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Zafar M, Alhelali AYS, Alfuwis MSM, Alshammari WZAL. Relationship between attention deficit hyperactive disorders with life satisfaction among medical students in city of Hail, KSA. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:437. [PMID: 38464643 PMCID: PMC10920718 DOI: 10.4103/jehp.jehp_334_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/30/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Attention deficit hyperactive disorder (ADHD) begins in childhood, and its symptoms persist into adulthood. Students with ADHD symptoms will be at increased risk of antisocial behavior, depression, and loss of inhibition. This study determines the relationship between ADHD and life satisfaction level among medical students in the city of Hail, KSA. MATERIALS AND METHODS This is a cross-sectional study that was conducted in a public-sector medical college. A total of 200 students were recruited through stratified cluster sampling. Validated, structured scales of ADHD and life satisfaction were used, and known psychiatric disorders among students were excluded from the study. Correlation and linear regression analyses were used to determine the relationship between ADHD and life satisfaction and identify the determinants of ADHD. P value < 0.05 was considered statistically significant. RESULT The prevalence rate of ADHD among medical students was 33.3%. Female gender, third-year academic year student, and 21-26-year-old age group were the high-risk groups of ADHD. Inattention (r = -0.263, P value -0.000) and hyperactivity (r = -0.260, P value 0.000) were significantly correlated with life satisfaction level, with 92% of the variability in life satisfaction determined by inattention and hyperactivity. CONCLUSION The burden of ADHD is high among medical students, and it negatively correlates with life satisfaction level. Students' academic and social functioning was affected due to ADHD. There is a need to address this issue with early diagnosis and management of this disorder.
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Affiliation(s)
- Mubashir Zafar
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
| | - Alaa Y. S. Alhelali
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
| | - Mohamed S. M. Alfuwis
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
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Capp SJ, Agnew-Blais J, Lau-Zhu A, Colvert E, Tye C, Aydin Ü, Lautarescu A, Ellis C, Saunders T, O'Brien L, Ronald A, Happé F, McLoughlin G. Is quality of life related to high autistic traits, high ADHD traits and their Interaction? Evidence from a Young-Adult Community-Based twin sample. J Autism Dev Disord 2023; 53:3493-3508. [PMID: 35802291 PMCID: PMC10465683 DOI: 10.1007/s10803-022-05640-w] [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] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
This study explored whether high autistic traits, high attention deficit hyperactivity disorder (ADHD) traits and their interaction were associated with quality of life (QoL) in a sample of 556 of young-adult twins (Mean age 22 years 5 months, 52% Female). Four participant groups were created: high autistic traits, high ADHD traits, high autistic/ADHD traits, and low ADHD/autistic traits. High autistic traits were associated with lower QoL across domains (physical, psychological, social, and environmental). High ADHD traits associated with lower physical, psychological, and environmental QoL. The interaction of autistic and ADHD traits was not significant in any domain. While mental health difficulties were associated with lower QoL, after accounting for mental health, most relationships between autistic traits, ADHD traits and QoL remained.
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Affiliation(s)
- Simone J Capp
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Medical Sciences Division, Oxford Institute for Clinical Psychology Training and Research, University of Oxford, Oxford, UK.
| | - Jessica Agnew-Blais
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, School of School of Biological and Chemical Sciences, Queen Mary University London, London, UK
| | - Alex Lau-Zhu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Colvert
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Tye
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ümit Aydin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexandra Lautarescu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claire Ellis
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tyler Saunders
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University of Edinburgh, Edinburgh, UK
| | - Lucy O'Brien
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, University of London, Birkbeck, London, UK
| | - Francesca Happé
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gráinne McLoughlin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Stickley A, Shirama A, Sumiyoshi T. Are attention-deficit/hyperactivity disorder symptoms associated with negative health outcomes in individuals with psychotic experiences? Findings from a cross-sectional study in Japan. Front Psychiatry 2023; 14:1133779. [PMID: 37205981 PMCID: PMC10188928 DOI: 10.3389/fpsyt.2023.1133779] [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: 12/29/2022] [Accepted: 04/04/2023] [Indexed: 05/21/2023] Open
Abstract
Objective Although research has indicated that the prevalence of attention-deficit/hyperactivity disorder (ADHD) may be elevated in individuals with psychotic disorders, as yet, there has been comparatively little research on this association and its effects among adults at the subclinical level. To address this deficit, the current study examined the association between psychotic experiences (PE) and ADHD symptoms in Japanese individuals and whether the presence of ADHD symptoms increases the risk for negative health outcomes in people with PE. Method Data were analyzed from an online sample of 1,452 individuals (age 18-89; 51.5% female) collected in 2021. Information on PE was obtained with the PRIME Screen-Revised (PS-R), while the Adult ADHD Self-Report Scale (ASRS) Screener was used to measure ADHD symptoms. Information was also obtained on a number of health outcomes including anxiety and depressive symptoms and suicidal ideation. Logistic regression was used to assess associations. Results In a fully adjusted analysis PE were associated with almost three times higher odds for ADHD symptoms (OR: 2.92, 95%CI: 1.19-7.17). In an analysis that was restricted to individuals with PE, ADHD symptoms were associated with significantly increased odds for depressive symptoms, lifetime suicidal ideation, perceived stress and severe sleep problems. Conclusion ADHD symptoms are present in some individuals with PE and increase the odds for several detrimental health outcomes in this population. Identifying co-occurring PE and ADHD/ADHD symptoms may facilitate treatment options and help prevent negative health outcomes in individuals with these conditions.
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Peasgood T, Bhardwaj A, Brazier JE, Biggs K, Coghill D, Daley D, Cooper CL, De Silva C, Harpin V, Hodgkins P, Nadkarni A, Setyawan J, Sonuga-Barke EJS. What Is the Health and Well-Being Burden for Parents Living With a Child With ADHD in the United Kingdom? J Atten Disord 2021; 25:1962-1976. [PMID: 32552265 PMCID: PMC8527548 DOI: 10.1177/1087054720925899] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective: To explore the burden associated with childhood ADHD in a large observational study. Methods: We recruited familes with at least one child (6-18 years) with ADHD via 15 NHS trusts in the UK, and collected data from all family members. We made careful adjustments to ensure a like-for-like comparison with two different control groups, and explored the impact of controlling for a positive parental/carer ADHD screen, employment, and relationship status. Results: We found significant negative impacts of childhood ADHD on parents'/carers' hours and quality of sleep, satisfaction with leisure time, and health-related quality of life (measured by the EuroQol-5D [EQ-5D]). We found a decrement in life satisfaction, mental well-being (as measured by the Short-Warwick Edinburgh Mental Well-Being Scale [S-WEMWBS]), and satisfaction with intimate relationships, but this was not always robust across the different control groups. We did not find any decrement in satisfaction with health, self-reported health status, or satisfaction with income. Conclusion: The study quantifies the impact on the health and well-being of parents living with a child with ADHD using a survey of families attending ADHD clinics in the United Kingdom.
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Affiliation(s)
- Tessa Peasgood
- School of Health and Related Research
(ScHARR), Sheffield, UK
| | - Anupam Bhardwaj
- Cambridgeshire and Peterborough NHS
Foundation Trust, Cambridge, UK
| | - John E. Brazier
- School of Health and Related Research
(ScHARR), Sheffield, UK
| | - Katie Biggs
- Clinical Trials Research Unit (CTRU),
ScHARR, Sheffield, UK,Katie Biggs, Clinical Trials Research Unit,
School of Health and Related Research, Regent Court, 30 Regent Street, Sheffield
S1 4DA, UK.
| | - David Coghill
- Department of Paediatrics &
Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - David Daley
- Division of Psychiatry & Applied
Psychology & Centre for ADHD and Neurodevelopmental Disorders Across the
Lifespan, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | | | | | - Val Harpin
- Sheffield Children’s NHS Foundation
Trust, UK
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Zamboni L, Marchetti P, Congiu A, Giordano R, Fusina F, Carli S, Centoni F, Verlato G, Lugoboni F. ASRS Questionnaire and Tobacco Use: Not Just a Cigarette. A Screening Study in an Italian Young Adult Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062920. [PMID: 33809225 PMCID: PMC8001583 DOI: 10.3390/ijerph18062920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Abstract
Young adults exhibit greater sensitivity than adults to nicotine reinforcement, and Attention Deficit Hyperactivity Disorder (ADHD) increases the risk for early-onset smoking. We investigated the correlation between ADHD Self-Report Scale (ASRS) scores and smoking, evaluated the prevalence of ADHD symptomatology (not diagnoses) in smokers and non-smokers and its comorbidity with benzodiazepine and gambling addictions. A total of 389 young adults from 14 schools in Northern Italy fill out a survey and the Adult ADHD Self-Report Scale (ASRS). A total of 15.2% of subjects tested positive at the ASRS, which correlated with smoking; moreover, smokers had twice the probability of testing positive at the ASRS. ADHD symptomatology, especially when comorbid with tobacco abuse, is an important condition to monitor because early nicotine exposure could be a gateway for other addictive behaviors.
