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Diez-Canseco F, Carbonel A, Bernabe-Ortiz A, Olivar N, Gómez-Restrepo C, Toyama M, Uribe-Restrepo JM, Brusco LI, Hidalgo-Padilla L, Ramirez-Meneses D, Carbonetti FL, Ariza-Salazar K, Sureshkumar DS, Fung C, Priebe S. Association between stressful life events and depression, anxiety, and quality of life among urban adolescents and young adults in Latin America. Front Psychol 2024; 15:1466378. [PMID: 39575343 PMCID: PMC11580160 DOI: 10.3389/fpsyg.2024.1466378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 10/17/2024] [Indexed: 11/24/2024] Open
Abstract
Background Latin American youth have a high prevalence of mental health disorders and face major socioeconomic and public safety problems. This study assesses the association between stressful life events (SLEs) and depression, anxiety, and quality of life among adolescents and young adults from deprived neighbourhoods of Latin America. Methods The sample consisted of 2,402 participants, between adolescents (15-16 years) and young adults (20-24 years), from Bogotá (Colombia), Buenos Aires (Argentina), and Lima (Peru), assessed in 2021-2022 and recruited in education and community settings and social media. We evaluated the most frequent recent and distant SLEs (occurred in the previous year and more than a year ago, respectively), the relationship between SLEs and severity of depression (PHQ-8), anxiety (GAD-7), and quality of life (MANSA), and we tested for differences by gender and age group. Results The most common recent and distant SLEs were related to public safety issues and financial distress. Accidents and school suspensions were more frequent among men, and sexual harassment and bullying among women. Every additional reported recent SLE increased the odds of mild, moderate, and severe depression (18, 17, and 25%, respectively) and anxiety (10, 17, and 21%, respectively) symptoms. Similar trends were found with distant SLEs and depression (8, 9, and 11% for mild, moderate, and severe symptoms, respectively) and anxiety (9, 11, and 12%, respectively). Furthermore, a higher number of recent and distant SLEs were associated with lower quality of life (β = -0.05, p < 0.001, 95% CI [-0.06, -0.04] and β = -0.04, p < 0.001, 95% CI [-0.05, -0.03], respectively). The relationship between mental distress and quality of life of recent SLEs seems stronger than the one from distant SLEs, and recent SLEs may have a higher impact on adolescents' mental health compared with young adults. Conclusion Both recent and distant SLEs are related to mental distress and quality of life. Policies and programmes should aim to enhance public and health safety, as well as improve individual, family, and community protective factors that could mitigate the effect of SLEs on Latin American youth.
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Affiliation(s)
- Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Adriana Carbonel
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Natividad Olivar
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Gómez-Restrepo
- Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
- Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Mauricio Toyama
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Luis Ignacio Brusco
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Liliana Hidalgo-Padilla
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniela Ramirez-Meneses
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Fernando Luis Carbonetti
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Karen Ariza-Salazar
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Diliniya Stanislaus Sureshkumar
- Unit for Social and Community Psychiatry, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Catherine Fung
- Unit for Social and Community Psychiatry, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Stefan Priebe
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
- Unit for Social and Community Psychiatry, East London NHS Foundation Trust, London, United Kingdom
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Baboli R, Cao M, Martin E, Halperin JM, Wu K, Li X. Distinct structural brain network properties in children with familial versus non-familial attention-deficit/hyperactivity disorder (ADHD). Cortex 2024; 179:1-13. [PMID: 39089096 PMCID: PMC11401761 DOI: 10.1016/j.cortex.2024.06.019] [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: 01/04/2024] [Revised: 04/12/2024] [Accepted: 06/17/2024] [Indexed: 08/03/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is among the most prevalent, inheritable, and heterogeneous childhood-onset neurodevelopmental disorders. Children with a hereditary background of ADHD have heightened risk of having ADHD and persistent impairment symptoms into adulthood. These facts suggest distinct familial-specific neuropathological substrates in ADHD that may exist in anatomical components subserving attention and cognitive control processing pathways during development. The objective of this study is to investigate the topological properties of the gray matter (GM) structural brain networks in children with familial ADHD (ADHD-F), non-familial ADHD (ADHD-NF), as well as matched controls. A total of 452 participants were involved, including 132, 165 and 155 in groups of ADHD-F, ADHD-NF and typically developed children, respectively. The GM structural brain network was constructed for each group using graph theoretical techniques