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Nguyen V, Montout C, Mura T, Purper-Ouakil D, Lopez-Castroman J. Concordance and validity between versions of the ADHD Conners scale for Parents. L'ENCEPHALE 2024; 50:373-379. [PMID: 37718199 DOI: 10.1016/j.encep.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/12/2023] [Accepted: 07/04/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The Conners Scale for Parents (CRS-P) is one of the reference tools for the diagnostic assessment of Attention Deficit and Hyperactivity Disorders (ADHD). It is commonly used in both research and clinical practice. The latest edition of the Conners Parents Scale Long Version (CRS-P3L) has undergone extensive modifications but has never been compared with the 2nd edition (CRS-P2L). We aim to study the concordance between the last two editions of the CRS-P, their internal consistency, and their validity against the criteria of the ADHD-RS. METHODS The study population was a cohort of 30 children diagnosed with ADHD participating in a clinical trial. The parents of these children completed both editions of the CRS (P2L and P3L), as well as a DSM-IV ADHD Diagnostic Criteria Rating Scale (ADHD-RS). A linear regression model with the calculation of Lin's concordance coefficient (LCC) was used to study the concordance between the scales. Internal validity was estimated with Cronbach's alpha and inter-criteria validity with Spearman's correlation coefficient. RESULTS The internal consistency found was "correct" to "good" for both editions (Cronbach alpha 0.85 and 0.77), their correlation with the ADHD-RS was medium to low (Spearman's coefficient 0.25 and 0.09). Concordance between the overall score and the sub-scores of the two editions of the same Conners scale (CRS-P2L and CRS-P3L) was fair to medium (LCC 0.29 to 0.69). CONCLUSIONS The third edition of the long version of the CRS-P showed very poor concordance with the previous edition. The diagnostic profile of the children seems to have evolved with the new edition, which appears to affect the interpretation of the tests.
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Affiliation(s)
| | - Christine Montout
- Department of Psychiatry, CHU de Nimes, Nimes, France; BESPIM, CHU de Nimes, Nimes, France
| | - Thibaut Mura
- BESPIM, CHU de Nimes, Nimes, France; University of Montpellier, INSERM, INM (Institute for Neurosciences of Montpellier), Montpellier, France
| | - Diane Purper-Ouakil
- CHU de Montpellier; Child and Adolescent Psychiatry (MPEA1), Saint-Eloi Hospital, Montpellier, France; Inserm, U1018 CESP University Paris Saclay, Psychiatry, Development and Trajectories, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, CHU de Nimes, Nimes, France; BESPIM, CHU de Nimes, Nimes, France; Institut de Génomique Fonctionnelle, CNRS, Inserm & University of Montpellier, Montpellier, France; CIBERSAM, Madrid, Spain; Department of Signal Theory and Communications, Carlos III University, Madrid, Spain.
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Girela-Serrano B, Miguélez-Fernández C, Abascal-Peiró S, Peñuelas-Calvo I, Jiménez-Muñoz L, Moreno M, Delgado-Gómez D, Bello HJ, Nicholls D, Baca-García E, Carballo JJ, Porras-Segovia A. Diagnostic trajectories of mental disorders in children and adolescents: a cohort study. Eur Child Adolesc Psychiatry 2024; 33:1481-1494. [PMID: 37422547 DOI: 10.1007/s00787-023-02254-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
Mental disorders in children and adolescents may follow different trajectories, such as remission, change of diagnosis, or addition of two or more comorbid diagnoses, showing a heterotypic pattern. This study aims to describe the main diagnostic trajectories across a broad range of mental disorder diagnostic categories, from childhood to adolescence and from adolescence to young adulthood in a clinical population. A prospective study was conducted among a clinical sample of children and adolescents who were aged 3-17 years at the face-to-face baseline interview. Electronic health records of these participants were reviewed 10 years later. The diagnostic stability over time was examined using the kappa coefficient, and factors associated with stability were explored using simple logistic regression. The study included a sample of 691 participants. The kappa coefficient for diagnostic stability across all diagnoses was 0.574 for the transition from childhood to adulthood, 0.614 from childhood to adolescence, and 0.733 from adolescence to adulthood. Neurodevelopmental diagnoses had the highest stability. Factors associated with higher diagnostic stability included family history of mental disorders, receiving psychopharmacological treatment, and symptom severity at baseline. We found a variable diagnostic stability across different diagnoses and age categories. The different life transitions represent complex periods that should not be overlooked from a clinical standpoint. An appropriate transition from child and adolescent mental health services to adult mental health services may have a positive impact on children and adolescents with mental disorders.
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Affiliation(s)
- Braulio Girela-Serrano
- Westminster Child and Adolescent Mental Health Service, Central and Northwest London NHS Foundation Trust, London, UK
- Division of Psychiatry, Imperial College London, London, UK
| | | | - Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - David Delgado-Gómez
- Department of Statistics, University Carlos III of Madrid, 28911, Leganés, Spain
| | - Hugo J Bello
- Department of Applied Mathematics, Universidad de Valladolid, Valladolid, Spain
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
| | - Enrique Baca-García
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
- CIBERSAM, Madrid, Spain
- Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alejandro Porras-Segovia
- Division of Psychiatry, Imperial College London, London, UK.
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain.
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Froude AM, Fawcett EJ, Coles A, Drakes DH, Harris N, Fawcett JM. The prevalence of cannabis use disorder in attention-deficit hyperactivity disorder: A clinical epidemiological meta-analysis. J Psychiatr Res 2024; 172:391-401. [PMID: 38452637 DOI: 10.1016/j.jpsychires.2024.02.050] [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: 05/10/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
Studies have shown that individuals with attention-deficit hyperactivity disorder (ADHD) pose an increased risk for developing substance use disorders. Increased cannabis product accessibility and recent legislative changes have led to increased cannabis consumption, thereby increasing the risk of cannabis use disorder (CUD). The present meta-analysis explored the lifetime and current prevalence of CUD in ADHD. A systematic review was conducted using the following databases: PubMed, PsycINFO and Web of Science. A total of 14 articles were included and used to estimate the aggregate lifetime and current prevalence of CUD in ADHD alongside risk ratios comparing increased risk of CUD in ADHD versus control samples. Mixed and random-effects models indicated that lifetime and current prevalence rates of CUD in ADHD populations were 26.9% and 19.2%, respectively (although prediction intervals ranged from 12.4% to 48.8% and 5.5%-39.1%, respectively). Analysis of the risk ratios indicated that those with ADHD were at 2.85- and 2.91-times greater risk of a lifetime or current diagnosis of CUD, respectively, than those in the general population. Our findings support the need for additional research on the prevalence of CUD in those with ADHD, as well as the inclusion of CUD screening in the treatment of ADHD.
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Affiliation(s)
- Anna M Froude
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
| | - Emily J Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Ashlee Coles
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Dalainey H Drakes
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Nick Harris
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Jonathan M Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Ryst E, Childress A. An updated safety review of the current drugs for managing ADHD in children. Expert Opin Drug Saf 2023; 22:1025-1040. [PMID: 37843488 DOI: 10.1080/14740338.2023.2271392] [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: 02/27/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent condition that causes persistent problems with attention and/or hyperactivity-impulsivity and often results in significant impairment when left untreated. Medications for this disorder continue to evolve and provide new treatment options. Ongoing review of related medication safety and tolerability remains an important task for prescribers. AREAS COVERED This manuscript provides an updated safety review of medications used to treat ADHD in children and adolescents. PubMed and OneSearch online databases were utilized to search for literature relevant to the topic of ADHD medications and safety. Clinical trials of medications used to treat ADHD, systematic reviews and meta-analyses, and articles covering specific safety issues (adverse or unfavorable events) such as cardiovascular effects, seizures, impact on growth, depression, suicidal ideation, substance use disorders, psychosis, and tics are described. EXPERT OPINION Available pharmacologic treatments for ADHD have favorable efficacy, safety and tolerability and allow many patients to achieve significant improvement of their symptoms. Despite the availability of multiple stimulant and non-stimulant formulations, some individuals with ADHD may not tolerate available medications or attain satisfactory improvement. To satisfy unmet clinical needs, ADHD pharmaceutical research with stimulant and nonstimulant formulations targeting dopamine, norepinephrine, and novel receptors is ongoing.