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Affiliation(s)
- Lorenzo Zamboni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (R.G.); (S.C.); (F.C.); (F.L.)
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37134 Verona, Italy
- Correspondence: ; Tel.: +39-045-812-8295
| | - Pierpaolo Marchetti
- Diagnostics and Public Health-Unit of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy; (P.M.); (G.V.)
| | - Alessio Congiu
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (R.G.); (S.C.); (F.C.); (F.L.)
| | - Rosaria Giordano
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (R.G.); (S.C.); (F.C.); (F.L.)
| | - Francesca Fusina
- Department of General Psychology, University of Padova, 35131 Padova, Italy;
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Silvia Carli
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (R.G.); (S.C.); (F.C.); (F.L.)
| | - Francesco Centoni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (R.G.); (S.C.); (F.C.); (F.L.)
| | - Giuseppe Verlato
- Diagnostics and Public Health-Unit of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy; (P.M.); (G.V.)
| | - Fabio Lugoboni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (R.G.); (S.C.); (F.C.); (F.L.)
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Valsecchi P, Nibbio G, Rosa J, Tamussi E, Turrina C, Sacchetti E, Vita A. Adult ADHD: Prevalence and Clinical Correlates in a Sample of Italian Psychiatric Outpatients. J Atten Disord 2021; 25:530-539. [PMID: 30569796 DOI: 10.1177/1087054718819824] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: ADHD remains a largely underdiagnosed disorder in Europe and especially in Italy. Aims of the present study were to assess the prevalence of ADHD and its clinical and demographic correlates in a large sample of Italian outpatients. Method: 634 outpatients accessing psychiatric services were assessed with the Mini-International Neuropsychiatric Interview (MINI) Plus V. 5.0.0 interview and the Adult ADHD self-report Scale Symptoms Checklist (ASRS)-V 1.1 Short Form. Patients positive to the ASRS-V 1.1 were assessed with the Diagnostic Interview for ADHD in Adults (DIVA) 2.0. Results: Of the total patients' sample, 81 (12.8%) were positive on the ASRS-V 1.1. After performing the DIVA 2.0, 44 patients (6.9%) met the criteria for Adult ADHD. Significant clinical and demographic differences between ADHD positive and negative groups were found. Conclusion: The prevalence and correlates of ADHD comorbidity in our outpatient psychiatric population were comparable to those found in other high-income countries. Considering the prevalence of ADHD and its impact on functioning, implementing specific knowledge on this subject is needed.
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Affiliation(s)
- Paolo Valsecchi
- University of Brescia, Italy.,Spedali Civili Hospital, Brescia, Italy
| | - Gabriele Nibbio
- University of Brescia, Italy.,Spedali Civili Hospital, Brescia, Italy
| | - Jennifer Rosa
- University of Brescia, Italy.,Spedali Civili Hospital, Brescia, Italy
| | | | - Cesare Turrina
- University of Brescia, Italy.,Spedali Civili Hospital, Brescia, Italy
| | | | - Antonio Vita
- University of Brescia, Italy.,Spedali Civili Hospital, Brescia, Italy
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Yeom CW, Oh GH, Jung S, Moon JY, Son KL, Kim WH, Jung D, Baik M, Shim EJ, Moon H, Hahm BJ. Prevalence and comorbidities of adult adhd in male military conscripts in korea: Results of an epidemiological survey of mental health in korean military service. Psychiatry Res 2020; 293:113401. [PMID: 32861097 DOI: 10.1016/j.psychres.2020.113401] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/30/2023]
Abstract
We assessed the prevalence/comorbidities of attention deficit hyperactivity disorder (ADHD) in Korean servicemen using the Epidemiological Survey of Mental Health in Military Service in Korea. A total of 3,441 participants were assessed for adult ADHD, depression, social anxiety, generalized anxiety, somatization, insomnia, suicidality, cigarette dependence, and alcohol dependence using a self-report scale. Participants were also asked to rank their perception of their career prospects, health status, and quality of life on a Likert scale. Participants were classified as ADHD according to the WHO A-ADHD self-report scale. Firth multiple logistic regression and Cochran-Armitage trend tests were used to identify the risks of comorbidities and trends of self-perception between the two groups. ADHD (prevalence: 2.8%) was significantly associated with social anxiety (OR, 40.52; 95% CI 25.14-65.74), generalized anxiety (OR, 28.21; 95% CI 17.37-45.69), depression (OR, 16.36; 95% CI 10.50-25.52), somatization (OR, 14.47; 95% CI 9.21-22.76), suicidality (OR, 11.03; 95% CI 6.67-17.86), and insomnia (OR, 5.92; 95% CI 3.68-9.35). Servicemen with ADHD had negative perceptions (p <0.001) of their career prospects, health status, and quality of life compared to servicemen without ADHD. It is essential to revise the enlistment criteria for individuals with ADHD or to develop management programs for servicemen with ADHD.
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Affiliation(s)
- Chan-Woo Yeom
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sanghyup Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Yoon Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Neuropsychiatry, Dongguk University Ilsan Hospital, Gyeonggi-do, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Myungjae Baik
- Department of Mental Health Center, The Armed Forces Capital Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Hoseok Moon
- Department of Defense Science, Korea National Defense University, Chungcheongnam-do, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kroeger RA, Umberson D, Powers DA, Forrest DL. The Effects of Family Transitions on Depressive Symptoms: Differences among Young Adults with and without Childhood Symptoms of Attention-Deficit/ Hyperactivity Disorder. SOCIETY AND MENTAL HEALTH 2020; 10:237-256. [PMID: 34540341 PMCID: PMC8445594 DOI: 10.1177/2156869319859402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is tied to higher levels of depression, but the social factors that shape these associations are not well understood. This study considers whether family transitions affect depressive symptoms differently for young adults with and without childhood symptoms of ADHD at subthreshold or diagnostic levels. Between-within regression analysis of nationally representative longitudinal survey data shows that transitions into cohabitation and parenthood affect depressive symptoms differently for young adults with and without childhood symptoms of ADHD. Specifically, within-person effects indicate that transitions into cohabitation and parenthood are tied to decreases in depressive symptoms, but only for young adults without childhood symptoms of ADHD. In contrast, transitions into marriage are tied to decreases in depressive symptoms, and transitions out of coresidential unions are tied to increases in depressive symptoms, regardless of childhood symptoms of ADHD. The results suggest that some family transitions may work to widen ADHD disparities in depression, under-scoring the importance of family contexts for shaping mental health throughout the life course.
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Medication utilization among adult patients with attention-deficit/hyperactivity disorder after reimbursement criteria change. Int Clin Psychopharmacol 2020; 35:329-337. [PMID: 32897929 DOI: 10.1097/yic.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study analyzed the pattern of attention-deficit/hyperactivity disorder (ADHD) medication initiation in adult patients with ADHD after the reimbursement criteria change and identified the influencing factors associated with it using the claim data. We identified 243 adult patients with ADHD who had not been prescribed ADHD drugs before 1 September 2016. We conducted Kaplan-Meier survival analysis to calculate the time to initial prescription of ADHD medications, and Cox proportional hazard regression analysis to estimate the influencing factors. Approximately one-third of the patients (n = 76, 31.3%) were first prescribed ADHD medications after reimbursement approval, and 40 of them (16.5%) started treatment with osmotic release oral system methylphenidate. The patient's age group (30-39 years) and the status of diagnosis before the index date were associated with early initiation of pharmacotherapy. The odds of starting ADHD medications increased approximately 2.7-fold in the 30-39 age group and 0.2-fold in the case of patients who were diagnosed before the approval. Our findings show that both diagnosis and treatment of adult ADHD remains inadequate despite the change in reimbursement criteria. Improving awareness of adult ADHD among both the public and the professionals is essential to increase its chances of diagnosis and treatment.
