; p = 0.007), antisocial personality disorder (odds ratio = 3.59; p = 0.004) and substance (odds ratio = 2.29; p < 0.001) or alcohol (odds ratio = 2.28; p < 0.001) use disorders. Quality of the evidence was generally low or very low for the majority of correlates, except for bipolar disorder onset and alcohol/substance use disorders (high), and suicide attempts (moderate). CONCLUSION Comorbid bipolar disorder/attention deficit hyperactivity disorder may have some distinctive clinical features including an earlier onset of bipolar disorder and higher comorbid alcohol/substance use disorder rates. Further research is needed to identify additional clinical characteristics of this comorbidity.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Tommaso Callovini
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Bianca Bachi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Angela Calabrese
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Federico Moretti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Aurelia Canestro
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Morreale
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Christian Nasti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Dario Palpella
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Susanna Piacenti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Renata Nacinovich
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
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25
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Murray AL, Taut D, Baban A, Hemady CL, Walker S, Osafo J, Sikander S, Tomlinson M, Toit SD, Marlow M, Ward CL, Fernando A, Madrid B, Van Thang V, Tuyen HD, Dunne M, Hughes C, Fearon P, Valdebenito S, Eisner M. Associations Between ADHD Symptoms and Maternal and Birth Outcomes: An Exploratory Analysis in a Multi-Country Cohort of Expectant Mothers. J Atten Disord 2022; 26:1882-1894. [PMID: 35815439 PMCID: PMC9597155 DOI: 10.1177/10870547221105064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and fetal development; however, there has been almost no research examining their impact during pregnancy. We aimed to address this gap. METHOD We used data (n = 1,204) from a longitudinal birth cohort study spanning eight countries to address this gap. RESULTS ADHD symptoms in the third trimester of pregnancy were associated with lower social support from family (b = -0.16, p = .031), friends (b = -0.16, p = .024), and significant others (b = -0.09, p = .001); higher stress (b = 0.34, p < .001) and depressive symptoms (b = 0.31, p < .001), and increased likelihood of an unwanted pregnancy (b = 0.30, p = .009). Significant associations with tobacco use (b = 0.36, p = .023) and premature birth (b = 0.35, p = .007) did not survive correction for multiple comparisons and there were no significant associations with alcohol use, low birth weight, or unplanned pregnancy. CONCLUSION Results suggest that women with ADHD symptoms could benefit from earlier, more regular screening for mental health difficulties and greater mental health support during pregnancy.
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Affiliation(s)
- Aja Louise Murray
- University of Edinburgh, UK,Aja Louise Murray, Department of
Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UK.
| | - Diana Taut
- Babes-Bolyai University, Cluj-Napoca,
Romania
| | | | | | - Susan Walker
- The University of the West Indies,
Kingston, Jamaica
| | | | | | - Mark Tomlinson
- Stellenbosch Uni`versity, Cape Town,
South Africa,Queens University, Belfast, UK
| | | | | | | | | | | | | | | | - Michael Dunne
- Queensland University of Technology,
Brisbane, Australia
| | | | | | | | - Manuel Eisner
- University of Cambridge, UK,University of Zurich,
Switzerland
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26
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Wootton RE, Riglin L, Blakey R, Agnew-Blais J, Caye A, Cadman T, Havdahl A, Gonçalves H, Menezes AMB, Wehrmeister FC, Rimfeld K, Davey Smith G, Eley TC, Rohde LA, Arseneault L, Moffitt TE, Stergiakouli E, Thapar A, Tilling K. Decline in attention-deficit hyperactivity disorder traits over the life course in the general population: trajectories across five population birth cohorts spanning ages 3 to 45 years. Int J Epidemiol 2022; 51:919-930. [PMID: 35403686 PMCID: PMC9189965 DOI: 10.1093/ije/dyac049] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/15/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Trajectories of attention-deficit hyperactivity disorder (ADHD) traits spanning early childhood to mid-life have not been described in general populations across different geographical contexts. Population trajectories are crucial to better understanding typical developmental patterns. METHODS We combined repeated assessments of ADHD traits from five population-based cohorts, spanning ages 3 to 45 years. We used two measures: (i) the Strengths and Difficulties Questionnaire (SDQ) hyperactive-inattentive subscale (175 831 observations, 29 519 individuals); and (ii) scores from DSM-referenced scales (118 144 observations, 28 685 individuals). Multilevel linear spline models allowed for non-linear change over time and differences between cohorts and raters (parent/teacher/self). RESULTS Patterns of age-related change differed by measure, cohort and country: overall, SDQ scores decreased with age, most rapidly declining before age 8 years (-0.157, 95% CI: -0.170, -0.144 per year). The pattern was generally consistent using DSM scores, although with greater between-cohort variation. DSM scores decreased most rapidly between ages 14 and 17 years (-1.32%, 95% CI: -1.471, -1.170 per year). Average scores were consistently lower for females than males (SDQ: -0.818, 95% CI: -0.856, -0.780; DSM: -4.934%, 95% CI: -5.378, -4.489). This sex difference decreased over age for both measures, due to an overall steeper decrease for males. CONCLUSIONS ADHD trait scores declined from childhood to mid-life, with marked variation between cohorts. Our results highlight the importance of taking a developmental perspective when considering typical population traits. When interpreting changes in clinical cohorts, it is important to consider the pattern of expected change within the general population, which is influenced by cultural context and measurement.