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Affiliation(s)
- Erika Ryst
- College of Education and Human Development, University of Nevada, Reno, USA
| | - Ann Childress
- Center for Psychiatry and Behavioral Medicine, Inc, Las Vegas, NV, USA
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Nicotine's effect on cognition, a friend or foe? Prog Neuropsychopharmacol Biol Psychiatry 2023; 124:110723. [PMID: 36736944 DOI: 10.1016/j.pnpbp.2023.110723] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
Tobacco smoking is a preventable cause of morbidity and mortality throughout the world. Smoking comes in form of absorption of many compounds, among which nicotine is the main psychoactive component of tobacco and its positive and negative reinforcement effects are proposed to be the key mechanism for the initiation and maintenance of smoking. Growing evidence suggests that the cognitive enhancement effects of nicotine may also contribute to the difficulty of quitting smoking, especially in individuals with psychiatric disorders. In this review, we first introduce the beneficial effect of nicotine on cognition including attention, short-term memory and long-term memory. We next summarize the beneficial effect of nicotine on cognition under pathological conditions, including Alzheimer's disease, Parkinson's disease, Schizophrenia, Stress-induced Anxiety, Depression, and drug-induced memory impairment. The possible mechanism underlying nicotine's effect is also explored. Finally, nicotine's detrimental effect on cognition is discussed, including in the prenatal and adolescent periods, and high-dose nicotine- and withdrawal-induced memory impairment is emphasized. Therefore, nicotine serves as both a friend and foe. Nicotine-derived compounds could be a promising strategy to alleviate neurological disease-associated cognitive deficit, however, due to nicotine's detrimental effect, continued educational programs and public awareness campaigns are needed to reduce tobacco use among pregnant women and smoking should be quitted even if it is e-cigarette, especially for the adolescents.
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Crouzet L, Gramond A, Suehs C, Fabbro-Peray P, Abbar M, Lopez-Castroman J. Third-generation cognitive behavioral therapy versus treatment-as-usual for attention deficit and hyperactivity disorder: a multicenter randomized controlled trial. Trials 2022; 23:83. [PMID: 35090544 PMCID: PMC8796622 DOI: 10.1186/s13063-021-05983-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background This study aims to compare improvements in attention deficit and hyperactivity disorder (ADHD) symptom severity between a group of ADHD children and parents undergoing a new therapeutic program based on third-generation cognitive behavioral therapy (Hyper-mCBT) and a similar group undergoing treatment-as-usual with the Barkley program. Methods Two hundred forty-eight children diagnosed with ADHD will be randomly assigned to either a Hyper-mCBT program or a Barkley program. This is a multicenter randomized (1:1), 2 parallel-group, superiority trial with evaluator blinding and stratification according to center and methylphenidate treatment. The Hyper-mCBT program consists in a series of 16 simultaneous-but-separate therapy sessions for parents and for children. Discussion More effective psychotherapeutic approaches are needed for ADHD children. Pharmacotherapy seems to be more effective in reducing ADHD symptoms but it is not always helpful, it carries side effects, and it is rejected by many parents/professionals. Results for psychotherapy programs for ADHD are inconsistent although several studies have shown clinical improvements. This trial will substantiate encouraging preliminary results of an innovative psychotherapy program for both parents and children. Trial registration ClinicalTrials.gov NCT03437772. Registered on February 19, 2018. Sponsor number: PHRC-N/2016/JLC-01. RCB identification: 2017-A01349-44 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05983-2.
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Affiliation(s)
- Laetitia Crouzet
- Department of Psychiatry, Nimes University Hospital, Nimes, France
| | - Anne Gramond
- Department of Psychiatry, Nimes University Hospital, Nimes, France
| | - Carey Suehs
- Departments of Medical Information and Respiratory Diseases, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Pascale Fabbro-Peray
- Department of Biostatistics, Epidemiology, Public Health and Medical Information, Nimes University Hospital, Nimes, France
| | - Mocrane Abbar
- Department of Psychiatry, Nimes University Hospital, Nimes, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nimes University Hospital, Nimes, France. .,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France. .,CIBERSAM, Madrid, Spain.
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Children and adolescents with ADHD followed up to adulthood: a systematic review of long-term outcomes. Acta Neuropsychiatr 2021; 33:283-298. [PMID: 34384511 DOI: 10.1017/neu.2021.23] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective is to highlight the clinical and social outcomes among adults who suffered from Attention-Deficit Hyperactivity Disorder (ADHD) in their childhood/adolescence. PubMed, PsycINFO, and Scopus databases were searched for prospective studies published during the last 5 years addressing patients with ADHD in childhood/adolescence followed-up to adulthood. We also included studies published before 2015 reported in other reviews with similar outcomes. Thousand four-hundred and eighty-five studies were identified, but only 39 were included for qualitative analysis and 27 for quantitative analysis. Overall, we found that ADHD persisted into adulthood with a mean rate of 43% and was mainly associated with both substance/alcohol use disorders and antisocial behavior and, less frequently, with anxiety and depressive disorders. The prevalence of persistent ADHD in adulthood reported by studies published after 2011 (55%) was higher than that reported by studies published previously from 1985 to 2011 (34%), suggesting a greater focus on ADHD in recent years. Our results highlight that ADHD can be considered not only a neurodevelopmental disorder, but also a persistent and complex condition, with detrimental consequences for quality of life in adulthood.
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Society for Developmental and Behavioral Pediatrics Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents with Complex Attention-Deficit/Hyperactivity Disorder. J Dev Behav Pediatr 2021; 41 Suppl 2S:S35-S57. [PMID: 31996577 DOI: 10.1097/dbp.0000000000000770] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder and is associated with an array of coexisting conditions that complicate diagnostic assessment and treatment. ADHD and its coexisting conditions may impact function across multiple settings (home, school, peers, community), placing the affected child or adolescent at risk for adverse health and psychosocial outcomes in adulthood. Current practice guidelines focus on the treatment of ADHD in the primary care setting. The Society for Developmental and Behavioral Pediatrics has developed this practice guideline to facilitate integrated, interprofessional assessment and treatment of children and adolescents with "complex ADHD" defined by age (<4 years or presentation at age >12 years), presence of coexisting conditions, moderate to severe functional impairment, diagnostic uncertainty, or inadequate response to treatment.
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Lam AP, Moeller S, Speitling C, Lam MC, Philipsen A, Müller HHO. Consumption of Synthetic Cannabinoids in Adult Attention-Deficit/Hyperactivity Disorder: a Pilot Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00248-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AbstractAttention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk for substance abuse and addiction. Synthetic cannabinoids (SC) have gained rising importance as their consumption increased rapidly in the last few years. However, SC consumption in patients with adult ADHD has not been investigated yet. A prospective clinical pilot study was conducted, including 60 adults with ADHD, assessing the prevalence of SC consumption and its associations with psychiatric comorbidities and patient characteristics. A drug consumption survey was utilized to investigate the use of SC and other drugs. Current ADHD symptoms were evaluated via ADHD Self-Rating Scale (ADHD-SR) and retrospective childhood ADHD symptom severity via Wender Utah Rating Scale (WURS-k) questionnaire. A positive lifetime prevalence of SC consumption was found in 15.0% of the analyzed sample. SC consumption was significantly associated with current smoking, lifetime use of natural cannabis (NC), cocaine, amphetamines, and benzodiazepines. Lifetime NC consumption was indicated by 65.0% and found to antecede SC use in adult ADHD patients. Logistic regression analysis identified substance use disorder and male sex as predictive for SC consumption. Patients with history of SC use scored significantly higher in both WURS-k and ADHD-SR questionnaire compared with nonusers and suffered significantly more frequently from psychiatric comorbidities. Main side-effects of SC included gastrointestinal, cardiovascular, and neuropsychiatric symptoms. SC consumption in adults with ADHD is frequent and associated with stronger ADHD symptom severity. Given the underestimated dangerous effects and related comorbidities, SC use should be subject to scrutiny by clinicians treating ADHD patients. More studies are needed to further elucidate the impact of SC use in ADHD.