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D'Agati E, Curatolo P, Mazzone L. Comorbidity between ADHD and anxiety disorders across the lifespan. Int J Psychiatry Clin Pract 2019; 23:238-244. [PMID: 31232613 DOI: 10.1080/13651501.2019.1628277] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives: Attention deficit/hyperactivity disorder (ADHD) and anxiety disorders are among the most common psychiatric disorders with a 25% comorbidity rate with each other. In this study, we overview the comorbidity between ADHD and anxiety disorders in a longitudinal perspective across the lifespan and we discuss possible therapeutic strategies.Methods: A literature search was performed using PubMed to identify clinical studies assessing comorbidity between ADHD and anxiety disorders from childhood to adulthood.Results: Anxiety disorders may substantially change the presentation, the prognosis, and the treatment of ADHD itself. In childhood, the presence of generalised anxiety disorder, could prevent the typical inhibitory dysfunction present in ADHD, in adolescence may increase the deficit of working memory, and in adulthood may enhance the presence of sleep problems. Individuals with comorbid ADHD and anxiety disorders would benefit from adjunctive psychosocial or adjunctive pharmacotherapy interventions to cognitive behavioural treatment.Conclusions: The management of individuals with comorbid ADHD and anxiety disorders could be challenging for clinicians, and assessing the developmental course is crucial in order to shed light on individualised treatment.KeypointsThe comorbidity between ADHD and anxiety disorders changes the clinical presentation, the prognosis and treatment of patients with ADHD across lifespan.ADHD and anxiety disorders shared common neurobiological dysfunctions but have also different neurobiological abnormalities suggesting that they are different diagnoses.These patients are less likely to benefit from cognitive behavioural treatment strategies alone and often need adjunctive pharmacological treatments.Studies that evaluated the response to MPH reported conflicting results. These patients could respond less well and get more unpleasant arousal side-effects, but these findings need to be confirmed.For his unique mechanism of action, low dose aripiprazole treatment in adolescents and adults with this comorbid condition could be an intriguing avenue of exploration.
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Affiliation(s)
- Elisa D'Agati
- Department of Systems Medicine, Unit of Child Neurology and Psychiatry, 'Tor Vergata' University of Rome, Rome, Italy
| | - Paolo Curatolo
- Department of Systems Medicine, Unit of Child Neurology and Psychiatry, 'Tor Vergata' University of Rome, Rome, Italy
| | - Luigi Mazzone
- Department of Systems Medicine, Unit of Child Neurology and Psychiatry, 'Tor Vergata' University of Rome, Rome, Italy
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Joseph A, Kosmas CE, Patel C, Doll H, Asherson P. Health-Related Quality of Life and Work Productivity of Adults With ADHD: A U.K. Web-Based Cross-Sectional Survey. J Atten Disord 2019; 23:1610-1623. [PMID: 30215265 PMCID: PMC6732822 DOI: 10.1177/1087054718799367] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The objective of this study was to assess health-related quality of life (HRQoL) in adult ADHD. METHOD U.K. residents aged 18 to 55 years with ADHD and no major mental health comorbidities completed an online survey of disorder history, the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L), and the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH). ADHD Rating Scale-IV (ADHD-RS-IV) score was assessed by telephone. RESULTS In total, 233 participants completed the study (mean age 32.6 years; 65.2% women). Mean ( SD) ADHD-RS-IV total score, EQ-5D utility, and visual analog scale (VAS) scores were 43.5 (7.88), 0.74 (.21), and 69.8 (17.76), respectively. Mean ( SD) WPAI:GH scores indicated that health problems caused 45.7% (29.9) overall work impairment and 45.8% (28.9) impairment in regular daily activities. Greater work and activity impairment were both significantly independently associated with lower utility after adjusting for age, gender, and somatic comorbidities. CONCLUSION Adult ADHD impairs HRQoL, work productivity, and regular daily activities.
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Affiliation(s)
| | | | | | | | - Philip Asherson
- King’s College London, Greater London,
UK,Philip Asherson, Professor, Institute of
Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF,
UK.
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12
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Regnart J, Truter I, Zingela Z, Meyer A. A pilot study: Use of the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale in a South African patient population. S Afr J Psychiatr 2019; 25:1326. [PMID: 31205781 PMCID: PMC6556992 DOI: 10.4102/sajpsychiatry.v25i0.1326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/13/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder which typically presents in childhood. This diagnosis may often be overlooked in adulthood, particularly in psychiatric populations. The Adult ADHD Self-Report Scale (ASRS) is an internationally used and reliable screener; however, studies investigating its use in African populations are limited. AIM To investigate the application of the ASRS in a South African setting. SETTING A patient population in Port Elizabeth, South Africa, was identified as representing a developing or low- and middle-income country population. METHODS A convenience sample of acutely presenting psychiatric participants admitted for stabilisation was used. Fieldworkers administered the ASRS; collected information relating to demographics, differential diagnoses, substance use disorder (SUD) presence and substance consumption; and prescribed medication relating to current or historical treatment of ADHD. RESULTS The study sample included 30 participants, with black people representing the majority of participants. Adult ADHD Self-Report Scale completion revealed the rate of ADHD within the study population to be 43.3%, a contrast to the initially presumed prevalence of 6.7% which was based on reported methylphenidate therapy. A difference in SUD prevalence was identified between subjects screening positively and negatively for ADHD with a greater tendency towards SUDs seen for ASRS-positive individuals. Significant differences were identified in relation to cannabis- and polysubstance use for ASRS-positive individuals. CONCLUSION Despite limitations related to the sample used and challenges in ASRS administration, investigation findings support recommendations for ADHD screening inclusion in acute inpatient settings in South Africa and ASRS translation into indigenous African languages.
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Affiliation(s)
- Judith Regnart
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa
| | - Ilse Truter
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa
| | - Zukiswa Zingela
- Department of Psychiatry and Behavioural Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Anneke Meyer
- Department of Psychology, Nelson Mandela University, Port Elizabeth, South Africa
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Oerbeck B, Overgaard K, Pripp AH, Aase H, Reichborn-Kjennerud T, Zeiner P. Adult ADHD Symptoms and Satisfaction With Life: Does Age and Sex Matter? J Atten Disord 2019; 23:3-11. [PMID: 26582800 PMCID: PMC6291909 DOI: 10.1177/1087054715612257] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate adult ADHD symptoms and satisfaction with life, with a focus on age and sex differences. METHOD This study is based on parents in the Norwegian Mother and Child Cohort Study (MoBa). The Adult Self-Report Scale (ASRS-6) and Satisfaction With Life Scale (SWLS) scores were analyzed from 33,210 men and 41,983 women from young to middle adulthood. RESULTS Mean ASRS total score was significantly higher in men, where 5.1% scored above cutoff, compared with 2.9% in women. Factor loadings supported the two ASRS subscales: Inattention (Inatt) and Hyperactivity-Impulsivity (HyImp) in both sexes. A significant decline with age was found on HyImp, whereas Inatt scores were reasonably stable in men and u-curved in women. High ASRS scores were associated with lower SWLS, but poor satisfaction with life was found only in high-scoring women. CONCLUSION Our findings suggest caution to age and sex when using the ASRS-6.
