1
|
Karagoz Tanigor E, Ozbek A, Ozyurt G, Pekcanlar Akay A. Comparisons of clinical subtypes, symptom severity, global functioning, emotional and behavior problems, and CPT test profiles in children and adolescents with ADHD with and without co-occurring internet gaming disorder. Nord J Psychiatry 2024; 78:247-254. [PMID: 38319235 DOI: 10.1080/08039488.2024.2311705] [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: 06/19/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES This study aims to assess whether the presence of Internet Gaming Disorder (IGD) is associated with disease severity, Attention Deficit Hyperactivity Disorder(ADHD) presentation, emotional problems, behavioral problems, and CPT profile in patients with ADHD. METHOD Forty children with IGD and sixty-four patients without IGD were included in the study, all of whom had a diagnosis of ADHD. Comorbid psychiatric disorders were determined using The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Conners's Parent Rating Scale-Revised Short form (CPRS-RS), The Strengths and Difficulties Questionnaire (SDQ), Internet Gaming Disorder Questionnaire (IGD-20), and MOXO Continuous Performance Test (MOXO d-CPT) were performed on the children, and Clinical Global Impression (CGI), Children's Global Assessment Scale (CGAS), comorbidities and ADHD presentations were evaluated. RESULTS The IGD group was found to have the combined presentation of ADHD more commonly, and their CGI, CGAS, SDQ behavior problems subscale, cognitive problems, attention problems, and ADHD index in the CPRS-RS questionnaire were found to be higher (p < 0.05). No differences were found in attention, timing, impulsiveness, and hyperactivity scores in CPT between groups (p > 0.05). CONCLUSION Our study has shown that children with both ADHD and IGD had more severe symptoms, more behavioral problems, and differences regarding the prevalence of the ADHD presentations when compared to children having ADHD without IGD. Longitudinal studies with higher sample sizes are required to investigate this possible connection in the context of a cause-effect relationship and draw a conclusion.
Collapse
Affiliation(s)
- Ezgi Karagoz Tanigor
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
- Department of Child and Adolescent Psychiatry, Izmir Katip Celebi University Faculty of Medicine, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Aylin Ozbek
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Gonca Ozyurt
- Department of Child and Adolescent Psychiatry, Izmir Katip Celebi University Faculty of Medicine, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
2
|
Koncz P, Demetrovics Z, Takacs ZK, Griffiths MD, Nagy T, Király O. The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis. Clin Psychol Rev 2023; 106:102343. [PMID: 37883910 DOI: 10.1016/j.cpr.2023.102343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/27/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.
Collapse
Affiliation(s)
- Patrik Koncz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar.
| | - Zsofia K Takacs
- School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| |
Collapse
|
3
|
Gimbach S, Vogel D, Fried R, Faraone SV, Banaschewski T, Buitelaar J, Döpfner M, Ammer R. The impact of the COVID-19 pandemic on ADHD medicine consumption in 47 countries and regions. Eur Neuropsychopharmacol 2023; 73:24-35. [PMID: 37119560 PMCID: PMC10106831 DOI: 10.1016/j.euroneuro.2023.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
The objective of this study is to quantify the impact of the COVID-19 pandemic on attention deficit hyperactivity disorder (ADHD) medication consumption globally and nationally using pharmaceutical sales data from 2014 to 2021 across 47 countries and regions. A seasonal autoregressive integrated moving average model (SARIMA) was applied to the time series until the end of 2019 at country level and used for the prediction of the ADHD medication consumption in 2020 and 2021. The deviations from the actual to the forecasted sales, which simulate the development without the emergence of COVID-19, yield estimates for the pandemic's impact. In 36 of the 47 countries and regions, the actual sales in 2020 were lower than predicted, with an average relative drop of 6.2% in defined daily doses (DDD) per 1000 inhabitants per day at country-level. In 2021, most countries recorded actually higher ADHD medication use than predicted at the end of 2019. On average, the consumption increased per country by 1.60%. The deviations strongly correlate with the stringency of anti-pandemic government policies. The findings suggest that the pandemic led to a substantially lower consumption of ADHD medication in 2020. However, in 2021 the pandemic had an accelerating effect as the increasing consumption trends are more pronounced than before the pandemic.
Collapse
Affiliation(s)
- Sophie Gimbach
- Medical Department, MEDICE Arzneimittel Pütter GmbH & Co. KG, 58638 Iserlohn, Germany,; Department of Statistics, TU Dortmund University, 44221 Dortmund, Germany
| | - Daniel Vogel
- Medical Department, MEDICE Arzneimittel Pütter GmbH & Co. KG, 58638 Iserlohn, Germany
| | - Roland Fried
- Department of Statistics, TU Dortmund University, 44221 Dortmund, Germany
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Tobias Banaschewski
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50969 Cologne, Germany
| | - Richard Ammer
- Medical Department, MEDICE Arzneimittel Pütter GmbH & Co. KG, 58638 Iserlohn, Germany,; Poliklinik und Innere Medizin, University Hospital Münster, 48149 Münster, Germany.
