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Jakobsson Støre S, Van Zalk N, Granander Schwartz W, Nilsson V, Tillfors M. The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review. J Atten Disord 2024; 28:1299-1319. [PMID: 38651640 PMCID: PMC11168018 DOI: 10.1177/10870547241247448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This review aimed to systematically gather empirical data on the link between social anxiety disorder and ADHD in both clinical and non-clinical populations among adolescents and adults. METHOD Literature searches were conducted in PsycInfo, PubMed, Scopus, and Web of Science, resulting in 1,739 articles. After screening, 41 articles were included. Results were summarized using a narrative approach. RESULTS The prevalence of ADHD in adolescents and adults with SAD ranged from 1.1% to 72.3%, while the prevalence of SAD in those with ADHD ranged from 0.04% to 49.5%. Studies indicate that individuals with both SAD and ADHD exhibit greater impairments. All studies were judged to be of weak quality, except for two studies which were rated moderate quality. DISCUSSION Individuals with SAD should be screened for ADHD and vice versa, to identify this common comorbidity earlier. Further research is needed to better understand the prevalence of comorbid ADHD and SAD in adolescents.
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Affiliation(s)
- Siri Jakobsson Støre
- Karlstad University, Sweden
- Child and Adolescent Psychiatry, Region Värmland, Karlstad, Sweden
| | | | | | - Victoria Nilsson
- Pediatric and Adolescent Medicine, Region Värmland, Karlstad, Sweden
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Hongo M, Oshima F, Guan S, Takahashi T, Nitta Y, Seto M, Hull L, Mandy W, Ohtani T, Tamura M, Shimizu E. Reliability and validity of the Japanese version of the camouflaging autistic traits questionnaire. Autism Res 2024; 17:1205-1217. [PMID: 38661257 DOI: 10.1002/aur.3137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
This study investigated the factor structure and determined the reliability and validity of the Camouflaging Autistic Traits Questionnaire-Japanese version (CAT-Q-J) among 204 autistic and 410 non-autistic people. Since a confirmatory factor analysis revealed no factor validity of the CAT-Q-J for both autistic and non-autistic adults, an exploratory factor analysis was conducted to ensure the psychometric properties matched those of the original scale as much as possible. The results showed the CAT-Q-J comprised three subscales, a four-item compensation subscale, a five-item masking scale, and a five-item assimilation subscale. The overall CAT-Q-J and all three subscales showed sufficient internal consistency and moderate-to-good and stable test-retest reliability in both the autistic and non-autistic samples. Convergent validity was also supported by the correlations found with measures of autistic traits, well-being, anxiety, and depression. Different from the original CAT-Q, compensation/masking for the autistic sample was not correlated with mental health or autistic traits. The reliability and the validity of the overall CAT-Q-J were confirmed; however, caution should be exercised when interpreting its subscales.
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Affiliation(s)
- Minako Hongo
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
| | - Siqing Guan
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | - Toru Takahashi
- Laureate Insutitute for Brain Research, Tulsa, USA
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Yusuke Nitta
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Laura Hull
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Mandy
- Reserch Department for Clinial, Educational & Health Psychology, University College London, London, UK
| | - Toshiyuki Ohtani
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Safety and Health Organization, Chiba University, Chiba, Japan
| | - Masaki Tamura
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Chen L, Mittendorfer-Rutz E, Björkenstam E, Rahman S, Gustafsson K, Kjeldgård L, Ekselius L, Taipale H, Tanskanen A, Helgesson M. Labour market integration among young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) at working age. Psychol Med 2024; 54:148-158. [PMID: 37185065 DOI: 10.1017/s003329172300096x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
METHODS Multiple Swedish nationwide registers were used to identify 8045 individuals, aged 20-29, with an incident diagnosis of ADHD 2006-2011. Labour market integration was conceptualized according to the core-peripheral model as a continuum from a strong (core) to a weak (peripheral) connection to the labour market. Sequence analyses categorized clusters of labour market integration, from 1 year before to 5 years after their ADHD diagnosis for individuals diagnosed with ADHD and a matched control group without ADHD. Multinomial logistic regression computed odds ratios (ORs) with 95% confidence intervals (CIs) between sociodemographic factors and comorbid disorders and the identified clusters. RESULTS About one-fourth of the young adults diagnosed with ADHD belonged to clusters characterized by a transition to a mainly peripheral labour market position, which was approximately four-times higher compared to controls without ADHD. Foremost, those living in small cities/villages (OR 1.9; CI 1.5-2.2), those having comorbid autism-spectrum disorder (OR 13.7; CI 6.8-27.5) or schizophrenia/psychoses (OR 7.8; CI 3.8-15.9) were associated with a transition towards a peripheral labour market position throughout the study period. Those with a high educational level (OR 0.1; CI 0.1-0.1), and men (OR 0.7; CI 0.6-0.8) were less likely to have a peripheral labour market position. CONCLUSIONS Young adults diagnosed with ADHD are four-times more likely to be in the peripheral labour market position compared to those without ADHD. To increase labour market participation, special attention is warranted to those with low educational level, those living outside big cities and those with comorbid mental disorders.