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Affiliation(s)
- Beate Oerbeck
- Oslo University Hospital, Norway,Beate Oerbeck, Division of Mental Health and
Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway.
| | | | | | - Heidi Aase
- Norwegian Institute of Public Health,
Oslo, Norway
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14
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Shi M, Liu L, Sun X, Wang L. Associations between symptoms of attention-deficit/ hyperactivity disorder and life satisfaction in medical students: the mediating effect of resilience. BMC MEDICAL EDUCATION 2018; 18:164. [PMID: 30005708 PMCID: PMC6043958 DOI: 10.1186/s12909-018-1261-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 06/19/2018] [Indexed: 05/11/2023]
Abstract
BACKGROUND Research on symptoms of attention-deficit/hyperactivity disorder (ADHD) in medical students is rather scant. Studying the disorder in this population, especially its associations with positive psychological constructs can further the understanding of mental health in future physicians. The objectives of the present study were to investigate the prevalence of ADHD symptoms in medical students, to examine the relationships between ADHD symptoms and life satisfaction, and to explore the mediating role of resilience on the associations. METHODS This cross-sectional study was carried out at one medical university in China, in June 2016. Self-reported questionnaires consisting of Adult ADHD Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Conner-Davidson Resilience Scale (CD-RISC), Satisfaction With Life Scale (SWLS), and socio-demographic characteristics, were distributed to the students. Hierarchical linear regression analyses were used to examine the effects of ADHD symptoms on life satisfaction, and asymptotic and resampling strategies were used to explore the mediating role of resilience. RESULTS A total number of 521 medical students became final subjects. Based on the cutoffs of the scales, 1.54% of the medical students were highly likely to have ADHD, and 6.91% of the students were likely to have ADHD. Only inattention was negatively correlated with life satisfaction in the students. Resilience functioned as a mediator in the relationship between inattention and life satisfaction. CONCLUSIONS The prevalence of ADHD symptoms among Chinese medical students could be relatively high. Inattention is significantly related to life satisfaction among the students. Early identification of medical students with ADHD symptoms should be warranted. Resilience intervention programs might be undertaken to enhance life satisfaction in medical students, especially for those with inattention symptoms.
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Affiliation(s)
- Meng Shi
- English Department, School of Fundamental Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Xiao Sun
- Section of Sports, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
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15
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Tsai ML, Kozłowska A, Li YS, Shen WL, Huang ACW. Social factors affect motor and anxiety behaviors in the animal model of attention-deficit hyperactivity disorders: A housing-style factor. Psychiatry Res 2017; 254:290-300. [PMID: 28501734 DOI: 10.1016/j.psychres.2017.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/04/2017] [Accepted: 05/05/2017] [Indexed: 10/19/2022]
Abstract
The present study examines whether housing style (e.g., single housing, same-strain-grouped housing, and different-strain-grouped housing) and rat strain (e.g., spontaneous hypertension rats [SHR] and Wistar-Kyoto rats [WKY]) mediate motor function and anxiety behavior in the open field task. From week 4 through week 10 following birth, the rats were measured 30min for locomotor activity and anxiety once per week in the open field task. The SHR rats exhibited hyperactivity in total distance traveled and movement time to form the animal model of ADHD. The SHR rats spent more time inside the square and crossed the inside-outside line more often than the WKY rats, indicating the SHR rats exhibited less anxiety behavior. The different-strain-grouped housing style (but neither the same-strain-grouped housing style nor the single housing style) decreased total distance traveled and facilitated anxiety behavior. The motor function was negatively correlated with anxiety behavior for SHR rats but not for WKY rats. Housing styles had a negative correlation between motor function and anxiety behavior. The present findings provide some insights regarding how social factors (such as housing style) affect motor function and anxiety behavior related to ADHD in a clinical setting.
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Affiliation(s)
- Meng-Li Tsai
- Department of Biomechatronic Engineering, National Ilan University, Yilan, Taiwan
| | - Anna Kozłowska
- Department of Human Physiology, Faculty of Medical Sciences; University of Warmia and Mazury, Olsztyn, Poland
| | - Yu-Sheng Li
- Department of Biomechatronic Engineering, National Ilan University, Yilan, Taiwan
| | - Wen-Ling Shen
- Department of Biomechatronic Engineering, National Ilan University, Yilan, Taiwan
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16
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Fan LY, Chou TL, Gau SSF. Neural correlates of atomoxetine improving inhibitory control and visual processing in Drug-naïve adults with attention-deficit/hyperactivity disorder. Hum Brain Mapp 2017; 38:4850-4864. [PMID: 28657141 DOI: 10.1002/hbm.23683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/22/2017] [Accepted: 05/29/2017] [Indexed: 11/09/2022] Open
Abstract
Atomoxetine improves inhibitory control and visual processing in healthy volunteers and adults with attention-deficit/hyperactivity disorder (ADHD). However, little is known about the neural correlates of these two functions after chronic treatment with atomoxetine. This study aimed to use the counting Stroop task with functional magnetic resonance imaging (fMRI) and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to investigate the changes related to inhibitory control and visual processing in adults with ADHD. This study is an 8-week, placebo-controlled, double-blind, randomized clinical trial of atomoxetine in 24 drug-naïve adults with ADHD. We investigated the changes of treatment with atomoxetine compared to placebo-treated counterparts using the counting Stroop fMRI and two CANTAB tests: rapid visual information processing (RVP) for inhibitory control and delayed matching to sample (DMS) for visual processing. Atomoxetine decreased activations in the right inferior frontal gyrus and anterior cingulate cortex, which were correlated with the improvement in inhibitory control assessed by the RVP. Also, atomoxetine increased activation in the left precuneus, which was correlated with the improvement in the mean latency of correct responses assessed by the DMS. Moreover, anterior cingulate activation in the pre-treatment was able to predict the improvements of clinical symptoms. Treatment with atomoxetine may improve inhibitory control to suppress interference and may enhance the visual processing to process numbers. In addition, the anterior cingulate cortex might play an important role as a biological marker for the treatment effectiveness of atomoxetine. Hum Brain Mapp 38:4850-4864, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Li-Ying Fan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.,Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Tai-Li Chou
- Department of Psychology, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.,Department of Psychology, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
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Nicastro R, Desseilles M, Prada P, Weibel S, Perroud N, Gex-Fabry M. Subjective Distress Associated with Adult ADHD: evaluation of a new self-report. ACTA ACUST UNITED AC 2017; 10:77-86. [PMID: 28601956 DOI: 10.1007/s12402-017-0234-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 06/02/2017] [Indexed: 11/28/2022]
Abstract
The current study aims at documenting the psychometric properties of the Subjective Distress Associated with Adult ADHD-Self-Report (SDAAA-SR), a newly developed instrument for the assessment of psychological suffering in ADHD adults. The SDAAA-SR was administered to 247 students and 142 ADHD adults. Factor structure, internal consistency, test-retest reliability, convergent validity and discriminant validity were assessed. Sensitivity to change was examined in a subsample of 25 ADHD patients who participated in a 1-year therapy. The initial pool of 62 items was reduced to 33 items distributed in a three-component structure. Internal consistency was excellent for the "distress due to inattention/disorganization" subscale and good for the "distress due to hyperactivity/impulsivity" and "distress due to self-esteem deficit" subscales. Test-retest reliability in a subsample of 98 students was substantial for all three subscales. ADHD patients scored significantly higher than students on distress due to "inattention/disorganization" and "hyperactivity/impulsivity," but no difference was observed for "self-esteem deficit." The components "inattention/disorganization" and "hyperactivity/impulsivity" displayed moderate to large correlations with the corresponding dimensions of the Adult Self-Report Scale for ADHD (ASRS-V1.1). Distress due to "inattention/disorganization" and "self-esteem deficit" was significantly associated with lower satisfaction with social behaviors (QFS, social functioning questionnaire) and quality of life (WHOQOL-BREF). Distress due to "inattention/disorganization" and "self-esteem deficit" significantly decreased after a 1-year therapy. The SDAAA-SR represents a reliable and valid measure of adult ADHD-associated distress, an important but often undocumented parameter in the clinical setting. Its use as an outcome variable in psychological interventions deserves further investigation.
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Affiliation(s)
- Rosetta Nicastro
- TRE Program, Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 20 bis rue de Lausanne, 1201, Geneva, Switzerland.
| | | | - Paco Prada
- TRE Program, Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 20 bis rue de Lausanne, 1201, Geneva, Switzerland
| | - Sébastien Weibel
- TRE Program, Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 20 bis rue de Lausanne, 1201, Geneva, Switzerland
| | - Nader Perroud
- TRE Program, Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 20 bis rue de Lausanne, 1201, Geneva, Switzerland
| | - Marianne Gex-Fabry
- TRE Program, Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, 20 bis rue de Lausanne, 1201, Geneva, Switzerland
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Abstract
OBJECTIVE To investigate clinical and functional outcomes in military men with ADHD. METHOD Clinical outcomes were measured via the Zung Self-Rating Depression Scale (Zung SDS) and the Zung Self-Rating Anxiety Scale (Zung SAS). Functional outcomes were measured using the "Car, Relax, Alone, Forget, Friends, Trouble" (CRAFFT) questionnaire and questionnaires about relationships, conduct problems, substance use, and sleep. RESULTS Men with ADHD ( n = 52) reported more depressive (34 [67.3%] vs. 19 [38%], p = .008) and anxiety symptoms (31 [61.5%] vs. 14 [28%], p = .009) compared with those without ( n = 50). They had relationships lasting less than 1 year (24 [80%] vs. 9 [37.5%], p = .006), were more likely to smoke (17 [32.7%] vs. 5 [10%], p = .005), were most likely to use illicit substances (6 [11.5%] vs. 0 [0%], p < .001), had more conduct problems at school (27 [51.9%] vs. 5 [10%], p < .001), and had longer sleep latency (53.96 min ± 46.48 vs. 25.78 min ± 25.93, p = .006). CONCLUSION Military men with ADHD are significantly associated with worse clinical and functional outcomes. They should be screened and monitored for depression, anxiety, sleep disorders, and substance use.