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Affiliation(s)
- Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People’s Mental Health, Cardiff University, UK
| | - Rachel Blakey
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jessica Agnew-Blais
- Department of Psychology, School of Biological and Chemical Science, Queen Mary University of London, London, UK
| | - Arthur Caye
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Brazil
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tim Cadman
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Kaili Rimfeld
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- Department of Psychology, Royal Holloway University of London, London, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Thalia C Eley
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents, Brazil
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Louise Arseneault
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Terrie E Moffitt
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People’s Mental Health, Cardiff University, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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27
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Babinski DE, Saunders EFH, He F, Liao D, Pearl AM, Waschbusch DA. Screening for ADHD in a general outpatient psychiatric sample of adults. Psychiatry Res 2022; 311:114524. [PMID: 35349861 DOI: 10.1016/j.psychres.2022.114524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/28/2022]
Abstract
Adults (n = 805) seeking outpatient psychiatric care completed the Adult ADHD Self-Report Scale (ASRS) and measures of impairment and co-occurring psychopathology as part of a measurement-based care initiative. Diagnostic indicators of ADHD (i.e., formal diagnosis and/or medication treatment) were recorded from the electronic medical record (EMR). Agreement between screening positive for ADHD and EMR indicators for the diagnosis was explored, and clinical characteristics of adults identified with ADHD using these indicators were examined. Lastly, the contribution of ADHD to functional impairment was examined, controlling for the contribution of other demographic and psychiatric comorbidities. In the full sample, 54.78% of adults screened positive for ADHD based on the ASRS, and using EMR indicators, only 11.93% of adults were identified with ADHD. Agreement emerged between self-reported ADHD and ADHD EMR indicators, although adults screening positive for ADHD generally reported greater psychiatric complexity relative to adults identified with ADHD in the EMR. ADHD was associated with clinical impairment even when controlling for other psychiatric comorbidities. The considerable difference in prevalence of ADHD based on self-report screening versus EMR indicators suggests that ADHD may be overlooked in adult psychiatric care. Findings point to the importance of assessing adult ADHD in routine psychiatric care.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Fan He
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Amanda M Pearl
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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28
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Lee CA, Goh PK, Shelton CR, Hartung CM. Networks of ADHD and SCT Symptoms in Emerging Adulthood. J Atten Disord 2022; 26:991-1000. [PMID: 34693775 DOI: 10.1177/10870547211045743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Emerging adulthood (18-25 years) is a transitional and understudied developmental period. Yet, little is known about how specific symptoms of ADHD, as well as those from the related SCT domain, may differentially relate to one another during this period, if there are differences based on biological sex, or how closely results will align with adulthood. METHODS We used network analysis techniques to explore the structure of ADHD and SCT symptoms within emerging adulthood, with additional comparisons between sexes as well as between emerging adulthood and adulthood. Using an online platform, 8,506 adults reported on their symptoms of ADHD and SCT. RESULTS Symptoms grouped together within their respective domains during emerging adulthood with no significant differences in overall network structure between sexes. Similarly, network structure appeared to be robust across emerging adulthood and adulthood. CONCLUSION Such consistency supports a conceptualization of ADHD in emerging adulthood as similar to adulthood.
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29
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Xie Y, Wang H, Chen Y, Liu F, Yao M, Zhang L, Liu P, Hong Q, Chi X, Yu D. Establishing Normative Data for the Number Cancelation Test Among Children in Kindergartens and Primary Schools in China. Front Psychiatry 2022; 13:788825. [PMID: 35479487 PMCID: PMC9035546 DOI: 10.3389/fpsyt.2022.788825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
This study aimed to suggest an attention assessment tool using a Digital Pen for measuring the temporal-spatial parameters during the Number Cancelation Test (NCT), and then to establish the normative data for the NCT among children in kindergartens and primary schools in China by recruiting a total of 989 children (496 males). Four measures, i.e., selective attention (SA), speed of cognitive processing (SpC), averaged time of circlings (ATC), and averaged circumference of circled curves (ACCC), were proposed to evaluate the NCT performance. They basically have a development trend with fast speed in the beginning before Grade 1 or 2 of primary schools, and then enter an extremely slow development period (with ceiling or floor effect). SA and SpC have gender and grade main effects, while ATC and ACCC have the grade main effect, only. In particular, females have higher SA scores than males in middle class of kindergarten, and Grade 2-Grade 5 of primary school, but no gender differences in other grades; females have higher SpC scores than males in middle class of kindergarten, and Grade 3-4 of primary school, but no gender differences in other grades. More importantly, in clinical practice, if SA or SpC measure of a child is below than the 5th centile (i.e., p5 level) of his/her grade-specific normative data, then this child may be predicted to have a high-risk of learning disabilities. Findings suggest that the proposed method can be used for early screening of learning disabilities by setting appropriate cut-off values.