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Affiliation(s)
- Lingjing Chen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Syed Rahman
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Klas Gustafsson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Linnea Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Heidi Taipale
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Antti Tanskanen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
| | - Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, SE-75237 Uppsala, Sweden
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Calabrese ME, Sideridis G, Weitzman C. Physical and Pharmacologic Restraint in Hospitalized Children With Autism Spectrum Disorder. Pediatrics 2024; 153:e2023062172. [PMID: 38073325 DOI: 10.1542/peds.2023-062172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 01/02/2024] Open
Abstract
OBJECTIVES Children with autism spectrum disorder (ASD) have high rates of cooccurring conditions and are hospitalized longer and more frequently than children without ASD. Little is known about use of involuntary physical or pharmacologic restraint in hospitalized children with ASD. This study compares use of restraint because of violent or self-injurious behavior during inpatient pediatric hospitalization in children with ASD compared with typical peers. METHODS This retrospective cohort study examines electronic health records of all children aged 5 to 21 years admitted to a pediatric medical unit at a large urban hospital between October 2016 and October 2021. Billing diagnoses from inpatient encounters identified ASD and cooccurring diagnoses. Clinical orders identified physical and pharmacologic restraint. Propensity score matching ensured equivalency between ASD and matched non-ASD groups on demographic factors. Logistic regression determined the odds of restraint in children with ASD compared with children without ASD, controlling for hospitalization factors and cooccurring diagnoses. RESULTS Of 21 275 hospitalized children, 367 (1.7%) experienced restraint and 1187 (5.6%) had ASD. After adjusting for reason for admission, length of stay, and cooccurring mental health, developmental, and behavioral disorders, children with ASD were significantly more likely to be restrained than children without ASD (odds ratio 2.3, 95% confidence interval 1.6-3.4; P < .001). CONCLUSIONS Hospitalized children with ASD have significantly higher odds of restraint for violent or self-injurious behavior compared with children without ASD after accounting for reason for admission, length of hospitalization and cooccurring diagnoses. Work is needed to modify the hospital environment for children with ASD to reduce behavioral dysregulation and restraint.
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Affiliation(s)
| | - Georgios Sideridis
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Carol Weitzman
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
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Högstedt E, Igelström K, Korhonen L, Käcker P, Marteinsdottir I, Björk M. 'It's like it is designed to keep me stressed'-Working sustainably with ADHD or autism. Scand J Occup Ther 2023; 30:1280-1291. [PMID: 36379218 DOI: 10.1080/11038128.2022.2143420] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adults with attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) face multiple challenges in obtaining and maintaining employment. AIMS To identify and describe how adults with ADHD or ASD experienced their ability to work and what factors affected their ability to find a sustainable work situation over time. METHODS Individual in-depth interviews were performed with 20 purposively sampled participants with ADHD/ASD. Data were analysed inductively using reflexive thematic analysis. RESULTS Three themes were identified, describing (1) one's own cognitive abilities and challenges, (2) enablement by flexibility and acceptance in the work environment, and (3) accumulated stress that makes the work situation unsustainable over time. CONCLUSIONS Over time, a lack of continuity and predictability of support measures caused great stress and exhaustion, with severe consequences for working life and in life in general. Adaptations needed to be individually tailored and include nonoccupational factors. SIGNIFICANCE The study shows that adults with ADHD/ASD need long-term interventions that flexibly adapt to individual needs, as they vary over time. The findings suggest that occupational therapists and other health care providers, employers, employment services and other involved agencies should pay a greater deal of attention to stability and predictability over time.