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Affiliation(s)
| | - Rui Kwan
- 1 Institute of Mental Health, Singapore
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19
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Ni HC, Lin YJ, Gau SSF, Huang HC, Yang LK. An Open-Label, Randomized Trial of Methylphenidate and Atomoxetine Treatment in Adults With ADHD. J Atten Disord 2017; 21:27-39. [PMID: 23475825 DOI: 10.1177/1087054713476549] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To directly compare the efficacy of methylphenidate and atomoxetine in improving symptoms, social functions, and quality of life among adults with ADHD. METHOD This was an 8-to-10-week, open-label, head-to-head, randomized clinical trial with two treatment arms: immediate-release methylphenidate (IR-methylphenidate; n = 31) and atomoxetine once daily ( n = 32). The outcome measures included ADHD symptom severity, quality of life, and functional impairments. RESULTS We found a significant reduction in overall ADHD symptoms and improvement in social functions and quality of life for both groups at Weeks 4 to 5 and Weeks 8 to 10. There was no significant difference in the slope of improvements over time except that atomoxetine was superior to IR-methylphenidate in reducing hyperactive/impulsive symptoms at Weeks 4 to 5. There was no significant group difference in the rates of adverse effects. CONCLUSION Both IR-methylphenidate and atomoxetine are well tolerated and efficacious in ethnic Chinese adults with ADHD.
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Affiliation(s)
- Hsing-Chang Ni
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
- 3 Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Yu-Ju Lin
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
- 4 Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Chun Huang
- 5 National Cheng Kung University Hospital, Tainan, Taiwan
| | - Li-Kuang Yang
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
- 6 Beitou Armed Forces Hospital, Taipei, Taiwan
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20
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Cheng SH, Lee CT, Chi MH, Sun ZJ, Chen PS, Chang YF, Yeh CB, Yang YK, Yang YC. Factors Related to Self-Reported Attention Deficit Among Incoming University Students. J Atten Disord 2016; 20:754-62. [PMID: 25270565 DOI: 10.1177/1087054714550335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study was designed to explore physical, social/behavioral, and mental health factors among incoming university students with elevated self-reported ADHD symptoms. METHOD A total of 5,240 incoming university students were recruited. The test battery included the ADHD Self-Report Scale, the Measurement of Support Functions, the Chinese Internet Addiction Scale-Revision, Quality of Life assessment, the Brief Symptoms Rating Scale, and the 10-item Social Desirability Scale. RESULTS ADHD symptoms were elevated in 8.6% of the sample. Only individuals with a lower social desirability score, however, were recruited for further analysis. Significant influential factors for higher self-reported levels for ADHD symptoms included greater suicidal ideation and emotional disturbance, as well as a higher Internet addiction tendency, lower levels of social support, and a greater amount of exercise. CONCLUSION Given the elevated prevalence of self-reported ADHD symptoms among this sample of university students, screening for these kinds of problems to detect early challenges before students fail in college as well as identify youth with undiagnosed ADHD should be considered.
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Affiliation(s)
- Shu Hui Cheng
- Office of Student Affairs, National Cheng Kung University, Tainan, Taiwan Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Addiction Research Center, National Cheng Kung University, Tainan, Taiwan Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Mediating effect of anxiety and depression on the relationship between Attention-deficit/hyperactivity disorder symptoms and smoking/drinking. Sci Rep 2016; 6:21609. [PMID: 26923609 PMCID: PMC4770422 DOI: 10.1038/srep21609] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 01/27/2016] [Indexed: 01/24/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has been often found to be comorbid with other disorders, including anxiety, depression, and unhealthy behaviors such as drinking alcohol and smoking. These factors were often discussed separately, and the mediating effects of mental health on substance use are unknown. To study the mediating effects of anxiety and depression on the relationship between ADHD and drinking/smoking behaviors, we conducted a cross-sectional study of 1870 college students from Shanghai, China. The Adult ADHD Self-Report Scale (ASRS-v1.1) and Wender Utah Rating Scale (WURS) were used to identify the current and past ADHD. Structural Equation Modeling was carried out to clarify the mediating effect of anxiety and depression on the relationship between core ADHD symptoms and smoking/drinking behaviors. We found that inattention as one of the core symptoms of ADHD was associated with an increased risk of depression as a direct effect, as well as slightly increased risk of smoking/drinking behaviors by an indirect effect of depression. Hyperactivity-impulsivity, as another core symptom of ADHD had a robust impact on smoking and drinking behaviors, while being mediated by anxiety and depression. In conclusion, anxiety and depression was associated with further increased risk behaviors of smoking/drinking alcohol among those students with ADHD.
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Lin YJ, Lo KW, Yang LK, Gau SSF. Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:48-60. [PMID: 26318976 DOI: 10.1016/j.ridd.2015.07.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/21/2015] [Accepted: 07/25/2015] [Indexed: 06/04/2023]
Abstract
The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n=147) and late-onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, New Taipei City 220, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
| | - Kuan-Wu Lo
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; School of Medicine, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road Section 1, Taipei 100, Taiwan.
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, No. 60, Xin-ming Road, Beitou District, Taipei 100, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
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Huang F, Qian Q, Wang Y. Cognitive behavioral therapy for adults with attention-deficit hyperactivity disorder: study protocol for a randomized controlled trial. Trials 2015; 16:161. [PMID: 25873090 PMCID: PMC4399752 DOI: 10.1186/s13063-015-0686-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/26/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is a mental disorder beginning in childhood, and about half of patients have symptoms lasting into adulthood. Adult ADHD causes various impairments of emotional, self-esteem, and executive function and life quality aspects. Furthermore, adverse outcomes include academic and occupational failures, traffic accidents and substance abuse, which would be a family and social burden. A combination of medication and psychotherapy is recommended as the treatment for adult ADHD, and cognitive behavioral therapy (CBT) has been validated mostly with evidence-based researches. However, there has been a lack of randomized controlled trials of CBT for patients in China. Moreover, booster sessions of CBT for other disorders have proven effective in reducing recurrence and improving long-term outcomes, which has not been investigated for adult ADHD. This study will testify to the effect of CBT and explore the efficacy of subsequent booster sessions on adult ADHD. METHODS/DESIGN It is a three-armed randomized controlled trial to evaluate the efficacy of 12 weeks of CBT based on the published and validated manual and its booster sessions. The 12 weeks of CBT will be conducted weekly and will end at the 12th week, and then the booster sessions will be conducted monthly and end at the 24th week. There are three randomized groups, including a CBT with booster sessions group, a CBT group and a waiting group. Participants are outpatients of the Peking University Sixth Hospital who are diagnosed as having adult ADHD. The Primary efficacy endpoints are the scores of ADHD core symptoms at 12 and 24 weeks. Secondary endpoints include emotion, executive function, self-esteem, life quality and functional magnetic resonance imaging (fMRI) data at different time points, and the change within every group will also be analyzed. DISCUSSION This is the first study to explore the efficacy of booster sessions of CBT in adult ADHD as far as we know. The results might increase proof of efficacy of CBT for adult ADHD in China, and the results showing efficacy of the booster sessions would also benefit our clinical practice. TRIAL REGISTRATION Current Controlled Trials: NCT02062411, date of registration: 12 February 2014.