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Mulraney M, Coghill D, Bishop C, Mehmed Y, Sciberras E, Sawyer M, Efron D, Hiscock H. A systematic review of the persistence of childhood mental health problems into adulthood. Neurosci Biobehav Rev 2021; 129:182-205. [PMID: 34363845 DOI: 10.1016/j.neubiorev.2021.07.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023]
Abstract
Many adult mental disorders have their origins in childhood yet our knowledge about this largely comes from studies assessing adults utilising retrospective recall of age of onset. In this systematic review we evaluate the current state of knowledge of how childhood exposure to mental health problems is associated with adult mental disorders using data from prospective longitudinal studies. We identified 40 studies that assessed mental health in childhood or adolescence and reassessed adults for mental disorders. Although there was substantial heterogeneity across studies in terms of methodology and findings, there was a clear pattern that experiencing mental health problems prior to 14 years of age increases risk of adult mental disorder. Importantly, elevated symptoms rather than diagnosis in childhood were generally more strongly associated with adult disorder. These findings provide strong support for the argument that prevention needs to be targeted to children in the primary school years and early intervention efforts to those who are beginning to experience elevated symptoms rather than waiting until a diagnosable disorder is evident.
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Affiliation(s)
- Melissa Mulraney
- Institute for Social Neuroscience, ISN Innovations, Ivanhoe, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia.
| | - David Coghill
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia; The Royal Children's Hospital, Melbourne, Australia
| | - Caitlin Bishop
- School of Psychology, Deakin University, Geelong, Australia
| | - Yasemin Mehmed
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia
| | - Emma Sciberras
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia; School of Psychology, Deakin University, Geelong, Australia
| | - Michael Sawyer
- Women's and Children's Health Network, North Adelaide, SA, Australia; Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Daryl Efron
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia; The Royal Children's Hospital, Melbourne, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia; The Royal Children's Hospital, Melbourne, Australia
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Farré‐Colomés À, Gerhardt S, Luderer M, Sobanski E, Kiefer F, Vollstädt‐Klein S. Common and distinct neural connectivity in attention‐deficit/hyperactivity disorder and alcohol use disorder studied using resting‐state functional magnetic resonance imaging. Alcohol Clin Exp Res 2021; 45:948-960. [DOI: 10.1111/acer.14593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/10/2021] [Accepted: 03/02/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Àlvar Farré‐Colomés
- Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | - Sarah Gerhardt
- Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | - Mathias Luderer
- Department of Psychiatry Psychosomatic Medicine and Psychotherapy University Hospital Goethe University Frankfurt Germany
| | - Esther Sobanski
- Department of Psychiatry and Psychotherapy Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Mannheim Germany
- Department of Child and Adolescent Psychiatry University Medical Center Mainz Mainz Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Mannheim Germany
- Mannheim Center for Translational Neurosciences (MCTN) Medical Faculty Mannheim University of Heidelberg Mannheim Germany
- Feuerlein Center on Translational Addiction Medicine University of Heidelberg Heidelberg Germany
| | - Sabine Vollstädt‐Klein
- Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Mannheim Germany
- Mannheim Center for Translational Neurosciences (MCTN) Medical Faculty Mannheim University of Heidelberg Mannheim Germany
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Maternal depressive and anxiety symptoms and the risk of attention deficit hyperactivity disorder symptoms in offspring aged 17: Findings from the Raine Study. J Affect Disord 2021; 284:149-156. [PMID: 33601244 DOI: 10.1016/j.jad.2021.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND While previous studies have suggested that maternal anxiety and depressive symptoms are associated with increased risk of attention-deficit/hyperactivity disorder (ADHD) in their offspring in early and late childhood, studies exploring the risk in late adolescence are however lacking. This study aims to examine the association between maternal anxiety and depressive symptoms and the risk of ADHD symptoms in late adolescence (at age 17). METHODS We used data from the Raine Study. Maternal depressive and anxiety symptoms were measured when the child was 10 years of age using the Depression, Anxiety, and Stress Scale (DASS). Offspring ADHD symptoms at age 17 were assessed using the DSM-oriented scales of the child behavior checklist (CBCL). Log-binomial regression was used to explore the associations. RESULTS We found an increased risk of ADHD symptoms in offspring of mothers with comorbid anxiety and depressive symptoms when compared with offspring of mothers with no symptoms [RR 5.60 (95%CI 3.02-10.37)]. There was a nearly three-fold increase in the risk of ADHD symptoms in offspring of mothers with increased anxiety symptoms compared with offspring of mothers who were in the normal range [RR 2.84 (95%CI 1.18-6.83)]. No association was observed with maternal depressive symptoms. CONCLUSION This study found an increased risk of ADHD symptoms in the offspring of mothers with anxiety as well as comorbid anxiety and depressive symptoms but not among the offspring of mothers with depressive symptoms. Early screening and intervention for ADHD symptoms in offspring with maternal anxiety and comorbid anxiety and depressive symptoms are warranted.
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Depression and ADHD-Related Risk for Substance Use in Adolescence and Early Adulthood: Concurrent and Prospective Associations in the MTA. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1903-1916. [PMID: 31273568 DOI: 10.1007/s10802-019-00573-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) is prospectively linked to substance use and disorder. Depression emerging in adolescence is an understudied risk factor that may explain some of this risk. In the present study, we considered mediating and moderating roles of adolescent depression in explaining this association by using longitudinal data from the prospective 16-year follow-up of the Multimodal Treatment Study of ADHD (MTA). Participants were 547 children diagnosed with DSM-IV ADHD Combined Type, and 258 age- and sex-matched comparison children. In adolescence, depressive symptoms did not exacerbate effects of childhood ADHD on any substance use. For both groups, time-varying and average depressive symptoms were associated with more frequent use of all substances. Prospectively, we found no evidence of depression mediation to adult substance use. However, adolescent depression moderated the association between childhood ADHD and adult marijuana use. Although adults without ADHD histories used marijuana more frequently if they had elevated depressive symptoms in adolescence, marijuana use by adults with ADHD histories was independent of their adolescent depression. In adulthood, depression diagnoses and ADHD persistence continued to operate as independent, additive correlates of substance use risk. Our findings suggest a circumscribed role for depression in substance use risk that adds to, but does not alter or explain, ADHD-related risk.