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Affiliation(s)
- Yachun Xie
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Yuxin Chen
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Fulin Liu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Mengmeng Yao
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Lei Zhang
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Panting Liu
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Qin Hong
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Xia Chi
- Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Dongchuan Yu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Lab of Language Rehabilitation for Children, Sanmenxia Center Hospital, Sanmenxia, China
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30
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Hinshaw SP, Nguyen PT, O'Grady SM, Rosenthal EA. Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. J Child Psychol Psychiatry 2022; 63:484-496. [PMID: 34231220 DOI: 10.1111/jcpp.13480] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 01/13/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) - and its underlying behavioral dimensions of inattention and hyperactivity-impulsivity - have been understudied in females. We first cover the conceptual issues of prevalence, diagnostic practices, diversity, comorbidity, and causal factors, plus forces limiting awareness of ADHD in females. After a narrative review of cross-sectional and longitudinal findings, we conclude the following. (a) Girls meet diagnostic criteria for ADHD at just under half the rates of boys, a ratio that becomes much closer to equal by adulthood. (b) Girls and women with ADHD show a predominance of inattention and associated internalizing problems; boys and men display greater levels of hyperactive-impulsive symptoms and associated externalizing problems. (c) Sex differences in ADHD symptoms and related outcomes depend heavily on the clinical versus nonreferred nature of the samples under investigation. (d) Females with ADHD experience, on average, serious impairments, with a particularly heightened risk for problems in close relationships and engagement in self-harm. (e) Clinicians may overlook symptoms and impairments in females because of less overt (but still impairing) symptom manifestations in girls and women and their frequent adoption of compensatory strategies. Our review of predictors and mediators of adult outcomes highlights (a) the potential for heterotypically continuous pathways in females with childhood ADHD and (b) developmental progressions to self-harm, intimate partner violence, unplanned pregnancy, and comorbid psychopathology. Focusing on ADHD in females is necessary to characterize causal and maintaining mechanisms with accuracy and to foster responsive interventions, as highlighted in our closing list of clinical implications and research priorities.
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Affiliation(s)
- Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Phuc T Nguyen
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Sinclaire M O'Grady
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Emily A Rosenthal
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
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31
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Li L, Chang Z, Sun J, Jangmo A, Zhang L, Andersson LM, Werner-Kiechle T, Ahnemark E, D’Onofrio BM, Larsson H. Association Between Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder and Long-term Unemployment Among Working-Age Individuals in Sweden. JAMA Netw Open 2022; 5:e226815. [PMID: 35476068 PMCID: PMC9047436 DOI: 10.1001/jamanetworkopen.2022.6815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
IMPORTANCE Adults with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for unemployment. Pharmacological treatment is effective in reducing the core symptoms of ADHD, but whether it helps to reduce the unemployment rate among adult patients remains unclear. OBJECTIVE To investigate the association between use of ADHD medication and long-term unemployment in working-age adults with ADHD. DESIGN, SETTING, AND PARTICIPANTS Data for this population-based cohort study were extracted from Swedish national registers. Among 25 358 individuals with ADHD born from 1958 to 1978, 12 875 middle-aged adults among the workforce were included. The longitudinal cohort was followed up from January 1, 2008, to December 31, 2013. Data were analyzed from March 1, 2020, through May 31, 2021. EXPOSURES Use of medication for ADHD during the previous 2 years was the main exposure, as both categorical and continuous variables. MAIN OUTCOMES AND MEASURES Yearly accumulated unemployed days were derived from the Public Employment Service, and long-term unemployment was defined as 90 or more days of unemployment per year. Overall and sex-specific relative risks (RRs) with 95% CIs were estimated using generalized estimating equations. RESULTS Among 12 875 individuals with ADHD (5343 women [41.50%] and 7532 men [58.50%]; mean [SD] age, 37.9 [5.6] years), the use of ADHD medications during the previous 2 years was associated with a 10% lower risk of long-term unemployment in the following year (adjusted RR, 0.90 [95% CI, 0.87-0.95]). An association between use of ADHD medications and long-term unemployment was found among women (RR, 0.82 [95% CI, 0.76-0.89]) but not men (RR, 0.96 [95% CI, 0.91-1.01]). Longer treatment duration was associated with a lower risk of subsequent long-term unemployment among women (RR for use of 1-6 months, 0.86 [95% CI, 0.78-0.95]; RR for use of 18-24 months, 0.72 [95% CI, 0.58-0.90]; P < .001 for trend). Within-individual comparisons showed that the long-term unemployment rate was lower during periods of ADHD medication treatment compared with nontreatment periods (RR, 0.89; 95% CI, 0.85-0.94). CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that the use of ADHD medication is associated with a lower risk of subsequent long-term unemployment for middle-aged women. These findings should be considered together with the existing knowledge of risks and benefits of ADHD medication when developing treatment plans for working-age adults.
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Affiliation(s)
- Lin Li
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jiangwei Sun
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Jangmo
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Le Zhang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Ewa Ahnemark
- Medical Affairs, Shire Sweden AB, Stockholm, Sweden
| | - Brian M. D’Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Henning C, Summerfeldt LJ, Parker JDA. ADHD and Academic Success in University Students: The Important Role of Impaired Attention. J Atten Disord 2022; 26:893-901. [PMID: 34384265 PMCID: PMC8859654 DOI: 10.1177/10870547211036758] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To improve on several methodological issues regarding current literature investigating the relationship between ADHD symptomatology and academic success in adults and examine the relative contributions of specific dimensions of ADHD symptomatology (i.e., inattention, hyperactivity, and impulsivity) to post-secondary academic success. METHOD A large sample of 3,688 post-secondary students were examined using a longitudinal design. The Conners' Adult ADHD Rating Scale (CAARS) was used to assess adult ADHD symptoms and academic success was assessed using students' official academic records (e.g., final GPAs and degree completion status). RESULTS Students with greater inattention symptomatology at the start of their academic program showed consistently poorer long-term academic success (i.e., lower GPAs, higher dropout rates), regardless of gender. CONCLUSION Inattention symptoms are the primary driver of the relationship between ADHD symptomatology and academic underachievement in adults. Post-secondary education institutions should target and prioritize educational programming for inattention symptoms of ADHD in at-risk post-secondary students.