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Affiliation(s)
- Fang Huang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51, Hua Yuan Bei Lu, Haidian District, Beijing, 100191, China. .,Key Laboratory of Mental Health, Ministry of Health, Peking University, No. 51, Hua Yuan Bei Lu, Haidian District, Beijing, 100191, China.
| | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51, Hua Yuan Bei Lu, Haidian District, Beijing, 100191, China. .,Key Laboratory of Mental Health, Ministry of Health, Peking University, No. 51, Hua Yuan Bei Lu, Haidian District, Beijing, 100191, China.
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51, Hua Yuan Bei Lu, Haidian District, Beijing, 100191, China. .,Key Laboratory of Mental Health, Ministry of Health, Peking University, No. 51, Hua Yuan Bei Lu, Haidian District, Beijing, 100191, China.
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The subjective well-being of individuals diagnosed with comorbid intellectual disability and attention deficit hyperactivity disorders. Qual Life Res 2015; 24:1875-86. [PMID: 25676860 DOI: 10.1007/s11136-015-0936-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The present study's aim was to empirically explore subjective well-being (SWB) and its correlates among adults diagnosed with comorbid intellectual disability (ID) and attention deficit hyperactivity disorder (ADHD). This exploration was guided by the Theory of SWB Homeostasis as a conceptual framework for examining determinants and processes underlying the SWB of this understudied population. METHOD A total of 246 adults receiving residential support completed questionnaires measuring their SWB, ADHD symptomatology, functional limitations, and individual internal (self-determination) and external (financial resources, and social support) resources. RESULTS The participants' SWB was found to be within the normative range. ADHD symptomatology directly predicted reductions in SWB; however, according to the theory, this effect was fully mediated by the individual's internal and external resources. CONCLUSIONS The main findings support the applicability of the SWB Homeostasis theory for understanding the SWB of individuals with comorbid ID and ADHD. The study findings shed light on the psychosocial determinants of SWB and highlight the importance of psychosocial resources as buffers of the effect of health and environmental conditions.
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Co-occurrence of attention-deficit hyperactivity disorder symptoms with other psychopathology in young adults: parenting style as a moderator. Compr Psychiatry 2015; 57:85-96. [PMID: 25465651 DOI: 10.1016/j.comppsych.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/30/2014] [Accepted: 11/03/2014] [Indexed: 11/23/2022] Open
Abstract
The extent to which parenting styles can influence secondary psychiatric symptoms among young adults with ADHD symptoms is unknown. This issue was investigated in a sample of 2284 incoming college students (male, 50.6%), who completed standardized questionnaires about adult ADHD symptoms, other DSM-IV symptoms, and their parents' parenting styles before their ages of 16. Among them, 2.8% and 22.8% were classified as having ADHD symptoms and sub-threshold ADHD symptoms, respectively. Logistic regression was used to compare the comorbid rates of psychiatric symptoms among the ADHD, sub-threshold ADHD and non-ADHD groups while multiple linear regressions were used to examine the moderating role of gender and parenting styles over the associations between ADHD and other psychiatric symptoms. Both ADHD groups were significantly more likely than other incoming students to have other DSM-IV symptoms. Parental care was negatively associated and parental overprotection/control positively associated with these psychiatric symptoms. Furthermore, significant interactions were found of parenting style with both threshold and sub-threshold ADHD in predicting wide-ranging comorbid symptoms. Specifically, the associations of ADHD with some externalizing symptoms were inversely related to level of paternal care, while associations of ADHD and sub-threshold ADHD with wide-ranging comorbid symptoms were positively related to level of maternal and paternal overprotection/control. These results suggest that parenting styles may modify the effects of ADHD on the risk of a wide range of temporally secondary DSM-IV symptoms among incoming college students, although other causal dynamics might be at work that need to be investigated in longitudinal studies.
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Mautner VF, Granström S, Leark RA. Impact of ADHD in adults with neurofibromatosis type 1: associated psychological and social problems. J Atten Disord 2015; 19:35-43. [PMID: 22786884 DOI: 10.1177/1087054712450749] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze the psychological phenotype of ADHD, and the effect of ADHD on life satisfaction and personality in adults with neurofibromatosis type 1 (NF1). METHOD Adults with NF1 without (n = 26) and with ADHD (n = 22), and adults with ADHD only (n = 27) completed questionnaires on personality traits and life satisfaction. Differences between groups were analyzed. RESULTS Participants with NF1 and ADHD present an emotionally instable psychological phenotype similar to adults with ADHD only, which differed significantly from that in adults with NF1 only. Participants with NF1 and ADHD had significantly lower overall life satisfaction than NF1 participants without such symptoms, affecting general health, self-satisfaction, sexuality, and family. CONCLUSION The authors' findings show that ADHD symptoms can persist through adulthood. These NF1 patients display problems similar to those of adults with ADHD only. This finding is highly relevant to understand the behavioral and psychological phenotype in adults with NF1 and to offer psychological and/or medical treatment.
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Chen VCH, Yeh CJ, Lee TC, Chou JY, Shao WC, Shih DH, Chen CI, Lee PC. Symptoms of attention deficit hyperactivity disorder and quality of life of mothers of school-aged children: The roles of child, mother, and family variables. Kaohsiung J Med Sci 2014; 30:631-8. [DOI: 10.1016/j.kjms.2014.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 07/31/2014] [Accepted: 05/07/2014] [Indexed: 11/27/2022] Open
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Seo JY, Lee CS, Park CS, Kim BJ, Cha BS, Lee SJ, Ahn IY. Mediating Effect of Depressive Symptoms on the Relationship between Adult Attention Deficit Hyperactivity Disorder and Quality of Life. Psychiatry Investig 2014; 11:131-6. [PMID: 24843367 PMCID: PMC4023086 DOI: 10.4306/pi.2014.11.2.131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 05/22/2013] [Accepted: 05/28/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate whether depressive symptoms affect the relationship between adult attention deficit hyperactivity disorder (ADHD) and the quality of life (QOL) in Korean soldiers. METHODS We evaluated past and present symptoms of adult ADHD (the Korean Adult Attention-Deficit/Hyperactivity Disorder Scale and the Wender Utah Rating Scale), depression (the Center for Epidemiological Studies Depression Scale) and QOL (the Korean version of the SmithKline Beecham 'Quality of Life' scale) in 131 soldiers during mental health screenings performed by a local mental health center. A structured equation model using AMOS 19.0 was used to evaluate the mediating effect of depression. RESULTS In our first model (without depressive symptoms), adult ADHD significantly affected QOL (standardized regression weight=-0.51, p<0.01). After depressive symptoms were added to this model, the direct effect of adult ADHD on QOL was not significant (standardized regression weight=0.10, p=0.43). Regarding the indirect effect, adult ADHD significantly affected depression (standardized regression weight=0.78, p<0.01), and depression also affected QOL (standardized regression weight=-0.79, p<0.01). CONCLUSION Through structural equation modeling, the complete mediation model for the influence of depressive symptoms on ADHD and QOL was confirmed. These findings indicated that it might be important to consider comorbidities, such as depression, when adult ADHD is being evaluated.
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Affiliation(s)
- Ji-Yeong Seo
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Chul-Soo Park
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Bo-Seok Cha
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - In-Young Ahn
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
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Takahashi M, Goto T, Takita Y, Chung SK, Wang Y, Gau SSF. Open-label, dose-titration tolerability study of atomoxetine hydrochloride in Korean, Chinese, and Taiwanese adults with attention-deficit/hyperactivity disorder. Asia Pac Psychiatry 2014; 6:62-70. [PMID: 23857916 DOI: 10.1111/j.1758-5872.2012.00204.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 04/24/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The primary objective of this study was to assess the overall safety and tolerability of atomoxetine in Korean, Chinese, and Taiwanese adults with attention-deficit/hyperactivity disorder (ADHD). METHODS A total of 44 patients aged ≥18 years who met the Conners' Adult ADHD Diagnostic Interview for DSM-IV diagnostic criteria for ADHD were enrolled from China, Korea, and Taiwan. In this open-label, dose-escalation study, patients received atomoxetine orally once daily over a period of eight weeks, starting at 40 mg/day (one week) up to a maximum dosage of 120 mg/day. Tolerability was evaluated by rate of discontinuation due to adverse events. Safety was assessed by recording all adverse events, laboratory tests, vital signs, and electrocardiograms. ADHD symptoms were evaluated by the Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV) for efficacy assessment. RESULTS Thirty-four patients (77.3%) completed the study. Atomoxetine was well tolerated with a discontinuation rate of 2.3% (1/44) due to adverse events. The most commonly reported adverse events were nausea, dizziness, and somnolence. The mean change from baseline to endpoint in CAARS-Inv:SV total ADHD symptom score was -12.5 (P < 0.001). A significant reduction in the CAARS-Inv:SV subscales (inattentive, hyperactive/impulsive, and ADHD index score, P < 0.001) was observed. DISCUSSION This is the first atomoxetine clinical trial in adult patients with ADHD in China, Korea, and Taiwan. Atomoxetine was well tolerated in doses of up to 120 mg/day with no unknown safety concerns.