| |
Collapse
|
4
|
Masi G, Carucci S, Muratori P, Balia C, Sesso G, Milone A. Contemporary diagnosis and treatment of conduct disorder in youth. Expert Rev Neurother 2023; 23:1277-1296. [PMID: 37853718 DOI: 10.1080/14737175.2023.2271169] [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: 06/07/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Conduct disorder (CD) is characterized by repetitive and persistent antisocial behaviors, being among the most frequently reported reasons of referral in youth. CD is a highly heterogeneous disorder, with possible specifiers defined according to age at onset, Limited Prosocial Emotions (LPE) otherwise known as Callous-Unemotional (CU) traits, Emotional Dysregulation (ED), and patterns of comorbidity, each with its own specific developmental trajectories. AREAS COVERED The authors review the evidence from published literature on the clinical presentations, diagnostic procedures, psychotherapeutic and psychoeducational approaches, and pharmacological interventions from RCT and naturalistic studies in youth. Evidence from studies including youths with LPE/CU traits, ED and aggression are also reviewed, as response moderators. EXPERT OPINION Due to its clinical heterogeneity, relevant subtypes of CD should be carefully characterized to gain reliable information on prognosis and treatments. Thus, disentangling this broad category in subtypes is crucial as a first step in diagnosis. Psychosocial interventions are the first option, possibly improving LPE/CU traits and ED, especially if implemented early during development. Instead, limited information, based on low-quality studies, supports pharmacological options. Second-generation antipsychotics, mood stabilizers, and stimulants are first-line medications, according to different target symptoms, such as aggression and emotional reactivity. Developmental pathways including ADHD suggest a specific role of psychostimulants.
Collapse
Affiliation(s)
- Gabriele Masi
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Sara Carucci
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatric Unit, "A. Cao" Paediatric Hospital-ARNAS "G. Brotzu" Hospital Trust, Department of Paediatrics, Cagliari, Italy
| | - Pietro Muratori
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Carla Balia
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatric Unit, "A. Cao" Paediatric Hospital-ARNAS "G. Brotzu" Hospital Trust, Department of Paediatrics, Cagliari, Italy
| | - Gianluca Sesso
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Annarita Milone
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| |
Collapse
|
5
|
Taubin D, Wilson JC, Wilens TE. ADHD and Substance Use Disorders in Young People: Considerations for Evaluation, Diagnosis, and Pharmacotherapy. Child Adolesc Psychiatr Clin N Am 2022; 31:515-530. [PMID: 35697399 DOI: 10.1016/j.chc.2022.01.005] [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: 11/03/2022]
Abstract
Co-occurring ADHD and substance use disorder (SUD) is a common clinical presentation associated with significant impairment requiring careful evaluation, diagnosis, and treatment. Treatment with medication, along with cognitive behavioral therapy, is generally regarded as effective in addressing symptoms and impairments associated with both disorders. Options for pharmacotherapy include stimulant and nonstimulant therapies administered with careful monitoring of dosage and compliance to optimize efficacy. In high-risk groups such as college students and/or those with SUD, prescribers should address risks of stimulant misuse and diversion through patient and family education, medication monitoring, and other risk-reducing practices.
Collapse
Affiliation(s)
- Daria Taubin
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Warren Building 628B, 55 Fruit Street, Boston, MA 02114, USA
| | - Julia C Wilson
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Warren Building 628B, 55 Fruit Street, Boston, MA 02114, USA
| | - Timothy E Wilens
- Division of Child and Adolescent Psychiatry, Child Psychiatry Service, Massachusetts General Hospital, 55 Fruit Street, YAW 6A, Boston, MA 02114, USA; Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA 02114, USA; Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA.
| |
Collapse
|
6
|
Muzwagi AB, Motiwala FB, Manikkara G, Rizvi A, Varela MA, Rush AJ, Zafar MK, Jain SB. How Are Attention-deficit Hyperactivity and Internet Gaming Disorders Related in Children and Youth? J Psychiatr Pract 2021; 27:439-447. [PMID: 34768266 DOI: 10.1097/pra.0000000000000582] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This review addresses important practical questions facing clinicians regarding internet gaming disorder (IGD) and attention-deficit/hyperactivity disorder (ADHD) in children and youth (C-Y). The authors investigated data concerning the risk that C-Y who have ADHD will develop IGD, whether effective treatment of ADHD positively influences the course of IGD in C-Y who have both, and other findings that might be of benefit to clinicians who treat C-Y with these conditions. METHODS We conducted a literature review using 4 databases: PubMed, Scopus, PsychInfo, and Embase. RESULTS C-Y with ADHD are at greater risk for developing IGD than those without ADHD. A close association exists between the severity of ADHD symptoms and the severity of IGD. It is unknown what proportion of C-Y with ADHD will develop IGD during their developmental trajectory; however, C-Y with IGD are at risk for developing ADHD, and ADHD can also increase the vulnerability of C-Y to IGD. Adolescents with ADHD and IGD have greater deficits in social skills than those with ADHD but no IGD. Lower parental occupational and socioeconomic status and poor family relationships are associated with more severe IGD symptoms. Atomoxetine and methylphenidate are equally effective in alleviating IGD symptoms comorbid with ADHD. CONCLUSIONS C-Y with ADHD are at increased risk for developing IGD compared with C-Y without ADHD, but it has not been determined at what developmental stage IGD is likely to emerge. Since IGD and ADHD are strongly associated, it is imperative to consider ADHD as a significant risk factor for IGD and vice versa, which can help psychiatrists be alert for early signs of IGD and manage them accordingly.
Collapse
Affiliation(s)
- Ashraf B Muzwagi
- MUZWAGI, MOTIWALA, MANIKKARA, RIZVI, VARELA, RUSH, ZAFAR, and JAIN: The Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX
| | | | | | | | | | | | | | | |
Collapse
|
7
|
|