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Stevens AK, Gunn RL, Jackson KM, Borsari B, Metrik J. Examining motivational pathways from adult attention-deficit/hyperactivity disorder symptoms to cannabis use: Results from a prospective study of veterans. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 35:16-28. [PMID: 32881541 DOI: 10.1037/adb0000682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) is linked prospectively to cannabis; however, no study has examined mechanisms underlying this comorbidity. We examined 5 cannabis motives (i.e., coping with negative affect, sleep, social anxiety, perceived low risk of cannabis, and altered perception) as mediators of the prospective ADHD-cannabis relation. Method: Veterans reporting lifetime cannabis use (N = 361; 93% male; 80% White) completed three semiannual assessments. Prospective mediation models using structural equation modeling analyzed the indirect effects of baseline ADHD symptoms on 12-month cannabis use and problems via each motive at 6 months. Zero-inflated negative binomial models were employed for both manifest outcomes and ADHD symptoms and motives were each modeled as 1-factor latent variables. Results: Sleep motives was a robust mediator for cannabis use frequency in single mediator models and was marginally significant when examined simultaneously with other motives after accounting for baseline cannabis use, demographics, other substance use, and other psychopathology. Coping with negative affect was the only significant mediator of ADHD symptoms and subsequent cannabis problem severity. Conclusion: Among veterans with ADHD symptoms, sleep disturbance is a salient motive for cannabis use, whereas coping with negative affect is a proximal predictor of cannabis problems. Findings support addressing sleep disturbance in adults with ADHD symptoms and converge with extant literature demonstrating robust associations between coping motives and substance use problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Gbessemehlan A, Arsandaux J, Orri M, Montagni I, Macalli M, Tournier M, Tzourio C, Galéra C. Perceived stress partially accounts for the association between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and suicidal ideation among students. Psychiatry Res 2020; 291:113284. [PMID: 32763545 DOI: 10.1016/j.psychres.2020.113284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/05/2020] [Accepted: 07/05/2020] [Indexed: 11/26/2022]
Abstract
The association between Attention Deficit Hyperactivity Disorder (ADHD) and suicidal ideation has been the focus of recent research interest among youths and young adults. However, the role perceived stress plays in this association is unclear. We investigated whether perceived stress accounts for the association between ADHD and subsequent suicidal ideation among French students enrolled in the i-Share cohort. The associations between ADHD symptoms, perceived stress at baseline, and suicidal ideation during follow-up were investigated using logistic regression models, and Structural Equation Modeling was used to estimate the indirect effect via perceived stress. In total 4333 participants (median age: 20.3 years; [interquartile range: 18.7-21.8]) were included in the main analyses. ADHD was associated with suicidal ideation (adjusted Odds Ratio = 1.15 [95% Confidence Interval: 1.04-1.26]). Perceived stress partially accounts for the association between ADHD and suicidal ideation (proportion explained 49%). Our study suggests that ADHD and perceived stress represent mental health targets for suicide prevention programs.
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Affiliation(s)
- Antoine Gbessemehlan
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France
| | - Julie Arsandaux
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France
| | - Massimiliano Orri
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France; McGill Group for Suicide Studies, Douglas Mental Health University Institure, McGill University, Montreal, Quebec, Canada
| | - Ilaria Montagni
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France
| | - Melissa Macalli
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France
| | - Marie Tournier
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France; Charles Perrens Hospital, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, 33076 Bordeaux, France
| | - Christophe Tzourio
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France
| | - Cédric Galéra
- Bordeaux Population Health Research Center, INSERM UMR1219, Team HEALTHY, 33000 Bordeaux, France; University of Bordeaux, 33076 Bordeaux, France; Charles Perrens Hospital, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, 33076 Bordeaux, France.
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Regan T, Tubman J. Attention Deficit Hyperactivity Disorder (ADHD) Subtypes, Co-Occurring Psychiatric Symptoms and Sexual Risk Behaviors among Adolescents Receiving Substance Abuse Treatment. Subst Use Misuse 2020; 55:119-132. [PMID: 31502500 PMCID: PMC6917828 DOI: 10.1080/10826084.2019.1657895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Adolescents entering substance abuse treatment report clustered psychiatric symptoms and sexual risk behaviors representing differential levels of impairment and risk for maladaptive health outcomes. Objectives: To examine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) subtypes among adolescents receiving outpatient substance abuse treatment; To document group differences in (a) past-year psychiatric symptom scores and (b) sexual risk behaviors by ADHD subtype and gender. Methods: Self-report data were collected via structured interviews from 394 adolescents (280 males, M = 16.33 years, SD = 1.15 years), enrolled in an HIV/STI risk reduction intervention for adolescents receiving outpatient substance abuse treatment. ADHD diagnostic subtypes and other past-year psychiatric symptoms were assessed using the Brief Michigan Version of the Composite Internal Diagnostic Interview (UM-CIDI). Adolescents provided self-report data on sexual risk behaviors. Results: Multivariate analyses of variance (MANOVAs) documented that Inattentive and Hyperactive-Impulsive ADHD subtypes were significantly associated with higher scores for all past-year psychiatric symptoms. The combined ADHD subtype was significantly associated with higher scores for all psychiatric symptoms except affective disorder. Girls reported significantly higher mean symptoms than boys for alcohol abuse and dependence, anxiety, and affective disorder symptoms. Sexual risk behavior scores were not associated with ADHD status, but girls reported consistently higher scores for multiple risk behavior outcomes. Several psychiatric disorder symptoms were significant covariates of multiple sexual risk behaviors. Conclusion/Importance: Brief screenings for ADHD, other psychiatric disorders and sexual risk behaviors can provide data for tailoring substance abuse services to improve adolescent health outcomes for high-risk subgroups.
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Affiliation(s)
- Timothy Regan
- Department of Psychological & Brain Sciences, Texas A&M University College Station, College Station, Texas, USA
| | - Jonathan Tubman
- Department of Psychology, American University, Washington D.C., USA
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Moggi F, Schorno D, Soravia LM, Mohler-Kuo M, Estévez-Lamorte N, Studer J, Gmel G. Screened Attention Deficit/Hyperactivity Disorder as a Predictor of Substance Use Initiation and Escalation in Early Adulthood and the Role of Self-Reported Conduct Disorder and Sensation Seeking: A 5-Year Longitudinal Study with Young Adult Swiss Men. Eur Addict Res 2020; 26:233-244. [PMID: 32564034 PMCID: PMC7592926 DOI: 10.1159/000508304] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/28/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and sensation seeking (SS) have been consistently related to a higher risk of substance use (SU) and substance use disorder (SUD). OBJECTIVES To investigate the relationship between ADHD and prevalence rates in males at age 20 and age 25, the initiation of SU and SUD after age 20, and the escalation of SU from age 20 to age 25, and to explore the role of CD and SS in the relation of ADHD with SU and SUD initiation and escalation. METHOD Data were obtained as part of the Cohort Study on Substance Use Risk Factors (C-SURF), which focused on young Swiss men aged 20 years at baseline and 25 years at follow-up. RESULTS Participants who screened positive for ADHD at baseline exhibited a higher rate of SU and SUD than participants who screened negative. The presence of ADHD symptoms at age 20 predicted initiation of all SU between age 20 and age 25, except for alcohol and smoking. After controlling for self-reported CD and SS, ADHD still predicted this late initiation of use of hallucinogens, meth-/amphetamines, and ecstasy/MDMA; non-medical use of ADHD medication and sedatives, and alcohol use disorder (AUD). No escalation of weekly drinking and smoking or annual cannabis use was observed from age 20 to age 25. CONCLUSION Screened-positive ADHD is an independent predictor of late SU and AUD, along with self-reported CD and SS. From a public health perspective, identifying ADHD is not only important in childhood and adolescence but also in early adulthood to guide specific interventions to lower risks of drug use initiation and the development of AUD in early adulthood.