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Affiliation(s)
| | | | - James D. A. Parker
- Trent University, Peterborough, ON, Canada,James D. A. Parker, Department of Psychology, Trent University, 1600 West Bank Drive, DNA Building, Suite C104, Peterborough, ON K9J 7B8, Canada.
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Towards equitable diagnoses for autism and attention-deficit/hyperactivity disorder across sexes and genders. Curr Opin Psychiatry 2022; 35:90-100. [PMID: 35084380 DOI: 10.1097/yco.0000000000000770] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Sex/gender-related factors contribute to contextual issues influencing the recognition of autism and attention-deficit/hyperactivity disorder (ADHD), and modulate how neurodevelopmental characteristics are manifested. This review summarizes the empirical literature to provide directions for improving clinical diagnostic practices. RECENT FINDINGS Timing of autism and/or ADHD diagnosis, particularly in girls/women, is related to the individual's developmental characteristics and co-occurring diagnoses, and expectancy, alongside gender stereotype biases, of referral sources and clinicians. This is further compounded by sex and gender modulations of behavioural presentations. The emerging 'female autism phenotype' concept may serve as a helpful illustration of nuanced autism phenotypes, but should not be viewed as essential features of autism in a particular sex or gender. These nuanced phenotypes that can present across sexes and genders include heightened attention to socially salient stimuli, friendship and social groups, richness in language expression, and more reciprocal behaviours. The nuanced female-predominant ADHD phenotypes are characterized by subtle expressions in hyperactivity-impulsivity (e.g., hyper-verbal behaviours). Optimizing neurodevelopmental diagnoses across sexes and genders also requires an understanding of sex-related and gender-related variations in developmental trajectories, including compensation/masking efforts, and the influences of co-occurring conditions on clinical presentations. SUMMARY Equitable diagnoses across sexes and genders for autism and ADHD require understanding of the nuanced presentations and the Gestalt clinical-developmental profiles, and addressing contextual biases that influence diagnostic practices.
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Relationship between sex hormones, reproductive stages and ADHD: a systematic review. Arch Womens Ment Health 2022; 25:1-8. [PMID: 34487213 DOI: 10.1007/s00737-021-01181-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This systematic review aims to summarize current available evidence for the relationship between sex hormones or reproductive life stages (adrenarche in males and females, menarche, pregnancy, postpartum and menopause) and ADHD. METHODS We systematically reviewed studies investigating the relationship between sex hormones and symptoms of inattention and/or hyperactivity in individuals with an ADHD diagnosis or equivalent assessment of symptoms with validated scales. Articles were screened sequentially by two reviewers who were clinically and academically familiar with ADHD. Studies were rated according to Oxford Levels of Evidence (CEBM 2009). RESULTS Four studies matched inclusion criteria. One article was a case report of a female with ADHD and premenstrual syndrome experiencing worsening symptoms prior to each period (Quinn, J Clin Psychol 61:579-587, 2005). Another was a review article analysing literature relating to the effect of hormones on ADHD symptoms and supporting that a relationship exists between ADHD symptoms and sex hormone levels, without further characterization (Haimov-Kochman and Berger, Front Hum Neurosci 8, 2014). Giotakos and colleagues found no relationship between Wender Utah scores and sex hormone levels (Giotakos et al., J Forensic Psychiatry Psychol 16:423-433, 2005). An exploratory study by Ostojic and Miller found evidence for an association between early pubertal onset, inattention and risk-taking behaviour (Ostojic and Miller, J Atten Disord 20:782-791, 2016). CONCLUSION The literature on the relationship between sex hormones and ADHD is limited. Available studies present contradicting information. It is not known how this lack of evidence affects the treatment of ADHD during the lifespan. Further research is required to correctly characterize the mechanisms behind ADHD symptoms and its potential association with sex hormones.
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Male sex bias in early and late onset neurodevelopmental disorders: shared aspects and differences in autism spectrum disorder, attention deficit/hyperactivity disorder, and schizophrenia. Neurosci Biobehav Rev 2022; 135:104577. [DOI: 10.1016/j.neubiorev.2022.104577] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/23/2022] [Accepted: 02/11/2022] [Indexed: 12/22/2022]
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Murray AL, Caye A, McKenzie K, Auyeung B, Murray G, Ribeaud D, Freeston M, Eisner M. Reciprocal Developmental Relations Between ADHD and Anxiety in Adolescence: A Within-Person Longitudinal Analysis of Commonly Co-Occurring Symptoms. J Atten Disord 2022; 26:109-118. [PMID: 32172640 DOI: 10.1177/1087054720908333] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
UNLABELLED Objective: Significant anxiety often occurs in the presence of ADHD symptoms; however, the reasons are not well understood. We aimed to establish whether the relations between ADHD symptons and anxiety are bidirectional or unidirectional. METHOD Weexamined the developmental relations between ADHD and anxiety symptoms across adolescence (ages 13, 15, and 17) in a community-ascertained, normative longitudinal sample of 1,483 youth (52% male). We used an autoregressive latent trajectory model with structured residuals (ALT-SR) to examine within-person developmental relations between ADHD and anxiety symptoms to determine whether it is ADHD symptoms that lead to anxiety symptoms and/or the reverse. RESULTS Results suggested that there are reciprocal within-person developmental relations between ADHD and anxiety symptoms. CONCLUSIONS Our findings support the recommendation that targeting ADHD symptoms can be fruitful for addressing anxiety symptoms; however, they suggest that targeting anxiety symptoms may also benefit ADHD symptoms. Results also underline the importance of careful assessment for underlying ADHD symptoms among adolescents presenting with anxiety.