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Affiliation(s)
- Erika Högstedt
- Community Care Department, The Municipality of Norrköping, Norrköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kajsa Igelström
- Division of Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Pia Käcker
- Disability Research Division, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Ina Marteinsdottir
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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6
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So R, Sato Y, Hashimoto N, Furukawa TA. Prevalence of suspected autism spectrum disorder and attention-deficit hyperactivity disorder in a Japanese clinical sample with gambling disorder: A cross-sectional study. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e131. [PMID: 38867830 PMCID: PMC11114339 DOI: 10.1002/pcn5.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 06/14/2024]
Abstract
Aim Studies show gambling disorders are associated with attention-deficit hyperactivity disorder (ADHD). The association between gambling disorders and autism spectrum disorder (ASD) has not been well studied, although ASD is often comorbid with ADHD and is associated with gaming disorder. The aim of this study was to estimate the prevalence of ASD and ADHD traits comorbid with gambling disorders and to examine the relationships between these traits and gambling problems in a clinical population. Methods This single-site cross-sectional study was conducted at a Japanese addiction outpatient clinic treating gambling disorders. The Autism-Spectrum Quotient (AQ) test and the Adult ADHD Self-Report Scale (ASRS) were used to screen ASD and ADHD. The Problem Gambling Severity Index (PGSI) was used to assess the severity of the gambling problems. We calculated the prevalence of suspected ASD and ADHD with 95% confidence intervals (CI) based on a binomial distribution and performed univariate analyses to examine the relationships between the AQ and ASRS scores and the total PGSI score. Results We included 97 of 197 potential participants. After screening the participants using the AQ and ASRS, we found that the prevalence of ASD traits was 29.8% (95% CI: 21.0%-40.2%), while the prevalence of ADHD traits was 26.0% (95% CI: 17.9%-36.2%). Univariate regression analyses revealed that the total AQ score was inversely associated with the total PGSI score. However, the total ASRS score and some ASRS subscores were positively associated with the total PGSI score. Conclusion ASD and ADHD may be prevalent among patients with gambling disorders in clinical settings.
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Affiliation(s)
- Ryuhei So
- Department of Health Promotion of Human BehaviorKyoto University Graduate School of Medicine/School of Public HealthKyotoJapan
- Okayama Psychiatric Medical CenterOkayamaJapan
| | | | | | - Toshi A. Furukawa
- Department of Health Promotion of Human BehaviorKyoto University Graduate School of Medicine/School of Public HealthKyotoJapan
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Wright E, Pagliaro C, Page IS, Diminic S. A review of excluded groups and non-response in population-based mental health surveys from high-income countries. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1265-1292. [PMID: 37212903 PMCID: PMC10423166 DOI: 10.1007/s00127-023-02488-y] [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: 10/26/2022] [Accepted: 04/30/2023] [Indexed: 05/23/2023]
Abstract
National mental health surveys play a critical role in determining the prevalence of mental disorders in a population and informing service planning. However, current surveys have important limitations, including the exclusion of key vulnerable groups and increasing rates of non-response. This review aims to synthesise information on excluded and undersampled groups in national mental health surveys. We conducted a targeted review of nationally representative adult mental health surveys performed between 2005 and 2019 in high-income OECD countries. Sixteen surveys met our inclusion criteria. The response rate for included surveys ranged between 36.3% and 80.0%. The most frequently excluded groups included people who were homeless, people in hospitals or health facilities and people in correctional facilities. Males and young people were the most commonly underrepresented groups among respondents. Attempts to collect data from non-responders and excluded populations were limited, but suggest that mental health status differs among some of these cohorts. The exclusion of key vulnerable groups and high rates of non-response have important implications for interpreting and using the results of national mental health surveys. Targeted supplementary surveys of excluded or hard-to-reach populations, more inclusive sampling methodologies, and strategies aimed at improving response rates should be considered to strengthen the accuracy and usefulness of survey findings.