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Affiliation(s)
- Michihiro Takahashi
- Lilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, Japan; Terauchi-Takahashi Psychiatric Clinic, Ashiya, Japan
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Haavik J, Halmøy A, Lundervold AJ, Fasmer OB. Clinical assessment and diagnosis of adults with attention-deficit/hyperactivity disorder. Expert Rev Neurother 2014; 10:1569-80. [DOI: 10.1586/ern.10.149] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Oğuztürk Ö, Ekici M, Çimen D, Ekici A, Senturk E. Attention deficit/hyperactivity disorder in adults with sleep apnea. J Clin Psychol Med Settings 2013. [PMID: 23179074 PMCID: PMC3676641 DOI: 10.1007/s10880-012-9331-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and 32 controls. Measures included each patient completed a questionnaire regarding sleep, Adult ADHD scale. Clinical information, body mass index, 36-item Short Form Health Survey (SF-36), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and polysomnography.The subjects with Apnea-Hypopnea Index (AHI) ≥ 5 events/h were defined as patients with OSA. The control group was accepted as individuals with AHI > 0 events/h. The prevalence of adult ADHD was not different between the patients with OSA and the control group [(7.4 % (6/75) vs. 6.3 % (2/30), p = 0.8, respectively]. OSA patients with ADHD, as compared with those without, had higher anxiety scores and poorer physical component scores of quality of life and higher ESS scores. ADHD scores in patients with OSA were associated with anxiety and depression scores and SF36 physical and mental component scores in bivariate analyses. Thus, in our sample ADHD was not a frequent illness in adult patients with OSA. However, in patients with OSA and ADHD higher levels of anxiety and daytime sleepiness and poorer quality of life was found.
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Affiliation(s)
- Ömer Oğuztürk
- Department of Psychiatry Diseases, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
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Yang HN, Tai YM, Yang LK, Gau SSF. Prediction of childhood ADHD symptoms to quality of life in young adults: adult ADHD and anxiety/depression as mediators. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3168-3181. [PMID: 23886759 DOI: 10.1016/j.ridd.2013.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 06/10/2013] [Accepted: 06/13/2013] [Indexed: 06/02/2023]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms may persist, co-occur with anxiety and depression (ANX/DEP), and influence quality of life (QoL) in later life. However, the information about whether these persistent ADHD and ANX/DEP mediate the influence of childhood ADHD on adverse QoL in adulthood is lacking. This study aimed to determine whether adult ADHD symptoms and/or ANX/DEP mediated the association between childhood ADHD and QoL. We assessed 1382 young men aged 19-30 years in Taiwan using self-administered questionnaires for retrospective recall of ADHD symptoms at ages 6-12, and assessment of current ADHD and ANX/DEP symptoms, and QoL. We conducted mediation analyses and compared the values of mediation ratio (PM) by adding mediators (adult ADHD and ANX/DEP), individually and simultaneously into a regression model with childhood ADHD as an independent variable and QoL as a dependent variable. Our results showed that both adult ADHD and ANX/DEP symptoms significantly mediated the association between childhood ADHD and QoL (PM=0.71 for ANX/DEP, PM=0.78 for adult ADHD symptoms, and PM=0.91 for both). The significance of negative correlations between childhood ADHD and four domains of adult QoL disappeared after adding these two mediators in the model. Our findings suggested that the strong relationship between childhood ADHD and adult life quality can be explained by the presence of persistent ADHD symptoms and co-occurring ANX/DEP. These two mediators are recommended to be included in the assessment and intervention for ADHD to offset the potential adverse life quality outcome in ADHD.
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Affiliation(s)
- Hui-Nien Yang
- Department of Psychiatry, BeitouBranch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Thaulow CM, Jozefiak T. A comparison between child psychiatric outpatients with AD/HD and anxiety/depression. Nord J Psychiatry 2012; 66:396-402. [PMID: 22452272 DOI: 10.3109/08039488.2012.660546] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies have shown that children with attention-deficit/hyperactivity disorder (AD/HD) have a lower quality of life (QoL), and lower school and psychosocial functioning than healthy children. AIMS This is the first study to compare these domains and child competence between children with AD/HD- and anxiety/depression-related problems and healthy children using data from multiple informants. METHOD Children were matched by age and sex, resulting in two clinical groups consisting of 62 children with AD/HD-related problems, 49 children with anxiety/depression-related problems and a reference group of 65 healthy schoolchildren. The Inventory of Life Quality for Children and Adolescents (parent and child report), the Child Behaviour Checklist (parent report), the Teacher's Report Form and the Children's Global Assessment Scale (therapist evaluation) were used. Differences between group means were analysed by t-tests and analysis of variance. RESULTS The AD/HD group reported a significantly higher QoL than did the Anxiety/Depression group. However, no significant differences in QoL were found between the two clinical groups by parent proxy report. The AD/HD group reported a significantly higher QoL than shown by parent proxy evaluation. According to parent and teacher reports, both clinical groups showed significantly lower school functioning than the group of healthy children. Further, the AD/HD group showed significantly lower school functioning and total competence than the Anxiety/Depression group. CONCLUSION To obtain a full clinical picture of subgroups of patients with AD/HD- and anxiety/depression-related problems referred to child mental health outpatient treatment, clinicians should always use multiple informants to evaluate symptoms/problems, functioning and QoL.
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Epstein JN, Weiss MD. Assessing treatment outcomes in attention-deficit/hyperactivity disorder: a narrative review. Prim Care Companion CNS Disord 2012; 14:PCC.11r01336. [PMID: 23585986 PMCID: PMC3622525 DOI: 10.4088/pcc.11r01336] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/11/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span. DATA SOURCES Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]). STUDY SELECTION Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied. DATA EXTRACTION Narrative review. RESULTS The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples. CONCLUSIONS Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD.
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Affiliation(s)
- Jeffery N Epstein
- The Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Epstein); and The Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada (Dr Weiss)
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Yeh CB, Huang WS, Lo MC, Chang CJ, Ma KH, Shyu JF. The rCBF brain mapping in adolescent ADHD comorbid developmental coordination disorder and its changes after MPH challenging. Eur J Paediatr Neurol 2012; 16:613-8. [PMID: 22417719 DOI: 10.1016/j.ejpn.2012.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 02/06/2012] [Accepted: 02/17/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Comorbid developmental coordination disorder (DCD) in the patients with attention-deficit hyperactivity disorder (ADHD) often complicated the treatment strategy. Methylphenidate (MPH) improves the coordination problem in patients with ADHD. AIM The study intended to investigate the pathophysiology and the mechanisms of MPH in comorbid DCD of the adolescents with ADHD. METHODS Brain images using technetium-99m ethyl cysteinate dimmer ((99m)Tc-ECD) single photon emission computed tomography (SPECT) were done in 10 drug-naïve adolescents with ADHD without DCD and 5 adolescents with ADHD comorbid DCD. The baseline rCBF and changes of rCBF after 10 mg MPH challenge between two groups were compared using statistical parametric mapping (SPM99) analysis. RESULTS Lower rCBF of bilateral frontal lobe, inferior parental lobe, and increased rCBF of right posterior cingulate gyrus, anterior lobe of cerebellum were found in ADHD comorbid DCD group compared to ADHD without DCD group. Decreased rCBF in the right occipital, inferior temporal lobe was found in ADHD comorbid DCD group after MPH while ADHD alone group revealed increased rCBF in bilateral occipital lobe. CONCLUSIONS The results help us understand the pathophysiology of DCD in ADHD adolescents. The different rCBF response to MPH provides a clue for future intervention of DCD in ADHD adolescents.