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Affiliation(s)
| | - Arthur Caye
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | | | - Manuel Eisner
- University of Cambridge, UK.,University of Zurich, Switzerland
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Murray AL, Ushakova A, Speyer L, Brown R, Auyeung B, Zhu X. Sex/gender differences in individual and joint trajectories of common mental health symptoms in early to middle adolescence. JCPP ADVANCES 2021. [DOI: 10.1002/jcv2.12057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Anastasia Ushakova
- Center for Health Informatics, Computing and Statistics Medical School Lancaster University Lancaster UK
| | - Lydia Speyer
- Department of Psychology University of Edinburgh Edinburgh UK
- Department of Psychology University of Cambridge Cambridge UK
| | - Ruth Brown
- Department of Psychology University of Edinburgh Edinburgh UK
| | - Bonnie Auyeung
- Department of Psychology University of Edinburgh Edinburgh UK
| | - Xinxin Zhu
- Department of Psychology University of Edinburgh Edinburgh UK
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Callahan BL, Shammi P, Taylor R, Ramakrishnan N, Black SE. Longitudinal Cognitive Performance of Older Adults With ADHD Presenting to a Cognitive Neurology Clinic: A Case Series of Change Up to 21 Years. Front Aging Neurosci 2021; 13:726374. [PMID: 34867269 PMCID: PMC8634492 DOI: 10.3389/fnagi.2021.726374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The neuropsychological features of older adults with ADHD are largely unknown. This retrospective chart review aims to elucidate their cognitive trajectories using a case series of six older adults with ADHD presenting with memory complaints to a cognitive neurology clinic, whom we argue are a particularly relevant group to study due to their potential to mimic neurodegenerative syndromes. Methods: Participants were included if they were age 40 or older at intake, had ADHD based on DSM-5 criteria, and had cognitive data collected prior to 2014 with follow-up at least 5 years later. Results: Five men and one woman were included (M = 53.8 years at intake) and had an average of 135.0 months of follow-up data available. Despite notable between- and within-subject variability, cognition generally improved or remained stable across visits. Two participants experienced notable memory decline, but a global consideration of their performance in other domains suggests these deficits may be frontally-mediated. Conclusion: In this small sample, cognition remained generally unchanged across 5–21 years. Isolated impairments likely reflect substantial intra-individual variability across time and measures.
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Affiliation(s)
- Brandy L Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Prathiba Shammi
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rebecca Taylor
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Mohamed SMH, Börger NA, van der Meere JJ. Executive and Daily Life Functioning Influence the Relationship Between ADHD and Mood Symptoms in University Students. J Atten Disord 2021; 25:1731-1742. [PMID: 31971050 PMCID: PMC8404724 DOI: 10.1177/1087054719900251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Many studies have indicated a close relationship between ADHD and mood symptoms in university students. In the present study, we explore the role of daily functional impairments and executive functioning in the ADHD-mood relationship. Method: A total of 343 adults (126 males) filled out (a) the Conners' Adult ADHD Rating Scale, (b) the Depression Anxiety and Stress Scale, (c) the Weiss Functional Impairment Rating Scale, and (d) the Executive Function Index Scale. Results: The correlation between mood symptoms and ADHD was .48 (moderate correlation) and dropped to .15 (weak correlation) when controlling for functional problems and executive functioning. Hierarchical regression analyses showed that both functional impairments and executive functioning significantly explained 42% to 53% of the variance of mood symptoms. The addition of ADHD symptoms to the model slightly increased the explained mood variance by only 1%. Conclusion: These findings underline the role of experienced difficulties in triggering mood symptoms in ADHD symptomatology.