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Affiliation(s)
- Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,*Prof. Franz Moggi, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, CH–3000 Bern 60 (Switzerland),
| | - Deborah Schorno
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leila Maria Soravia
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,Südhang Clinic, Research Deparment, Kirchlindach, Switzerland
| | - Meichun Mohler-Kuo
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland,Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Natialia Estévez-Lamorte
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Swiss Institute for the Prevention of Alcohol and Drug Problems, Research Department, Lausanne, Switzerland,Center for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada,University of the West of England, Faculty of Health and Social Sciences, Bristol, United Kingdom
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18
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Icick R, Moggi F, Slobodin O, Dom G, Mathys F, van den Brink W, Levin FR, Blankers M, Kaye S, Demetrovics Z, van de Glind G, Velez-Pastrana MC, Schellekens ASA. Attention Deficit/Hyperactivity Disorder and Global Severity Profiles in Treatment-Seeking Patients with Substance Use Disorders. Eur Addict Res 2020; 26:201-210. [PMID: 32570249 DOI: 10.1159/000508546] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Comorbid attention deficit/hyperactivity disorder (ADHD) is present in 15-25% of all patients seeking treatment for substance use disorders (SUDs). Some studies suggest that comorbid ADHD increases clinical severity related to SUDs, other psychiatric comorbidities, and social impairment, but could not disentangle their respective influences. OBJECTIVES To investigate whether comorbid adult ADHD in treatment-seeking SUD patients is associated with more severe clinical profiles in these domains assessed altogether. METHODS Treatment-seeking SUD patients from 8 countries (N = 1,294: 26% females, mean age 40 years [SD = 11 years]) were assessed for their history of DSM-IV ADHD, SUDs, and other psychiatric conditions and sociodemographic data. SUD patients with and without comorbid ADHD were compared on indicators of severity across 3 domains: addiction (number of SUD criteria and diagnoses), psychopathological complexity (mood disorders, borderline personality disorder, lifetime suicidal thoughts, or behavior), and social status (education level, occupational and marital status, and living arrangements). Regression models were built to account for confounders for each severity indicator. RESULTS Adult ADHD was present in 19% of the SUD patients. It was significantly associated with higher SUD severity, more frequent comorbid mood or borderline personality disorder, and less frequent "married" or "divorced" status, as compared with the absence of comorbid ADHD. ADHD comorbidity was independently associated with a higher number of dependence diagnoses (OR = 1.97) and more psychopathology (OR = 1.5), but not marital status. CONCLUSIONS In treatment-seeking SUD patients, comorbid ADHD is associated with polysubstance dependence, psychopathological complexity, and social risks, which substantiates the clinical relevance of screening, diagnosing, and treating ADHD in patients with SUDs.
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Affiliation(s)
- Romain Icick
- Integrative Neurobiology of Cholinergic Systems, CNRS UMR 3571, Institut Pasteur, Paris, France, .,Assistance Publique - Hôpitaux de Paris, University Hospital Saint-Louis - Lariboisière - Fernand Widal, Paris, France, .,INSERM UMR-S1144, Paris, France, .,Paris University, Paris, France,
| | - Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Israel
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
| | - Frieda Mathys
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Institute for Addiction Research - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Frances R Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute - Columbia University Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - Matthijs Blankers
- Trimbos, Netherlands Institute of Mental Health and Addiction, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Psychiater Radboudumc, Donders Centre for Neuroscience, Afdeling Psychiatrie Wetenschappelijk, Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | | | - Arnt S A Schellekens
- Psychiater Radboudumc, Donders Centre for Neuroscience, Afdeling Psychiatrie Wetenschappelijk, Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
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Fluharty ME, Sallis H, Munafò MR. Investigating possible causal effects of externalizing behaviors on tobacco initiation: A Mendelian randomization analysis. Drug Alcohol Depend 2018; 191:338-342. [PMID: 30173087 PMCID: PMC6152577 DOI: 10.1016/j.drugalcdep.2018.07.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/07/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022]
Abstract
Observational studies suggest childhood externalizing disorders are associated with increased smoking and earlier initiation. However, causality cannot be inferred from observational data alone. The current study uses two-sample MR to examine the causal relationship between externalizing behaviors and tobacco use. Single nucleotide polymorphisms (SNPs) associated with aggression were obtained from the Early Life Epidemiology Consortium (mean age 8), ADHD from the Integrative Psychiatric Research and Psychiatric Genomics Consortiums (age range 6-18), and tobacco initiation and age of onset from the Tobacco and Genetics Consortium. SNPs were combined using the inverse variance weighted approach, weighted median approach, and MR-Egger regression. There was no clear evidence of an effect of aggression on tobacco initiation or age of onset for childhood aggression (initiation: β -0.002, 95% CI -0.005, 0.001, P = 0.286; age: β -0.001 95% CI -0.002, 0.000, P = 0.310) or adolescent aggression (initiation: β -0.001, 95% CI -0.006, 0.003, P = 0.610; age: β 0.000, 95% CI 0.000, 0.001, P = 0.183)]. However, there was some evidence of an association of ADHD on tobacco initiation (OR 1.23, 95% CI 1.10, 1.35, P = 0.016), although no clear evidence of an effect of ADHD on age of onset (OR = 1.022, 95% CI 0.992, 1.052, P = 0.215). Our results provide some evidence that genetic risk of childhood ADHD is causally related to increased risk of tobacco initiation; however, the causal estimate is relatively small. We found no clear evidence that genetic risk of childhood aggression is causally related to the risk of tobacco initiation or age of onset.
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Affiliation(s)
- Meg E Fluharty
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, United Kingdom; UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, United Kingdom.
| | - Hannah Sallis
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, United Kingdom; UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, United Kingdom; Centre of Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, United Kingdom; UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, United Kingdom
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20
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Molina BS, Howard AL, Swanson JM, Stehli A, Mitchell JT, Kennedy TM, Epstein JN, Arnold LE, Hechtman L, Vitiello B, Hoza B. Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study. J Child Psychol Psychiatry 2018; 59:692-702. [PMID: 29315559 PMCID: PMC5985671 DOI: 10.1111/jcpp.12855] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. METHODS Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. RESULTS In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. CONCLUSIONS Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.
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Affiliation(s)
- Brooke S.G. Molina
- Departments of Psychiatry, Psychology, & Pediatrics, University of Pittsburgh
| | | | | | | | - John T. Mitchell
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center
| | - Traci M. Kennedy
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | | | - Lily Hechtman
- Division of Child Psychiatry, McGill University and Montreal Children’s Hospital
| | | | - Betsy Hoza
- Department of Psychological Science, University of Vermont
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21
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Associations between childhood ADHD, gender, and adolescent alcohol and marijuana involvement: A causally informative design. Drug Alcohol Depend 2018; 184:33-41. [PMID: 29402677 PMCID: PMC5818293 DOI: 10.1016/j.drugalcdep.2017.11.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/24/2017] [Accepted: 11/27/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND We report whether the etiology underlying associations of childhood ADHD with adolescent alcohol and marijuana involvement is consistent with causal relationships or shared predispositions, and whether it differs by gender. METHODS In three population-based twin samples (N = 3762; 64% monozygotic), including one oversampling females with ADHD, regressions were conducted with childhood inattentive or hyperactive-impulsive symptoms predicting alcohol and marijuana outcomes by age 17. To determine whether ADHD effects were consistent with causality, twin difference analyses divided effects into those shared between twins in the pair and those differing within pairs. RESULTS Adolescents with more severe childhood ADHD were more likely to initiate alcohol and marijuana use earlier, escalate to frequent or heavy use, and develop symptoms. While risks were similar across genders, females with more hyperactivity-impulsivity had higher alcohol consumption and progressed further toward daily marijuana use than did males. Monozygotic twins with more severe ADHD than their co-twins did not differ significantly on alcohol or marijuana outcomes, however, suggesting a non-causal relationship. When co-occurring use of other substances and conduct/oppositional defiant disorders were considered, hyperactivity-impulsivity remained significantly associated with both substances, as did inattention with marijuana, but not alcohol. CONCLUSIONS Childhood ADHD predicts when alcohol and marijuana use are initiated and how quickly use escalates. Shared familial environment and genetics, rather than causal influences, primarily account for these associations. Stronger relationships between hyperactivity-impulsivity and heavy drinking/frequent marijuana use among adolescent females than males, as well as the greater salience of inattention for marijuana, merit further investigation.
