1
|
Nolan LJ, Higgs S. The role of irrational beliefs in the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and disordered eating in two general student samples. Appetite 2024; 195:107229. [PMID: 38246426 DOI: 10.1016/j.appet.2024.107229] [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: 08/09/2023] [Revised: 12/21/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
Attention deficit hyperactivity disorder (ADHD) symptoms are associated with disordered eating and negative mood. The purpose of this study was to examine whether irrational beliefs mediate this relationship along with previously reported mediators such as depression and impulsivity. Irrational beliefs trigger negative automatic thoughts which are believed, in cognitive behavior therapies, to be a source of psychopathology. Challenges brought about by symptoms of ADHD may lead to habitual emotion-eliciting thought patterns which, in turn, could lead to negative mood and disordered eating. Undergraduate students (N = 127) completed online questionnaires assessing ADHD symptoms and disordered eating and several potential mediators including irrational beliefs, depression, impulsivity, interoceptive accuracy, and reward responsiveness. The results, which were replicated in a second study (N = 254), indicated that irrational beliefs and depression mediated the relationship between ADHD symptoms and disordered eating. In the second study, impulsivity due to negative urgency was also a mediator. These findings support the theory that the symptoms of ADHD lead to enhancement of irrational beliefs, depression, and negative urgency which are linked to disordered eating.
Collapse
Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, NY, 10301, USA.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
| |
Collapse
|
2
|
Jespersen AE, Obel Z, Lumbye A, Kessing LV, Miskowiak KW. Bipolar-ADHD comorbidity: screening for differences in neurocognition and virtual reality-based cognitive performance. Nord J Psychiatry 2024; 78:238-246. [PMID: 38294688 DOI: 10.1080/08039488.2024.2309496] [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: 04/13/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES Identification of comorbid attention-deficit/hyperactivity disorder (ADHD) in patients with bipolar disorder (BD) is complicated by overlapping cognitive symptoms and methodological challenges. This cross-sectional study investigated whether virtual reality (VR)-based cognitive assessment that mimics daily life cognitive challenges can aid in the detection of sustained attention impairment in BD individuals with comorbid ADHD (BD + ADHD). METHODS Forty-nine fully or partially remitted outpatients with BD, of whom 14 (24%) had BD + ADHD, were assessed with the Cognition Assessment in Virtual Reality (CAVIR) test, including a sustained attention test that involves distractions, and the Screen for Cognitive Impairment in Psychiatry (SCIP). Patients were also rated for mood symptoms and functioning and completed questionnaires assessing subjective cognition and quality of life. Patients' cognitive impairment on the SCIP was estimated with reference to n = 100 demographically comparable healthy control participants. RESULTS BD + ADHD participants exhibited more pronounced performance deficits on the CAVIR sustained attention test (t(48) = 2.15, p = .037, d = .66). Notably, deficits on this test were proportional to self-reported daily life concentration difficulties in BD + ADHD individuals. Exploratory analyses revealed that BD + ADHD participants also displayed greater impairment on the SCIP working memory- and delayed verbal learning subtests and greater subjective cognitive complaints than BD patients without this comorbidity (p-levels < .001), but only the difference in subjective cognition survived correction for multiple comparisons (F(1,47) = 14.13, p = .005, np2 = 0.24). CONCLUSION Screening for deficits in sustained attention with an ecologically valid VR test involving distracting stimuli may be useful for identifying BD + ADHD individuals.