with cortical and subcortical structures as nodes and correlations between volume of each pair of the nodes within each group as edges, while controlled for confounding factors using regression analysis. Relative to controls, children in both ADHD-F and ADHD-NF groups showed significantly higher nodal global and nodal local efficiencies in the left caudal middle frontal gyrus. Compared to controls and ADHD-NF, children with ADHD-F showed distinct structural network topological patterns associated with right precuneus (significantly higher nodal global efficiency and significantly higher nodal strength), left paracentral gyrus (significantly higher nodal strength and trend toward significantly higher nodal local efficiency) and left putamen (significantly higher nodal global efficiency and trend toward significantly higher nodal local efficiency). Our results for the first time in the field provide evidence of familial-specific structural brain network alterations in ADHD, that may contribute to distinct clinical/behavioral symptomology and developmental trajectories in children with ADHD-F.
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Affiliation(s)
- Rahman Baboli
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA; Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ, USA
| | - Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA; Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ, USA
| | - Elizabeth Martin
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA
| | - Jeffrey M Halperin
- Department of Psychology, Queens College, City University of New York, NY, USA
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, China
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA; Department of Electrical and Computer Engineering, New Jersey Institute of Technology, NJ, USA.
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Widding-Havneraas T, Elwert F, Markussen S, Zachrisson HD, Lyhmann I, Chaulagain A, Bjelland I, Halmøy A, Rypdal K, Mykletun A. Effect of ADHD medication on risk of injuries: a preference-based instrumental variable analysis. Eur Child Adolesc Psychiatry 2024; 33:1987-1996. [PMID: 37742289 PMCID: PMC11211136 DOI: 10.1007/s00787-023-02294-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023]
Abstract
ADHD is associated with an increased risk of injury. Causal evidence for effects of pharmacological treatment on injuries is scarce. We estimated effects of ADHD medication on injuries using variation in provider preference as an instrumental variable (IV). Using Norwegian registry data, we followed 8051 patients who were diagnosed with ADHD aged 5 to 18 between 2009 and 2011 and recorded their ADHD medication and injuries treated in emergency rooms and emergency wards up to 4 years after diagnosis. Persons with ADHD had an increased risk of injuries compared to the general population (RR 1.35; 95% CI: 1.30-1.39), with higher risk in females (RR 1.47; 95% CI: 1.38-1.56) than males (RR 1.23; 95% CI: 1.18-1.28). The between-clinics variation in provider preference for ADHD medication was large and had a considerable impact on patients' treatment status. There was no causal evidence for protective effects of pharmacological treatment on injuries overall for young individuals with ADHD characterized by milder or atypical symptoms. However, there was an apparent effect of pharmacological treatment over time on the risk of injuries treated at emergency wards in this patient group.
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Affiliation(s)
- Tarjei Widding-Havneraas
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Felix Elwert
- Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Ingvild Lyhmann
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ashmita Chaulagain
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ingvar Bjelland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Anne Halmøy
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Knut Rypdal
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Arnstein Mykletun
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway
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Smith MCF, Mukherjee RAS, Müller-Sedgwick U, Hank D, Carpenter P, Adamou M. UK adult ADHD services in crisis. BJPsych Bull 2024; 48:1-5. [PMID: 38058161 PMCID: PMC10801359 DOI: 10.1192/bjb.2023.88] [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: 06/28/2023] [Revised: 08/26/2023] [Accepted: 10/12/2023] [Indexed: 12/08/2023] Open
Abstract
The UK's services for adult attention-deficit hyperactivity disorder (ADHD) are in crisis, with demand outstripping capacity and waiting times reaching unprecedented lengths. Recognition of and treatments for ADHD have expanded over the past two decades, increasing clinical demand. This issue has been exacerbated by the COVID-19 pandemic. Despite an increase in specialist services, resource allocation has not kept pace, leading to extended waiting times. Underfunding has encouraged growth in independent providers, leading to fragmentation of service provision. Treatment delays carry a human and financial cost, imposing a burden on health, social care and the criminal justice system. A rethink of service procurement and delivery is needed, with multiple solutions on the table, including increasing funding, improving system efficiency, altering the service provision model and clinical prioritisation. However, the success of these solutions hinges on fiscal capacity and workforce issues.