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22
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Owens EB, Zalecki C, Gillette P, Hinshaw SP. Girls with childhood ADHD as adults: Cross-domain outcomes by diagnostic persistence. J Consult Clin Psychol 2017; 85:723-736. [PMID: 28414486 DOI: 10.1037/ccp0000217] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To ascertain adult outcomes in 10 domains reflecting symptomatology (internalizing, externalizing, self-injury, substance use), attainment (education, employment), and impairment (health, social, driving, overall) as a function of both childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) and persistence of ADHD symptoms across time. METHOD We prospectively followed 140 grade-school-aged girls with rigorously diagnosed childhood ADHD and 88 age- and ethnicity-matched comparison girls for 16 years. Outcome measures were obtained via self- and parent-report questionnaires, interviews, and objective tests. RESULTS Childhood ADHD, whether it remitted or persisted, was a pernicious risk factor for a limited number of poor outcomes, including low educational attainment, unplanned pregnancy, body mass index (BMI), and clinician-rated impairment. Childhood ADHD that persisted over time, whether completely or partially, was associated with a number of additional detrimental outcomes in the externalizing, internalizing, self-injury, occupational, social, and overall impairment domains. Finally, in this all-female sample, ADHD was not associated with objective measures of employment, substance use, or driving outcomes. CONCLUSIONS We discuss the considerable impairments accruing from both childhood-limited and adult-persisting ADHD, with major implications for the health and well-being of females with this neurodevelopmental disorder. (PsycINFO Database Record
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Affiliation(s)
| | | | - Peter Gillette
- Institute of Human Development, University of California, Berkeley
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Caye A, Swanson J, Thapar A, Sibley M, Arseneault L, Hechtman L, Arnold LE, Niclasen J, Moffitt T, Rohde LA. Life Span Studies of ADHD-Conceptual Challenges and Predictors of Persistence and Outcome. Curr Psychiatry Rep 2016; 18:111. [PMID: 27783340 PMCID: PMC5919196 DOI: 10.1007/s11920-016-0750-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span.
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Affiliation(s)
- Arthur Caye
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - James Swanson
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Margaret Sibley
- Department of Psychiatry and Behavioral Health at the Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Louise Arseneault
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lily Hechtman
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - L Eugene Arnold
- Department of Psychiatry, Nisonger Center, Ohio State University, Columbus, OH, USA
| | - Janni Niclasen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Centre for Collaborative Health, Aarhus University, Aarhus, Denmark
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil.
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clinicas de Porto Alegre, 4o andar, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil.
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Sibley MH, Mitchell JT, Becker SP. Method of adult diagnosis influences estimated persistence of childhood ADHD: a systematic review of longitudinal studies. Lancet Psychiatry 2016; 3:1157-1165. [PMID: 27745869 DOI: 10.1016/s2215-0366(16)30190-0] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/14/2016] [Accepted: 07/15/2016] [Indexed: 11/30/2022]
Abstract
Several studies have questioned the stability of attention-deficit hyperactivity disorder (ADHD) from childhood to adulthood. This systematic review illustrates how variability in diagnostic methods influences adult ADHD persistence estimates. Systematic database searches identified studies reporting adult ADHD persistence rates that were published in English between Jan 1, 1992, and May 31, 2016. Study inclusion criteria were systematic childhood diagnosis of attention-deficit disorder, ADHD, or a research diagnostic protocol that matched DSM-III, DSM-III-R, or DSM-IV standards; mean childhood age of younger than 12·0 years with no participants older than 18·0 years; and mean adult age of 18·0 years or older with no participants younger than 17·0 years. Across 12 included samples, we identified 41 estimates of ADHD persistence, which ranged from 4·0% to 77·0%. Methods of diagnosing ADHD in adulthood varied widely with respect to source of information, diagnostic instruments (eg, rating scales, interviews), diagnostic symptom threshold, and whether impairment was required for diagnosis. Sole reliance on self reports and a strict threshold of six DSM symptoms led to very low persistence estimates. To minimise false-negative and false-positive classifications, recommended methods for determining adult persistence of ADHD include collecting self and informant ratings, requiring the presence of impairment, and using an age-appropriate symptom threshold. Very few persistence estimates utilised these methods, but those that did indicated persistence rates of 40-50%.
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Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry and Behavioral Health, Center for Children and Families, Florida International University, Miami, FL, USA.
| | - John T Mitchell
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Caye A, Spadini AV, Karam RG, Grevet EH, Rovaris DL, Bau CHD, Rohde LA, Kieling C. Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta-analysis. Eur Child Adolesc Psychiatry 2016; 25:1151-1159. [PMID: 27021056 DOI: 10.1007/s00787-016-0831-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is traditionally conceptualized as a neurodevelopmental disorder that continues into adulthood in up to half of diagnosed cases. In light of current evidence, factors associated with the course of the disorder remain unknown. We performed a systematic review of the literature searching for risk markers from childhood that predicted the persistence of ADHD into adulthood. We reviewed 26,168 abstracts and selected 72 for full-text review. We identified data from 16 studies, comprising 6 population-based retrospective samples and 10 clinical follow-ups. We performed meta-analyses of factors evaluated by at least three studies. Severity of ADHD (OR 2.33, 95 % CI = 1.6-3.39, p < 0.001), treatment for ADHD (OR 2.09, 95 % CI = 1.04-4.18, p = 0.037), comorbid conduct disorder (OR 1.85, 95 % CI = 1.06-3.24, p = 0.030), and comorbid major depressive disorder (OR 1.8, 95 % CI = 1.1-2.95, p = 0.019) emerged as predictors already presented in childhood for ADHD persistence into adulthood. Further, we suggest that cohort studies should be designed to clarify such an important question for research and clinical practice.
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Affiliation(s)
- Arthur Caye
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Alex V Spadini
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Rafael G Karam
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Eugenio H Grevet
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Diego L Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis A Rohde
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Porto Alegre, Brazil
| | - Christian Kieling
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
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Erskine HE, Norman RE, Ferrari AJ, Chan GCK, Copeland WE, Whiteford HA, Scott JG. Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry 2016; 55:841-50. [PMID: 27663939 DOI: 10.1016/j.jaac.2016.06.016] [Citation(s) in RCA: 292] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 06/14/2016] [Accepted: 07/28/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common externalizing disorders. Despite previous research demonstrating that both are longitudinally associated with adverse outcomes, there have been no systematic reviews examining all of the available evidence linking ADHD and CD with a range of health and psychosocial outcomes. METHOD Electronic databases (EMBASE, Medline, and PsycINFO) were searched for studies published from 1980 up to March 2015. Published cohort and case-control studies were included if they reported a longitudinal association between ADHD or CD and adverse outcomes with a minimum follow-up of 2 years. Outcomes with sufficient data were pooled in a random effects meta-analysis to give overall odds ratios (ORs) with corresponding 95% CIs. RESULTS Of the 278 studies assessed, 114 met inclusion criteria and 98 were used in subsequent meta-analyses. ADHD was associated with adverse outcomes including academic achievement (e.g. failure to complete high school; odds ratio [OR] = 3.7, 95% CIs 2.0-7.0), other mental and substance use disorders (e.g. depression; OR = 2.3, 1.5-3.7), criminality (e.g. arrest; OR = 2.4, 1.5-3.8), and employment (e.g., unemployment; OR = 2.0, 1.0-3.9). CD was associated with outcomes relating to academic achievement (e.g. failure to complete high school; OR = 2.7, 1.5-4.7), other mental and substance use disorders (e.g., illicit drug use; OR = 2.1, 1.7-2.6), and criminality (e.g. violence; OR = 3.5, 2.3-5.3). CONCLUSION This study demonstrated that ADHD and CD are associated with disability beyond immediate health loss. Although the analyses could not determine the mechanisms behind these longitudinal associations, they demonstrate the importance of addressing ADHD and CD early in life so as to potentially avert a wide range of future adverse outcomes.