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Affiliation(s)
- Chin-Bin Yeh
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
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Development of an internet-based support and coaching model for adolescents and young adults with ADHD and autism spectrum disorders: a pilot study. Eur Child Adolesc Psychiatry 2012; 21:611-22. [PMID: 22736195 DOI: 10.1007/s00787-012-0297-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 06/06/2012] [Indexed: 10/28/2022]
Abstract
The aims of this paper were to develop an internet-based support and coaching model for young people with autism spectrum disorder (ASD) and/or attention-deficit/hyperactivity disorder (ADHD), and to validate the model. A user-centred design was applied to develop a model for internet-based support and coaching, where individuals received 8-week support via internet (chat). The model was validated by 10 individuals, 15-26 years of age, with ASD and/or ADHD. Self-report questionnaires [Sense of Coherence (SOC), the Rosenberg Self Esteem Scale, the Manchester Short Assessment of Quality of Life, Montgomery Åsberg Depression Rating Scale, and the Hospital Anxiety and Depression Scale] were distributed before and after intervention. A structured interview regarding the quality of the model, the Patient perspective of Care and Rehabilitation process (POCR), was used after the intervention. The validation showed significant improvement of SOC, self-esteem and subjective Quality of Life at follow-up and the majority perceived high fulfilment/importance on the POCR. In conclusion, The model can be an important complement to other interventions for young people with ASD and/or ADHD.
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Zambrano-Sánchez E, Martínez-Cortés JA, Río-Carlos YD, Dehesa-Moreno M, Poblano A. Low quality of life scores in school children with attention deficit-hyperactivity disorder related to anxiety. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:180-4. [DOI: 10.1590/s0004-282x2012000300005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 08/31/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is an alteration that begins early in infancy and whose cardinal symptoms are inattention, hyperactivity and impulsivity. There are few studies for specific tests to measure Quality of Life (QoL) in children with ADHD. METHODS: We evaluated QoL of 120 children from 7-12 years of age with ADHD and of a group of 98 healthy control children. To measure QoL, we utilized the Questionnaire of Quality of Life for Children in Pictures (AutoQuestionnaire Qualité de Vie Enfant Imagé, AUQUEI). We evaluated anxiety in children by the Children´s Manifest Anxiety Scale-Revisited (CMAS-R). We compared results among groups and employed the calculation of correlation between the AUQUEI questionnaire and the CMAS-R scale. RESULTS: The total average of the AUQUEI questionnaire in children with ADHD was 45.2, while in the control group it was 54.3 (p<0.05). We also observed significant differences between the control group and groups of children with ADHD in the CMAS-R scale. We found significant correlations between AUQUEI questionnaire and CMAS-R scale. CONCLUSION: The main result was to the disclosure that low QoL scores in ADHD children was anxiety-related.
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Larochette AC, Harrison AG, Rosenblum Y, Bowie CR. Additive Neurocognitive Deficits in Adults with Attention-Deficit/Hyperactivity Disorder and Depressive Symptoms. Arch Clin Neuropsychol 2011; 26:385-95. [DOI: 10.1093/arclin/acr033] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bae SM, Park JE, Lee YJ, Cho IH, Kim JH, Koh SH, Kim SJ, Cho SJ. Gender difference in the association between adult attention deficit hyperactivity disorder symptoms and morningness–eveningness. Psychiatry Clin Neurosci 2010; 64:649-51. [PMID: 21155167 DOI: 10.1111/j.1440-1819.2010.02140.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We aimed to investigate the association between attention deficit hyperactivity disorder (ADHD) and morningness–eveningness in adulthood. Subjects without psychiatric comorbidity on the Structured Clinical Interview for DSM-IV Axis I Disorders (n = 344) completed the Morningness–Eveningness Questionnaire (MEQ) and the Adult Self-Report Scale for ADHD. MEQ showed an independent and negative association with ADHD symptoms (P < 0.0001). In male subjects, both inattention (P < 0.0001) and hyperactivity–impulsivity were associated with MEQ (P = 0.01). In female subjects, only inattention was associated with MEQ (P < 0.001). Our findings suggest that eveningness may be strongly associated with inattention of adult ADHD and that it may be associated with hyperactivity–impulsivity of adult ADHD in male subjects only.
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Affiliation(s)
- Seung-Min Bae
- Department of Psychiatry, Gachon University of Medicine and Science, Incheon, Korea
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Schmidt S, Waldmann HC, Petermann F, Brähler E. Wie stark sind Erwachsene mit ADHS und komorbiden Störungen in ihrer gesundheitsbezogenen Lebensqualität beeinträchtigt? ACTA ACUST UNITED AC 2010. [DOI: 10.1024/1661-4747.a000002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hintergrund: Zur ADHS bei Erwachsenen liegen nur wenige Studien vor, die den Zusammenhang zwischen einer ADHS und komorbiden Störung erheben und mit der gesundheitsbezogenen Lebensqualität in Verbindung bringen. Methode: Die Teilnehmer der Studie wurden per Kreuzklassifikation in Gruppen unterteilt, nachdem sie als auffällig oder unauffällig eingestuft wurden. Neben χ2-Tests und korrelativen Beziehungen wurden prädiktive Werte und das relative Risiko bestimmt, um den Zusammenhang zwischen ADHS, komorbiden Störungen und der gesundheitsbezogenen Lebensqualität zu ermitteln. Ergebnisse: Während bei wenigen und begrenzten ADHS-Symptomen kaum komorbide Störungen festzustellen waren, so treten in der Hälfte aller Fälle von ADHS weitere psychische Belastungsfaktoren auf. Dabei hatten ADHS-Betroffene ein deutlich höheres Risiko für das Vorliegen psychischer Beschwerden als die Nichtbetroffenen. Diskussion: ADHS ist mit erhöhter psychischer Belastung bei gleichzeitiger Abnahme der gesundheitsbezogenen Lebensqualität verbunden. Neben dem generellen Nachweis einer hohen psychischen Belastung bei ADHS hat dies wichtige Konsequenzen für Diagnostik und Therapie. So ist eine umfassende Differenzialdiagnostik nötig, damit eine Therapie auch komorbide Störungen einbeziehen kann und sich somit die gesundheitsbezogene Lebensqualität verbessern lässt.
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Affiliation(s)
- Sören Schmidt
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | | | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Elmar Brähler
- Selbstständige Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
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Tai YM, Chiu HW. Comorbidity study of ADHD: applying association rule mining (ARM) to National Health Insurance Database of Taiwan. Int J Med Inform 2009; 78:e75-83. [PMID: 19853501 DOI: 10.1016/j.ijmedinf.2009.09.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Revised: 09/17/2009] [Accepted: 09/17/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This paper intends to apply association rule mining (ARM) to explore the labyrinthian network of ADHD comorbidity, and to examine the practicality of ARM in comorbidity studies using clinic databases. METHODS From clinic records of enrollees of Taiwan National Health Insurance (NHI), 18,321 youngsters aged 18 or less with diagnosis of ADHD in 2001 were recruited as case group in this study. And all their clinic diagnoses made from 2000 to 2002, as comorbidity, were categorized according to "The International Classification of Disease, 9th Revision, Clinical Modification" (ICD-9-CM) diagnosis system. For comparison, fourfold non-ADHD controls were recruited from 2001s NHI enrollees on a random base but matched gender and age of cases. ARM was done with Apriori algorithm to examine the strengths of associations among those diagnoses. The support and confidence values of ARM results were examined. Comorbidity rates and relative risk (RR) ratios of both groups of each diagnosis were compared one another. RESULTS ADHD case group has apparently higher risk of comorbidity with psychiatric comorbidity than with other physical illnesses. From results of ARM, developmental delay (DD) appears as an important node between ADHD and anxiety disorder (support: 5.12%, confidence: 97.42%), mild mental retardation (support: 4.42%, confidence: 92.09%) and autism (support: 6.49%, confidence: 94.93%). CONCLUSIONS The finding of this study, an important role of DD between ADHD and other psychiatric comorbidity, supports neurological findings in developmental delay of ADHD children's front cortex, as well as some epidemiology findings. This study also demonstrated the practicality of ARM in comorbidity studies using enormous clinic databases like NHIRD.
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Affiliation(s)
- Yueh-Ming Tai
- Department of Children and Adolescent Psychiatry, Beitou Armed Forces Hospital, Taiwan
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