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Affiliation(s)
- Saleh M. H. Mohamed
- University of Groningen, The Netherlands,Saleh M. H. Mohamed, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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Fuller-Thomson E, Lewis DA, Agbeyaka S. Attention-Deficit/Hyperactivity Disorder and Alcohol and Other Substance Use Disorders in Young Adulthood: Findings from a Canadian Nationally Representative Survey. Alcohol Alcohol 2021; 57:385-395. [PMID: 34343246 DOI: 10.1093/alcalc/agab048] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 12/31/2022] Open
Abstract
AIM (a) To document the prevalence and odds of (i) alcohol use disorders, (ii) cannabis use disorders, (iii) other drug use disorders and (iv) any substance use disorder (SUD), among young adults with and without ADHD, and (b) to investigate the degree to which the association between ADHD and SUDs is attenuated by socio-demographics, early adversities and mental health. METHOD Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (CCHS-MH). The sample included 6872 respondents aged 20-39, of whom 270 had ADHD. The survey response rate was 68.9%. MEASUREMENTS Substance Use Disorder: World Health Organization's Composite International Diagnostic Interview criteria, SUDs, were derived from lifetime algorithms for alcohol, cannabis and other substance abuse or dependence. ADHD was based on self-report of a health professional's diagnosis. FINDINGS One in three young adults with ADHD had a lifetime alcohol use disorder (36%) compared to 19% of those without ADHD (P < 0.001). After adjusting for all control variables, those with ADHD had higher odds of developing alcohol use disorders (OR = 1.38, 95% CI: 1.05, 1.81), cannabis use disorders (OR = 1.46, 95% CI: 1.06, 2.00), other drug use disorders (OR = 2.07, 95% CI: 1.46, 2.95) and any SUD (OR = 1.69, 95% CI: 1.28, 2.23). History of depression and anxiety led to the largest attenuation of the ADHD-SUD relationship, followed by childhood adversities and socioeconomic status. CONCLUSIONS Young adults with ADHD have a high prevalence of alcohol and other SUDs. Targeted outreach and interventions for this extremely vulnerable population are warranted.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, Canada.,Department of Family and Community Medicine, 500 University Avenue, 5th Floor University of Toronto, Toronto, Canada.,Institute for Life Course & Aging, University of Toronto, 246 Bloor St. W., Toronto, Canada
| | - Danielle A Lewis
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, Canada
| | - Senyo Agbeyaka
- Toronto General Hospital, 200 Elizabeth St, University Health Network, Toronto, ON, Canada
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Solberg BS, Hegvik T, Halmøy A, Skjærven R, Engeland A, Haavik J, Klungsøyr K. Sex differences in parent-offspring recurrence of attention-deficit/hyperactivity disorder. J Child Psychol Psychiatry 2021; 62:1010-1018. [PMID: 33341963 PMCID: PMC8451909 DOI: 10.1111/jcpp.13368] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental disorder sharing genetic risk factors with other common psychiatric disorders. However, intergenerational recurrence patterns of ADHD from parents to sons and daughters are not known. We aimed to examine the risk of ADHD in offspring of parents with ADHD and parents with other psychiatric disorders by parental and offspring sex, using parents without the specific disorders as comparison. METHODS In a generation study linking data from several population-based registries, all Norwegians born 1967-2011 (n = 2,486,088; Medical Birth Registry of Norway) and their parents were followed to 2015. To estimate intergenerational recurrence risk, we calculated prevalence differences (PD) and the relative risk (RR) of ADHD in offspring by parental ADHD, bipolar disorder (BD), schizophrenia spectrum disorder (SCZ), major depression (MDD), all by parental and offspring sex. RESULTS The absolute prevalence of ADHD in offspring of parents with ADHD was very high, especially in sons of two affected parents (41.5% and 25.1% in sons and daughters, respectively), and far higher than in offspring of parents with BD, SCZ or MDD. Intergenerational recurrence risks were higher for maternal than paternal ADHD (RRmaternal 8.4, 95% confidence interval (CI) 8.2-8.6 vs. RRpaternal 6.2, 6.0-6.4) and this was also true on the absolute scale (PDmaternal 21.1% (20.5-21.7) vs. PDpaternal 14.8% (14.3-15.4)). RRs were higher in daughters, while PDs higher in sons. Parental SCZ, BD and MDD were associated with an approximately doubled risk of offspring ADHD compared to parents without the respective disorders, and estimates did not differ significantly between daughters and sons. CONCLUSIONS The intergenerational recurrence risks of ADHD were high and higher from mothers with ADHD than fathers with ADHD. Other parental psychiatric disorders also conferred increased risk of offspring ADHD, but far lower, indicating a sex- and diagnosis-specific intergenerational recurrence risk in parents with ADHD.
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Affiliation(s)
- Berit S. Solberg
- Department of BiomedicineUniversity of BergenBergenNorway,Department of Global Public Health and Primary CareUniversity of BergenBergenNorway,Child and Adolescent Psychiatric Outpatient UnitHospital BetanienBergenNorway
| | | | - Anne Halmøy
- Department of PsychiatryHaukeland University HospitalBergenNorway,Department of Clinical MedicineUniversity of BergenBergenNorway
| | - Rolv Skjærven
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway,Centre for Fertility and HealthNorwegian Institute of Public HealthOsloNorway
| | - Anders Engeland
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway,Division of Mental and Physical HealthNorwegian Institute of Public HealthBergenNorway
| | - Jan Haavik
- Department of BiomedicineUniversity of BergenBergenNorway,Bergen Center for Brain PlasticityDivision of PsychiatryHaukeland University HospitalBergenNorway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway,Division of Mental and Physical HealthNorwegian Institute of Public HealthBergenNorway
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Wymbs BT, Canu WH, Sacchetti GM, Ranson LM. Adult ADHD and romantic relationships: What we know and what we can do to help. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:664-681. [PMID: 33421168 DOI: 10.1111/jmft.12475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/15/2020] [Accepted: 11/22/2020] [Indexed: 05/27/2023]
Abstract
It has been widely maintained that enduring and healthy romantic relationships are critical to quality of life in adulthood, and can buffer the impact of adversity, including psychological disorder. Unfortunately, much research points toward adults with attention-deficit hyperactivity disorder (ADHD) having short-lived and discordant romantic relationships. Despite this ample evidence, relatively little research has focused on identifying specific factors that may strengthen or explain their relational difficulties, which would have obvious relationship distress prevention and intervention implications. The current study reviews the state of the literature on romantic relationships in adults with ADHD, including differences that have been established between ADHD and non-ADHD populations as well as distal and proximal factors that appear to increase risk of relationship distress of adults with ADHD. Finally, notable gaps in the literature are identified and implications are raised with regards to prevention and intervention efforts designed to address functional impairment in adults with ADHD.