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Affiliation(s)
- Eryn Wright
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia.
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia.
| | - Claudia Pagliaro
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
| | - Imogen S Page
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
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Sinclair JMA, Aslan B, Agabio R, Anilkumar A, Brosnan M, Day E, Dowling NA, Flood C, Grant JE, Halliday R, Hofvander B, Howes L, Moseley R, Myers B, O'Connor V, Shaya G, Thomas S, Robinson J, Chamberlain SR. Identifying the most important research, policy and practice questions for substance use, problematic alcohol use and behavioural addictions in autism (SABA-A): A priority setting partnership. Compr Psychiatry 2023; 124:152393. [PMID: 37210935 PMCID: PMC7614597 DOI: 10.1016/j.comppsych.2023.152393] [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: 03/23/2023] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Autistic people are more likely to report problematic alcohol and other substance use when compared to the general population. Evidence suggests that up to one in three autistic adults may have an alcohol or other substance use disorder (AUD/SUD), although the evidence base for behavioural addictions is less clear. Autistic people may use substances or engage in potentially addictive behaviours as a means of coping with social anxiety, challenging life problems, or camouflaging in social contexts. Despite the prevalence and detrimental effects of AUD, SUD and behavioural addictions in community samples, literature focusing on the intersection between autism and these conditions is scarce, hindering health policy, research, and clinical practice. METHODS We aimed to identify the top 10 priorities to build the evidence for research, policy, and clinical practice at this intersection. A priority-setting partnership was used to address this aim, comprising an international steering committee and stakeholders from various backgrounds, including people with declared lived experience of autism and/or addiction. First, an online survey was used to identify what people considered key questions about Substance use, alcohol use, or behavioural addictions in autistic people (SABA-A). These initial questions were reviewed and amended by stakeholders, and then classified and refined to form the final list of top priorities via an online consensus process. OUTCOMES The top ten priorities were identified: three research, three policy, and four practice questions. Future research suggestions are discussed.
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Affiliation(s)
| | - Betul Aslan
- Faculty of Medicine, University of Southampton, UK
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy; Neuroscience Institute, Section of Cagliari, National Research Council, Italy
| | | | - Mark Brosnan
- Centre for Applied Autism Research, University of Bath, UK
| | - Ed Day
- Institute of Mental Health, University of Birmingham, UK
| | - Nicki A Dowling
- School of Psychology, Deakin University, Geelong, Australia; Melbourne Graduate School of Education, University of Melbourne, Australia
| | | | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | | | - Björn Hofvander
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Denmark
| | | | - Rachel Moseley
- Department of Psychology, Bournemouth University, Poole, UK
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health sciences, Curtin University, Perth, Western Australia, Australia; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research council, South Africa; Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | | | - Shane Thomas
- Vice Chancellor's Office, Federation University, Australia; Centre for Research on Ageing, Health and Wellbeing, Australian National University, Australia
| | - Janine Robinson
- Chitra Sethia Autism Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK
| | - Samuel R Chamberlain
- Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK.