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Affiliation(s)
- Holly E Erskine
- School of Public Health, University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland; and Institute for Health Metrics and Evaluation, University of Washington, Seattle; University of Queensland Centre for Clinical Research, Herston, Queensland.
| | - Rosana E Norman
- Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland
| | - Alize J Ferrari
- School of Public Health, University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland; and Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Gary C K Chan
- Centre for Youth Substance Abuse Research, The University of Queensland
| | | | - Harvey A Whiteford
- School of Public Health, University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland; and Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland; The University of Queensland Centre for Clinical Research, Herston, Queensland; and Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Queensland
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Watterson E, Spitzer A, Watterson LR, Brackney RJ, Zavala AR, Olive MF, Sanabria F. Nicotine-induced behavioral sensitization in an adult rat model of attention deficit/hyperactivity disorder (ADHD). Behav Brain Res 2016; 312:333-40. [PMID: 27363925 DOI: 10.1016/j.bbr.2016.06.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 06/23/2016] [Accepted: 06/26/2016] [Indexed: 12/23/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is associated with increased risk of tobacco dependence. Nicotine, the main psychoactive component of tobacco, appears to be implicated in ADHD-related tobacco dependence. However, the behavioral responsiveness to nicotine of the prevalent animal model of ADHD, the spontaneously hypertensive rat (SHR), is currently underinvestigated. The present study examined the activational effects of acute and chronic nicotine on the behavior of adult male SHRs, relative to Wistar Kyoto (WKY) controls. Experiment 1 verified baseline strain differences in open-field locomotor activity. Experiment 2 tested for baseline strain differences in rotational behavior using a Rotorat apparatus. Adult SHR and WKY rats were then exposed to a 7-day regimen of 0.6mg/kg/d s.c. nicotine, or saline, prior to each assessment. A separate group of SHRs underwent similar training, but was pre-treated with mecamylamine, a cholinergic antagonist. Nicotine sensitization, context conditioning, and mecamylamine effects were then tested. Baseline strain differences were observed in open-field performance and in the number of full rotations in the Rotorat apparatus, but not in the number of 90° rotations or direction changes. In these latter measures, SHRs displayed weaker nicotine-induced rotational suppression than WKYs. Both strains expressed nicotine-induced sensitization of rotational activity, but evidence for strain differences in sensitization was ambiguous; context conditioning was not observed. Mecamylamine reversed the effects of nicotine on SHR performance. These findings are consistent with the hypothesis that a reduced aversion to nicotine (expressed in rats as robust locomotion) may facilitate smoking among adults with ADHD.
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Affiliation(s)
- Elizabeth Watterson
- Arizona State University, Department of Psychology, P.O. Box 871104, Tempe, AZ 85287, United States
| | - Alexander Spitzer
- Arizona State University, Department of Psychology, P.O. Box 871104, Tempe, AZ 85287, United States
| | - Lucas R Watterson
- Arizona State University, Department of Psychology, P.O. Box 871104, Tempe, AZ 85287, United States; Center for Substance Abuse Research Temple University School of Medicine, 3500N. Broad St., Medical Education and Research Bldg., 8th Floor, Philadelphia, PA 19140, United States
| | - Ryan J Brackney
- Arizona State University, Department of Psychology, P.O. Box 871104, Tempe, AZ 85287, United States
| | - Arturo R Zavala
- California State University, Long Beach, CA 90840, United States
| | - M Foster Olive
- Arizona State University, Department of Psychology, P.O. Box 871104, Tempe, AZ 85287, United States
| | - Federico Sanabria
- Arizona State University, Department of Psychology, P.O. Box 871104, Tempe, AZ 85287, United States.
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Vogel T, Dom G, van de Glind G, Studer J, Gmel G, Strik W, Moggi F. Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15-month follow-up? A longitudinal study involving young Swiss men. Addiction 2016; 111:1867-78. [PMID: 27061514 PMCID: PMC5215781 DOI: 10.1111/add.13422] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 11/20/2015] [Accepted: 04/04/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Young adults with attention deficit/hyperactivity disorder (ADHD) show higher substance use disorder (SUD) prevalence relative to non-ADHD controls; few longitudinal studies have examined the course of substance use with reference to conduct disorder (CD). We compared initiation and escalation of substance use at 15-month follow-up in men screened positive or negative for ADHD (ADHD(+) versus ADHD(-) ), controlling for CD presence in early adolescence. DESIGN Participants were recruited during August 2010 and November 2011 from the census of all young men who have to pass mandatory army conscription from three of six Swiss Army recruitment centres. A two-wave data collection was performed via questionnaires at baseline and 15-month follow-up as a part of the longitudinal Cohort Study on Substance Use Risk Factors. SETTING Recruitment centres in Lausanne, Windisch and Mels, responsible for 21 cantons in German- and French-speaking areas of Switzerland. PARTICIPANTS Consecutive sample of 5103 male Swiss Army conscripts who provided informed consent and responded to questionnaires at baseline and 15-month follow-up. Their mean age was 20.0 (standard deviation = 1.21) years at baseline. MEASUREMENTS ADHD and CD were assessed using the adult ADHD Self-Report Scale and the MINI International Neuropsychiatric Interview Plus, respectively, at baseline, and substance use was measured via self-administered substance use questionnaires at baseline and follow-up. FINDINGS Compared with the ADHD(-) group, the ADHD(+) group (n = 215, 4.2%) showed heavier baseline substance use and increased likelihood of alcohol (χ(2) = 53.96; P < 0.001), tobacco (χ(2) = 21.73; P < 0.001) and cannabis use disorders (χ(2) = 48.43; P < 0.001). The extent of alcohol, tobacco and cannabis use in the two groups remained stable from baseline to follow-up (no escalation). The ADHD(+) group was more likely to initiate substance use compared with the ADHD(-) group (higher initiation rates), particularly with amphetamines [odds ratio (OR) = 3.81; 95% confidence interval (CI) = 2.20-6.60; P < 0.001] and non-medical use of ADHD medication (OR = 4.45; 95% CI = 2.06-9.60; P < 0.001). CD was associated with initiation of substance use but did not mediate the associations between ADHD and substance use, revealing that the impact of ADHD on substance use was independent of CD. CONCLUSIONS For men in their early 20s, attention deficit/hyperactivity disorder is a risk factor for continued heavier but not escalating use of alcohol, tobacco and cannabis when already consuming these substances, compared with young men with no ADHD. It is also a risk factor for initiating the use of cannabis, stimulants, hallucinogens and sedatives, independent of conduct disorder in early adolescence.