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Affiliation(s)
| | | | | | - Dietmar Hank
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Peter Carpenter
- University of Bristol, Bristol, UK
- Royal College of Psychiatrists, London, UK
| | - Marios Adamou
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK
- University of Huddersfield, Huddersfield, UK
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Stollhoff K. [ADHD during adolescence - lost in transition]. MMW Fortschr Med 2023; 165:58-63. [PMID: 37973756 DOI: 10.1007/s15006-023-3109-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Kirsten Stollhoff
- Zentrum für Kinderneurologie, Friesenweg 30, 22763, Hamburg, Deutschland.
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Praus P, Proctor T, Rohrmann T, Benedyk A, Tost H, Hennig O, Meyer-Lindenberg A, Wahl AS. Female sex and burden of depressive symptoms predict insufficient response to telemedical treatment in adult attention-deficit/hyperactivity disorder: results from a naturalistic patient cohort during the COVID-19 pandemic. Front Psychiatry 2023; 14:1193898. [PMID: 37867771 PMCID: PMC10585110 DOI: 10.3389/fpsyt.2023.1193898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a chronic neuropsychiatric disorder, that typically manifests itself during childhood and persists in a majority of the affected individuals into adulthood, negatively affecting physical and mental health. Previous studies have shown detrimental effects of the COVID-19 pandemic on mental health in individuals with ADHD. Thus, telemedicine could be a useful tool for optimizing treatment-outcomes in adult ADHD by improving treatment adherence and persistence. However, data on telemedical treatment outcomes in adult patients with ADHD is scarce. Methods We report here the sub-cohort analysis of a naturalistic cohort of adult patients (N = 254) recruited between April 2020-April 2021, comparing the effects of telemedical treatment on participants either clinically diagnosed with depression (N = 54) or ADHD (N = 67). Participants were asked to fill out the WHO-5 repetitively during >12 weeks of telemedical treatment. Furthermore scores of WHO-5, SCL-90R and BDI-II, psychopathology, psychosocial functioning, sociodemographic data, medical records and a feedback survey were analyzed for both groups and compared. Participants with ADHD were further stratified according to the development of well-being during the study period in order to identify factors associated with a satisfactory treatment outcome. Results Participants with depression reported a significant improvement of well-being during the course of the study, while no such effect could be seen in participants with ADHD on a group level. Despite the good outcome, participants with depression were more severely affected at baseline, with significantly worse psychopathology and a more precarious labor and financial situation. A detailed analysis of ADHD participants without clinical improvement revealed significantly higher BDI-II scores than for ADHD participants with a satisfactory outcome (p = 0.03, Mann-Whitney-U-Test), suggesting successful treatment was hampered by the combination of ADHD and depressive symptoms. Furthermore, female sex among ADHD patients was correlated with an unfavorable treatment outcome during the course of the study (p = 0.001, Spearman correlation) as well as living with children (p = 0.02, Spearman correlation). Conclusion Besides screening for depressive symptoms before telemedical treatment, future research should address the specific needs of female ADHD patients as these patients may be at a particularly high risk of being overburdened with family work.
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Affiliation(s)
- Peter Praus
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Tanja Proctor
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Tobias Rohrmann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Anastasia Benedyk
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Heike Tost
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Oliver Hennig
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | | | - Anna-Sophia Wahl
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Department of Neuroanatomy, Institute of Anatomy, Ludwigs-Maximilians-University, Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital of Ludwigs-Maximilians-University, Munich, Germany
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