Collapse
Affiliation(s)
- Andreas E Jespersen
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- NEAD Centre, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Zacharias Obel
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Lars V Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- NEAD Centre, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Onken M, Lohse L, Coulm B, Beghin D, Richardson JL, Bermejo-Sánchez E, Aguilera C, Bosch M, Cassina M, Chouchana L, De Santis M, Duman MK, Gören MZ, Johnson D, Bera APJ, Kaplan YC, Kennedy D, Kwok S, Lacroix I, Lepelley M, Pistelli A, Schaefer C, Te Winkel B, Uysal N, Winterfeld U, Yakuwa N, Diav-Citrin O, Vial T, Dathe K. Effects of maternal modafinil treatment on fetal development and neonatal growth parameters - a multicenter case series of the European Network of Teratology Information Services (ENTIS). Acta Psychiatr Scand 2023. [PMID: 38110225 DOI: 10.1111/acps.13643] [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: 06/23/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE In recent years, safety concerns about modafinil exposure during pregnancy have emerged. In particular, increased risks for major congenital anomalies (MCA) and impaired fetal growth were reported, although study results were conflicting. Our investigation aims to examine previously reported safety signals. METHOD Multicenter case series based on data from 18 Teratology Information Services from 12 countries. Modafinil exposed pregnancies with an estimated date of birth before August 2019 were included in this study. For prospectively ascertained pregnancies, cumulative incidences of pregnancy outcomes, rate of nonchromosomal MCA in first trimester exposed pregnancies and percentiles of neonatal/infant weight and head circumference (HC) were calculated. Potential dose-dependent effects on fetal growth were explored by linear regression models. Retrospectively ascertained cases were screened for pattern of MCA and other adverse events. RESULTS One hundred and seventy-five prospectively ascertained cases were included, of which 173 were exposed at least during the first trimester. Cumulative incidences for live birth, spontaneous abortion and elective termination of pregnancy were 76.9% (95% CI, 68.0%-84.8%), 9.3% (95% CI, 5.0%-16.9%), and 13.9% (95% CI, 8.1%-23.1%), respectively. Nonchromosomal MCA was present in 3/150 live births, corresponding to an MCA rate of 2.0% (95%CI, 0.6%-6.1%), none were reported in pregnancy losses. Compared to reference standards, birth weight (BW) tended to be lower and neonatal HC to be smaller in exposed newborns (data available for 144 and 73 of 153 live births, respectively). In nonadjusted linear regression models, each 100 mg increase of average dosage per pregnancy day was associated with a decrease in standard deviation score (SDS) of -0.28 SDS (95% CI, -0.45 to -0.10) for BW and of -0.28 SDS (95% CI, -0.56 to 0.01) for HC. Screening of 22 retrospectively reported cases did not reveal any specific pattern of MCA or other adverse outcomes. CONCLUSION The results do not indicate an increased risk of MCA after in utero exposure to modafinil, but a tendency toward lower BW and reduced neonatal HC. However, these findings should be regarded as preliminary. Until further studies allow for a definite conclusion, modafinil should not be used during pregnancy.
Collapse
Affiliation(s)
- Marlies Onken
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - Lukas Lohse
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - Bénédicte Coulm
- AP-HP.Sorbonne Université, Hôpital Trousseau, Département de Santé Publique, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, France
| | - Delphine Beghin
- AP-HP.Sorbonne Université, Hôpital Trousseau, Département de Santé Publique, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, France
| | - Jonathan L Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eva Bermejo-Sánchez
- Institute of Rare Diseases Research (IIER), Research Unit on Congenital Anomalies-UIAC and Spanish Teratology Information Services SITTE and SITE, Instituto Salud Carlos III (ISCIII), Madrid, Spain
| | - Cristina Aguilera
- Clinical Pharmacology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Montserrat Bosch
- Clinical Pharmacology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Laurent Chouchana
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de pharmacologie périnatale, pédiatrique et adulte, Centre Régional de Pharmacovigilance, Paris, France
| | - Marco De Santis
- Teratology Information Service, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Mine Kadioglu Duman
- Teratology Information Service, Department of Pharmacology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - M Zafer Gören
- Department of Medical Pharmacology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Diana Johnson
- Department of Pediatrics, University of California, San Diego, California, USA
| | - Annie Pierre Jonville Bera
- Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance Centre-Val de Loire, Tours, France
| | - Yusuf C Kaplan
- Department of Pharmacology, Izmir Katip Celebi University School of Medicine, Training and Research Center, Izmir, Turkey
| | - Debra Kennedy
- MotherSafe, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Susan Kwok
- MotherSafe, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Isabelle Lacroix
- Service de pharmacologie médicale et clinique, centre régional de pharmacovigilance, faculté de médecine, CHU de Toulouse, Toulouse, France
| | - Marion Lepelley
- Université Grenoble Alpes, Centre régional de pharmacovigilance, Grenoble, France
| | - Alessandra Pistelli
- Toxicology Unit and Poison Control Centre, Teratology Information Service, Careggi University Hospital, Florence, Italy
| | - Christof Schaefer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - Bernke Te Winkel
- Teratology Information Service, Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Nusret Uysal
- Department of Pharmacology, Izmir Katip Celebi University School of Medicine, Training and Research Center, Izmir, Turkey
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Naho Yakuwa
- Japan Drug Information Institute in Pregnancy, National Center for Child Health and Development, Tokyo, Japan
| | - Orna Diav-Citrin