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Affiliation(s)
- Tanja Vogel
- University Hospital of PsychiatryUniversity of BernBernSwitzerland
| | - Geert Dom
- Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA)PC Alexian BrothersBoechoutBelgium
| | - Geurt van de Glind
- International Collaboration on ADHD and Substance Abuse (ICASA) FoundationUtrechtthe Netherlands,Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical CenterUniversity of AmsterdamAmsterdamthe Netherlands
| | - Joseph Studer
- Alcohol Treatment CentreLausanne University Hospital CHUVLausanneSwitzerland
| | - Gerhard Gmel
- Alcohol Treatment CentreLausanne University Hospital CHUVLausanneSwitzerland,Swiss Institute for the Prevention of Alcohol and Drug ProblemsLausanneSwitzerland,Center for Addiction and Mental HealthOntarioCanada,University of the West of EnglandBristolUK
| | - Werner Strik
- University Hospital of PsychiatryUniversity of BernBernSwitzerland
| | - Franz Moggi
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
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Rhodes JD, Pelham WE, Gnagy EM, Shiffman S, Derefinko KJ, Molina BSG. Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:588-600. [PMID: 27824233 PMCID: PMC5117481 DOI: 10.1037/adb0000188] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with health risks in adolescence which includes the potential for smoking cigarettes, early smoking initiation, and rapid progression to daily smoking. Much less is known, however, about prognostically relevant smoking behaviors among individuals with childhood ADHD. Further research in this area is important for identifying individuals at pronounced risk for nicotine addiction, and for developing effective interventions for this population. This study examined initiation of cigarette smoking, progression to regular smoking, quantity of use, indicators of tobacco dependence, and quit rates among adolescents and young adults with (n = 364) and without (n = 240) childhood ADHD. Individuals with, versus without, ADHD histories were significantly more likely to become daily smokers independent of conduct disorder (CD). They were also more likely to initiate smoking at younger ages and to progress to regular smoking more quickly. There were no significant group differences in cigarettes smoked per day, Fagerström Test of Nicotine Dependence (FTND), or Nicotine Dependence Syndrome Scale (NDSS) scores or in smoking within 30 min of waking. However, smokers with ADHD reported more intense withdrawal and craving during periods of abstinence than non-ADHD smokers. There were no significant group differences in number of quit attempts. Lastly, there were no significant differences among symptom persisters and desisters in daily smoking and amount. Individuals with ADHD histories are at high risk for persistent smoking given their early onset, rapid course, and abstinence characteristics. Smoking cessation programs may need to be adapted or otherwise intensified for those with ADHD. (PsycINFO Database Record
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Affiliation(s)
| | - William E Pelham
- Center for Children and Families, Florida International University
| | | | | | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center
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Catchpole REH, McLeod SL, Brownlie EB, Allison CJ, Grewal A. Cigarette Smoking in Youths With Mental Health and Substance Use Problems: Prevalence, Patterns, and Potential for Intervention. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2016.1184600] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Rosalind E. H. Catchpole
- British Columbia Children's Hospital, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | | | - E. B. Brownlie
- Child, Youth, and Family Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | | | - Arvinder Grewal
- British Columbia Mental Health and Substance Use Services, Vancouver, BC, Canada
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Miranda A, Colomer C, Berenguer C, Roselló R, Roselló B. Substance use in young adults with ADHD: Comorbidity and symptoms of inattention and hyperactivity/impulsivity. Int J Clin Health Psychol 2016; 16:157-165. [PMID: 30487859 PMCID: PMC6225094 DOI: 10.1016/j.ijchp.2015.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/15/2015] [Indexed: 11/29/2022] Open
Abstract
Young adults with attention deficit hyperactivity disorder (ADHD) are at high risk of substance use (SU). The aims of the current study were: 1) to examine the use of alcohol, tobacco, marijuana and other illegal drugs by adults with and without ADHD; 2) to compare the oppositional, conduct, anxiety, depression, sleep and antisocial personality symptoms of ADHD adults with SU and ADHD adults without SU; 3) to examine the ability of ADHD symptoms and conduct problems to predict SU. A total of 93 young adults, 43 without ADHD and 50 with a childhood diagnosis of ADHD, who were part of the Spanish sample of the Multicenter ADHD Genetics (IMAGE) study, collaborated in a follow-up evaluation 10.1 years later. ADHD participants were divided into two groups based on the presence or absence of SU. Statistically significant differences were found between young adults with and without ADHD in their use of tobacco, marijuana and alcohol. A statistically significant association was also shown between externalization problems and a greater risk of SU. Conduct problems, to a greater degree than ADHD symptoms, affect SU in ADHD adults.
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Cognitive enhancers versus addictive psychostimulants: The good and bad side of dopamine on prefrontal cortical circuits. Pharmacol Res 2016; 109:108-18. [PMID: 26826399 DOI: 10.1016/j.phrs.2016.01.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 01/14/2016] [Accepted: 01/15/2016] [Indexed: 12/19/2022]
Abstract
In this review we describe how highly addictive psychostimulants such as cocaine and methamphetamine actions might underlie hypoexcitabilty in frontal cortical areas observed in clinical and preclinical models of psychostimulant abuse. We discuss new mechanisms that describe how increments on synaptic dopamine release are linked to reduce calcium influx in both pre and postsynaptic compartments on medial PFC networks, therefore modulating synaptic integration and information. Sustained DA neuromodulation by addictive psychostimulants can "lock" frontal cortical networks in deficient states. On the other hand, other psychostimulants such as modafinil and methylphenidate are considered pharmacological neuroenhancement agents that are popular among healthy people seeking neuroenhancement. More clinical and preclinical research is needed to further clarify mechanisms of actions and physiological effects of cognitive enhancers which show an opposite pattern compared to chronic effect of addictive psychostimulants: they appear to increase cortical excitability. In conclusion, studies summarized here suggest that there is frontal cortex hypoactivity and deficient inhibitory control in drug-addicted individuals. Thus, additional research on physiological effects of cognitive enhancers like modafinil and methylphenidate seems necessary in order to expand current knowledge on mechanisms behind their therapeutic role in the treatment of addiction and other neuropsychiatric disorders.
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Shrier LA, Ross CS, Blood EA. Momentary positive and negative affect preceding marijuana use events in youth. J Stud Alcohol Drugs 2015; 75:781-9. [PMID: 25208196 DOI: 10.15288/jsad.2014.75.781] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
UNLABELLED ABSTRACT. among young people. This study examined how positive and negative affect differ before marijuana use compared with other times. METHOD Forty medical outpatients ages 15-24 years who used marijuana recreationally at least twice a week (M = 18.7 years; 58% female) reported momentary positive affect, negative affect, companionship, perceived ease of obtaining marijuana, and marijuana use several times a day for 2 weeks on a handheld computer. Mean momentary positive affect and negative affect scores in the 24 hours leading up to a marijuana use event (n = 294) were compared with affect scores in times further from subsequent use. Generalized estimating equation models considered as potential moderators perceived ease of obtaining marijuana and being with friends. RESULTS Positive affect did not differ in the 24 hours before marijuana use compared with times further before use. Negative affect was significantly higher before marijuana use compared with other times. Being with friends and perceived easy marijuana availability did not moderate the associations. The association between negative affect and subsequent marijuana use was attenuated when negative affect was examined only for the moment just before use, suggesting that use may follow a period of increased negative affect. CONCLUSIONS The findings support an affect regulation model for marijuana use among frequently using youth. Specifically, these youth may use marijuana to manage increased negative affect.
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Affiliation(s)
- Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Craig S Ross
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Emily A Blood
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts
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Watterson E, Daniels CW, Watterson LR, Mazur GJ, Brackney RJ, Olive MF, Sanabria F. Nicotine-induced place conditioning and locomotor activity in an adolescent animal model of attention deficit/hyperactivity disorder (ADHD). Behav Brain Res 2015; 291:184-188. [PMID: 26008156 DOI: 10.1016/j.bbr.2015.05.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 05/09/2015] [Accepted: 05/16/2015] [Indexed: 11/28/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a risk factor for tobacco use and dependence. This study examines the responsiveness to nicotine of an adolescent model of ADHD, the spontaneously hypertensive rat (SHR). The conditioned place preference (CPP) procedure was used to assess nicotine-induced locomotion and conditioned reward in SHR and the Wistar Kyoto (WKY) control strain over a range of nicotine doses (0.0, 0.1, 0.3 and 0.6 mg/kg). Prior to conditioning, SHRs were more active and less biased toward one side of the CPP chamber than WKY rats. Following conditioning, SHRs developed CPP to the highest dose of nicotine (0.6 mg/kg), whereas WKYs did not develop CPP to any nicotine dose tested. During conditioning, SHRs displayed greater locomotor activity in the nicotine-paired compartment than in the saline-paired compartment across conditioning trials. SHRs that received nicotine (0.1, 0.3, 0.6 mg/kg) in the nicotine-paired compartment showed an increase in locomotor activity between conditioning trials. Nicotine did not significantly affect WKY locomotor activity. These findings suggest that the SHR strain is a suitable model for studying ADHD-related nicotine use and dependence, but highlights potential limitations of the WKY control strain and the CPP procedure for modeling ADHD-related nicotine reward.
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Affiliation(s)
| | | | - Lucas R Watterson
- Arizona State University, United States; Center for Substance Abuse Research, Temple University School of Medicine, United States
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