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Rabiee R, Lundin A, Agardh E, Allebeck P, Danielsson AK. Cannabis use disorder in relation to socioeconomic factors and psychiatric comorbidity: A cluster analysis of three million individuals born in 1970-2000. Scand J Public Health 2023; 51:82-89. [PMID: 36120841 PMCID: PMC9903242 DOI: 10.1177/14034948221122431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cannabis use disorder (CUD) is one of the main reasons for seeking substance use treatment. It is thus important to monitor and increase knowledge of individuals with CUD utilizing healthcare. We aimed to examine the number of CUD diagnoses over time, compare individuals with CUD with those without and identify subgroups based on CUD diagnosis, sex, birth year, socioeconomic factors and psychiatric comorbidity. METHODS A Swedish, population-based study with 3,307,759 individuals, born in 1970-2000, with register data extending to 2016. K-mode cluster analysis was used to identify potential subgroups. RESULTS The number of individuals with a CUD diagnosis was 14,046 (0.42%). CUD diagnoses increased over time (born 1990-1994: 61 per 100,000, born 1995-2000: 107 per 100,000, by 2016). A majority of those with a CUD had another psychiatric diagnosis (80%, compared with 19% for those without CUD). Four clusters were identified. Cluster 1 comprised mainly men with low income and substance use disorders, clusters 2, 3 and 4 comprised mainly women with higher proportions of mood-related, neurotic and stress-related and behavioural disorders. CONCLUSIONS
There was an increase in CUD diagnoses in Sweden over time, especially among younger birth cohorts. Individuals with CUD were more often male, from younger birth cohorts, with lower education and income than those without CUD. Men and women with CUD exhibited differences in education, income and psychiatric comorbidity. Our results demonstrate the importance of monitoring the impact of socioeconomic factors and psychiatric comorbidity in relation to CUD.
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Affiliation(s)
- Rynaz Rabiee
- Department of Global Public Health, Karolinska Institutet, Sweden,Rynaz Rabiee, Karolinska Institutet, Department of Global Public Health (GPH), Stockholm, SE-171 77, Sweden. E-mail:
| | - Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, Sweden,Centre for Epidemiology and Community Medicine, Sweden
| | - Emilie Agardh
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institutet, Sweden
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A systematic review of predictors of suicidal thoughts and behaviors among autistic adults: Making the case for the role of social connection as a protective factor. Clin Psychol Rev 2023; 99:102235. [PMID: 36459876 DOI: 10.1016/j.cpr.2022.102235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Autistic adults are a high-risk population for suicidal thoughts and behaviors (STBs). Accordingly, this systematic review aims to review the prevalence of STBs among autistic adults, review the risk and protective factors for STBs in autistic adults, and formulate a disorder-specific conceptualization of risk in this population. We systematically searched PsycINFO and Google Scholar for all studies published prior to March 28th, 2022. We included empirical articles focused on autistic adults, ages 18 years and older, reporting on suicide-related outcomes. In total, 45 peer-reviewed empirical articles were included in the current systematic review. The most frequently studied factors in relation to suicide risk among autistic adults were interpersonal constructs (42.4% of total studies looking at risk/protective factors) and depressive symptoms (36.4% of total studies looking at risk/protective factors). We conclude by summarize two key content areas: exploring social and interpersonal constructs and better understanding the role of depressive symptoms in autism. As researchers continue to explore STBs among autistic adults, it will be necessary to addressing the overreliance on autistic symptoms instead of autism diagnoses, measurement issues of STBs, and a need for treatment adaptations.
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Piccoli E, Hollander E. Editor's Commentary: Problematic Use of the internet in Autism Spectrum Disorder: A canary in the coal mine? J Psychiatr Res 2022; 155:260-262. [PMID: 36116405 DOI: 10.1016/j.jpsychires.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Eleonora Piccoli
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy.