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Affiliation(s)
- Brian T Wymbs
- Department of Psychology, Ohio University, Athens, OH, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, NC, USA
| | | | - Loren M Ranson
- Department of Psychology, Appalachian State University, Boone, NC, USA
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ADHD and Bipolar Disorder in Adulthood: Clinical and Treatment Implications. ACTA ACUST UNITED AC 2021; 57:medicina57050466. [PMID: 34068605 PMCID: PMC8151516 DOI: 10.3390/medicina57050466] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/22/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a condition that usually has its onset in childhood. Although the disorder persists into adulthood in half of cases, adult ADHD is often not recognized due to different psychopathological characteristics, quite often overlapping with other diagnoses such as mood, anxiety and personality disorders. This is especially true for bipolar disorder (BD), which shares several symptoms with adult ADHD. Moreover, besides an overlapping clinical presentation, BD is often co-occurring in adults with ADHD, with comorbidity figures as high as 20%. This review will focus on the comorbidity between ADHD and BD by exploring the magnitude of the phenomenon and evaluating the clinical and functional characteristics associated with ADHD-BD comorbidity in adults. Finally, the review will address the implications of pharmacologically treating the ADHD-BD comorbidity, providing suggestions in how to treat these complex patients and addressing the issue of treatment-induced manic switch with the use of stimulants and other medications for ADHD.
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Murray AL, Speyer LG, Hall HA, Valdebenito S, Hughes C. A Longitudinal and Gender Invariance Analysis of the Strengths and Difficulties Questionnaire Across Ages 3, 5, 7, 11, 14, and 17 in a Large U.K.-Representative Sample. Assessment 2021; 29:1248-1261. [PMID: 33874786 PMCID: PMC9301174 DOI: 10.1177/10731911211009312] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Developmental invariance is important for making valid inferences about child
development from longitudinal data; however, it is rarely tested. We evaluated
developmental and gender invariance for one of the most widely used measures of
child mental health: the parent-reported Strengths and Difficulties
Questionnaire (SDQ). Using data from the large U.K. population-representative
Millennium Cohort Study (N = 10,207; with data at ages 3, 5, 7,
11, 14, and 17 years), we tested configural, metric, scalar, and residual
invariance in emotional problems, conduct problems, hyperactivity/inattention,
prosociality, and peer problems. We found that the SDQ showed poor fit at age 3
in both males and females and at age 17 in males; however, it fit reasonably
well and its scores were measurement invariant up to the residual level across
gender at ages 5, 7, 11, and 14 years. Scores were also longitudinally
measurement invariant across this age range up to the partial residual level.
Results suggest that the parent-reported SDQ can be used to estimate
developmental trajectories of emotional problems, conduct problems,
hyperactivity/inattention, prosociality, and peer problems and their gender
differences across the age range 5 to 14 years using a latent model.
Developmental differences outside of this range may; however, partly reflect
measurement differences.
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Martinat M, Rossitto M, Di Miceli M, Layé S. Perinatal Dietary Polyunsaturated Fatty Acids in Brain Development, Role in Neurodevelopmental Disorders. Nutrients 2021; 13:1185. [PMID: 33918517 PMCID: PMC8065891 DOI: 10.3390/nu13041185] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 12/26/2022] Open
Abstract
n-3 and n-6 polyunsaturated fatty acids (PUFAs) are essential fatty acids that are provided by dietary intake. Growing evidence suggests that n-3 and n-6 PUFAs are paramount for brain functions. They constitute crucial elements of cellular membranes, especially in the brain. They are the precursors of several metabolites with different effects on inflammation and neuron outgrowth. Overall, long-chain PUFAs accumulate in the offspring brain during the embryonic and post-natal periods. In this review, we discuss how they accumulate in the developing brain, considering the maternal dietary supply, the polymorphisms of genes involved in their metabolism, and the differences linked to gender. We also report the mechanisms linking their bioavailability in the developing brain, their transfer from the mother to the embryo through the placenta, and their role in brain development. In addition, data on the potential role of altered bioavailability of long-chain n-3 PUFAs in the etiologies of neurodevelopmental diseases, such as autism, attention deficit and hyperactivity disorder, and schizophrenia, are reviewed.
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London AS, Landes SD. Cohort Change in the Prevalence of ADHD Among U.S. Adults: Evidence of a Gender-Specific Historical Period Effect. J Atten Disord 2021; 25:771-782. [PMID: 31189421 DOI: 10.1177/1087054719855689] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To document inter- and intra-cohort changes in adult ADHD and examine whether changes vary by gender. Method: We analyze data from the 2007 and 2012 U.S. National Health Interview Survey. Results: The prevalence of ADHD among adults aged 18 to 64 years increased from 3.41% in 2007 to 4.25% in 2012. As expected, patterns of inter- and intra-cohort change varied by gender. At younger ages, inter-cohort gender differences are more distinct due to a spike in prevalence among boys/men born in or after 1980. Consistent with a gender-specific historical period effect, recent intra-cohort increases among women have narrowed the gender gap. Conclusion: The gender gap in the prevalence of ADHD among adults decreased by 31.1% from 2007 to 2012 due to increased prevalence among adult women of all ages. We discuss these results in relation to diagnostic practice, adult health and well-being, data limitations and needs, and directions for future research.