- The Israeli Teratology Information Service, Ministry of Health, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Thierry Vial
- Pharmacovigilance Center, Hospital University Pharmacotoxicology Department, Lyon, France
| | - Katarina Dathe
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| |
Collapse
|
4
|
Risk of Mania After Methylphenidate in Patients With Bipolar Disorder. J Clin Psychopharmacol 2023; 43:28-34. [PMID: 36584246 DOI: 10.1097/jcp.0000000000001631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Bipolar disorder and attention-deficit/hyperactivity disorder are common comorbidities. Attention-deficit/hyperactivity disorder is commonly treated with stimulants (eg, methylphenidate), which, however, have been suggested to cause treatment-emergent mania in patients with bipolar disorder. Here, we assessed the risk of mania, depressive episodes, and psychiatric admissions after initiation of methylphenidate treatment in patients with bipolar disorder. METHODS Using Danish health registries, we identified all individuals registered with a diagnosis of bipolar disorder from January 1, 2000, to January 1, 2018, who were treated with methylphenidate. We applied a 1-year mirror-image model to compare the occurrence of mania, depression, and psychiatric admissions in the period leading up to and after methylphenidate treatment initiation. We furthermore assessed the trend in these outcomes from 4 years before to 1 year after initiation of methylphenidate treatment. RESULTS A total of 1043 patients with bipolar disorder initiated treatment with methylphenidate. The number of manic episodes decreased by 48% after methylphenidate treatment initiation (P = 0.01), both among patients using mood stabilizers (-50%) and among patients not using mood stabilizers (-45%). The number of manic episodes, however, peaked approximately 6 months before methylphenidate. The results were similar for the secondary outcomes. CONCLUSIONS Initiation of methylphenidate treatment was not associated with an increased risk of mania in patients with bipolar disorder. A decrease in mania, depressive episodes, and psychiatric admissions was observed after methylphenidate. However, these decreases seemed to be driven by regression to the mean after clinical deterioration preceding methylphenidate treatment, rather than by the methylphenidate treatment itself.
Collapse
|
5
|
Fountoulakis KN, Panagiotidis P, Tegos T, Kimiskidis V, Nimatoudis I. Paternal age and specific neurological soft signs as reliable and valid neurobiological markers for the diagnosis of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:1087-1096. [PMID: 34842982 DOI: 10.1007/s00406-021-01357-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022]
Abstract
Advanced parental age at delivery and neurological soft signs (NSS) constitute risk factors for schizophrenia. The aim of the current study was to develop a neurobiological diagnostic index by combining them, and without the contribution of clinical symptomatology. The study sample included 133 patients suffering from schizophrenia according to DSM-IV-TR (77 males and 56 females; aged 33.55 ± 11.22 years old) and 122 normal controls (66 males and 56 females; aged 32.89 ± 9.91 years old). The assessment included the Neurological Evaluation Scale (NES), and a number of scales assessing the clinical symptoms and adverse effects. The statistical analysis included exploratory t-test, Pearson Correlation coefficient (R) and Discriminant Function Analysis (DFA). Exploratory t-tests and Pearson's R suggested that sex, parental age and NSS constitute independent components. On the basis of DFA results, the Psychotic Neurological Index was developed. At the cut-off PNI score of 8.5, sensitivity was equal to 94.74 and specificity to 93.44. The current is probably the first study to report on an easily obtainable diagnostic neurobiological marker with identifiable properties which is absolutely independent from the clinical manifestations and could serve in distinguishing between patients with schizophrenia and healthy controls with high efficacy.
Collapse
Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Panagiotis Panagiotidis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Tegos
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Kimiskidis
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
6
|
Small TM, Dhat S, Faruqui Z. Dextroamphetamine-Amphetamine Augmentation in the Treatment of Treatment-Resistant Depression. Cureus 2022; 14:e27755. [PMID: 36106259 PMCID: PMC9445411 DOI: 10.7759/cureus.27755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2022] [Indexed: 11/05/2022] Open
Abstract
There is much debate over a precise definition of treatment-resistant depression (TRD) as well as the method of staging this illness. Although there is some non-consensus on a definition for TRD, the most widely accepted definition of TRD is a failure to achieve clinical improvement of depressive symptoms following a trial of two or more antidepressant medications from two or more different pharmacological classes at adequate dosage, duration, and compliance. Some sources lower the threshold to failure of one medication, but most support two medications. Although both men and women can be effected by TRD, our review found a slight predominance in older women. Here we present a 62-year-old female diagnosed with severe major depressive disorder that meets the criteria for treatment-resistant depression. This patient failed to experience consistent relief of symptoms using different antidepressant monotherapies as well as different combinations of therapies. Transcranial magnetic stimulation provided a brief relief of symptoms in this patient; however, relapse occurred a few months later. This case is unique as this patient has recently experienced significant relief of her depressive symptoms using amphetamine and dextroamphetamine (Adderall) as an adjunct to her antidepressant therapy. We will review the literature that currently exists on treatment-resistant depression and the treatment options for TRD, as well as present our case. To our knowledge, a case of TRD responding so strongly to Adderall after failing to respond to such drastic pharmacologic measures, as well as TMS, has not been reported.
Collapse
|