| | - Eric Hollander
- Psychiatric Research Institute of Montefiore Einstein (PRIME), Albert Einstein College of Medicine, Bronx, NY, USA
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12
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Tateno M, Matsuzaki T, Takano A, Higuchi S. Increasing important roles of child and adolescent psychiatrists in the treatment of gaming disorder: Current status in Japan. Front Psychiatry 2022; 13:995665. [PMID: 36339875 PMCID: PMC9627206 DOI: 10.3389/fpsyt.2022.995665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Digital gaming is the most common leisure activity among children and adolescents in Japan, especially in males. Playing online gaming has become more common among school-age children over the years. As a result, excessive online gaming in younger children has become a significant social problem in Japan. Previous studies have demonstrated that excessive online gaming could cause various mental health issues in children and adolescents. At medical institutions having child and adolescent psychiatry services, there is an increasing number of children and adolescents with various problems related to excessive gaming. The aim of this study was to investigate the current practice of gaming disorder (GD) in clinical settings in Japan. METHODS The subjects of this study were all of 414 child and adolescent psychiatrists certified by the Japanese Society for Child and Adolescent Psychiatry (JSCAP). The study questionnaire was mailed to all subjects from the official secretariat of JSCAP. Study subjects were requested to answer the questionnaire anonymously. The survey contained three types of responses: open responses; single and multiple-choice responses; and, responses on a five-point Likert scale. The questionnaire consisted of 14 questions regarding GD. RESULTS We received 159 responses. The most common reason for a visit to child and adolescent psychiatry service which results in a subsequent diagnosis of GD was school refusal/absenteeism followed by disruption of sleep-awake rhythm. The most common specialized treatment for GD currently offered at child and adolescent psychiatry service is individual psychotherapy. The two most frequently experienced difficulties in the treatment of GD were low motivation to achieve recovery and a large variety of combined problems other than excessive gaming itself. With regard to the three most common psychiatric comorbidities of GD, they were autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and depression. DISCUSSION The results of our survey revealed that although GD is a behavioral addiction, many children and adolescents with GD first visit child and adolescent psychiatry clinics rather than specialized clinics for addiction which are usually designed and staffed for adult patients. Because it is known that GD is more prevalent among young males, including junior high and high school students, GD has become one of the most important clinical issues in child and adolescent psychiatry today. The important roles of child and adolescent psychiatrists in the treatment of GD has been increasing.
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Affiliation(s)
- Masaru Tateno
- Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan
| | - Takanobu Matsuzaki
- Department of Psychiatry, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Ayumi Takano
- Department of Mental Health and Psychiatric Nursing, Tokyo Medical and Dental University, Tokyo, Japan
| | - Susumu Higuchi
- Department of Psychiatry, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
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Autism, Problematic Internet Use and Gaming Disorder: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00243-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AbstractThe present study investigated the association between autism and problematic internet use (PIU) and gaming disorder (GD). A systematic literature search was conducted in accordance with PRISMA guidelines. A total of 2286 publications were screened, and 21 were deemed eligible for inclusion in the review. The majority of the studies found positive associations between PIU and subclinical autistic-like traits with weak and moderate effect sizes and between PIU and Autism Spectrum Disorder (ASD) with varying effect sizes. Additionally, individuals with ASD were more likely to exhibit symptoms of GD with moderate and strong effect sizes. Future research would benefit from high-quality studies examining GD and PIU at a clinical level and their relationship with both clinical and subclinical autism.
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Yasuma N, Watanabe K, Nishi D, Ishikawa H, Tachimori H, Takeshima T, Umeda M, Kawakami N. Psychotic Experiences and Hikikomori in a Nationally Representative Sample of Adult Community Residents in Japan: A Cross-Sectional Study. Front Psychiatry 2021; 11:602678. [PMID: 33584370 PMCID: PMC7878546 DOI: 10.3389/fpsyt.2020.602678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/08/2020] [Indexed: 11/21/2022] Open
Abstract
Psychotic experiences (PEs) may be associated with hikikomori. In the present study, we analyzed interview data from a community-based representative sample (N = 1,616) in Japan to know the association of PEs over a life time, as well as the two components, hallucinatory experiences (HEs) and delusional experiences (DEs), with lifetime experience of hikikomori (severe social withdrawal). Logistic regression analysis was used to estimate the association between any PE, any HE, and any DE; and hikikomori, adjusting for socio-demographics and other psychopathologies (mental disorder in the past 12 months or having autistic spectrum disorder trait). Any PE was significantly associated with hikikomori [odds ratio (OR) =3.44, 95% CI = 1.14-10.33] after adjustment for sociodemographic factors, although the association attenuated after adjusting for other psychopathologies. Any DE remained significantly associated with hikikomori, even after adjustment for all the covariates (OR = 10.50, 95% CI = 1.57-70.29). Any HE was not significantly associated with hikikomori. DEs may be associated with hikikomori. However, because the study sample was small and the temporal association between DEs and hikikomori was unclear, a future study is needed to examine a causal relationship between DEs and hikikomori.
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Affiliation(s)
- Naonori Yasuma
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hanako Ishikawa
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisateru Tachimori
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | | | - Maki Umeda
- Research Institute of Nursing Care for People and Community, University of Hyogo, Akashi, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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