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Onandia-Hinchado I, Pardo-Palenzuela N, Diaz-Orueta U. Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review. J Neural Transm (Vienna) 2021; 128:893-937. [PMID: 33620582 DOI: 10.1007/s00702-021-02302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.
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Affiliation(s)
| | | | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Room 3.11, John Hume Building, North Campus, Maynooth, Co. Kildare, Ireland.
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Franceschini A, Fattore L. Gender-specific approach in psychiatric diseases: Because sex matters. Eur J Pharmacol 2021; 896:173895. [PMID: 33508283 DOI: 10.1016/j.ejphar.2021.173895] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/29/2020] [Accepted: 01/19/2021] [Indexed: 12/20/2022]
Abstract
In both animals and human beings, males and females differ in their genetic background and hormonally driven behaviour and show sex-related differences in brain activity and response to internal and external stimuli. Gender-specific medicine has been a neglected dimension of medicine for long time, and only in the last three decades it is receiving the due scientific and clinical attention. Research has recently begun to identify factors that could provide a neurobiological basis for gender-based differences in health and disease and to point to gonadal hormones as important determinants of male-female differences. Animal studies have been of great help in understanding factors contributing to sex-dependent differences and sex hormones action. Here we review and discuss evidence provided by clinical and animal studies in the last two decades showing gender (in humans) and sex (in animals) differences in selected psychiatric disorders, namely eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder), schizophrenia, mood disorders (anxiety, depression, obsessive-compulsive disorder) and neurodevelopmental disorders (autism spectrum disorders, attention-deficit/hyperactivity disorder).
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Affiliation(s)
- Anna Franceschini
- Addictive Behaviors Department, Local Health Authority, Trento, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council, Italy.
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Pironti VA, Vatansever D, Sahakian BJ. Shared alterations in resting-state brain connectivity in adults with attention-deficit/hyperactivity disorder and their unaffected first-degree relatives. Psychol Med 2021; 51:329-339. [PMID: 31769365 PMCID: PMC7893505 DOI: 10.1017/s0033291719003374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 09/15/2019] [Accepted: 11/04/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a developmental condition that often persists into adulthood with extensive negative consequences on quality of life. Despite emerging evidence indicating the genetic basis of ADHD, investigations into the familial expression of latent neurocognitive traits remain limited. METHODS In a group of adult ADHD probands (n = 20), their unaffected first-degree relatives (n = 20) and typically developing control participants (n = 20), we assessed endophenotypic alterations in the default mode network (DMN) connectivity during resting-state functional magnetic resonance imaging in relation to cognitive performance and clinical symptoms. In an external validation step, we also examined the dimensional nature of this neurocognitive trait in a sample of unrelated healthy young adults (n = 100) from the Human Connectome Project (HCP). RESULTS The results illustrated reduced anti-correlations between the posterior cingulate cortex/precuneus and right middle frontal gyrus that was shared between adult ADHD probands and their first-degree relatives, but not with healthy controls. The observed connectivity alterations were linked to higher ADHD symptoms that was mediated by performance in a sustained attention task. Moreover, this brain-based neurocognitive trait dimensionally explained ADHD symptom variability in the HCP sample. CONCLUSIONS Alterations in the default mode connectivity may represent a dimensional endophenotype of ADHD, hence a significant aspect of the neuropathophysiology of this disorder. As such, brain network organisation can potentially be employed as an important neurocognitive trait to enhance statistical power of genetic studies in ADHD and as a surrogate efficacy endpoint in the development of novel pharmaceuticals.
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Affiliation(s)
- Valentino Antonio Pironti
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Suno Innova Ltd, Unit 6, 109 Cambridge Road Industrial Estate, Cambridge, UK
| | - Deniz Vatansever
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, PR China
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Psychology, University of York, Heslington, York, UK
| | - Barbara Jacquelyn Sahakian
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, PR China
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Meyer BJ, Stevenson J, Sonuga-Barke EJS. Sex Differences in the Meaning of Parent and Teacher Ratings of ADHD Behaviors: An Observational Study. J Atten Disord 2020; 24:1847-1856. [PMID: 28800718 DOI: 10.1177/1087054717723988] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To test explanations for the underrecognition of female ADHD by examining differences in adult ratings of boys and girls matched for levels of directly observed ADHD behaviors. Method: In a secondary analysis of a population-based sample, 3- to 4-year-olds (n = 153, 79 male) and 8- to 9-year-olds (n = 144, 75 male) were grouped according to levels of directly observed ADHD behaviors (low/moderate/high). Groups were then compared with parent/teacher ADHD ratings. Results: There were no sex differences in levels of directly observed ADHD behaviors within groups. For preschoolers, parents' ratings of males, but not females, significantly increased across groups-mirroring levels of observed behaviors. For older children, both parent and teacher mean ratings were significantly higher for males than females across groups. Conclusion: Identified differences in adult ratings of males and females matched for directly observed behaviors may contribute to understanding the substantial ADHD underrecognition in females.
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