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Muacevic A, Adler JR, Pei-Chen Chang J, P J Tan M, Kayano R, Okumura Y, Horinouchi T, Ii T, Kuroki T, Akiyama T. Gender Biases Toward People With Difficulty in Balancing Work and Family Due to ADHD: Two Case Vignette Randomized Studies Featuring Japanese Laypersons and Psychiatrists. Cureus 2023; 15:e34243. [PMID: 36852366 PMCID: PMC9965895 DOI: 10.7759/cureus.34243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/28/2023] Open
Abstract
Objective The gender gap in labor force participation is likely larger in adults with attention deficit hyperactivity disorder (ADHD) than that in the general population. Thus, we investigated whether gender affected the perception toward persons displaying ADHD symptoms and experiencing difficulty in balancing work and family. Methods Both Japanese laypersons and psychiatrists were recruited for web-based surveys in March and October 2020 via an online survey company, Cross Marketing Inc., and the secretariat of the Japanese Society of Psychiatry and Neurology, respectively. The participants were randomly assigned to read either a male or female case vignette. The vignettes were identical, except for the gender of the patient in the case. The primary and secondary outcomes were the respondents' opinions on the seriousness of the case and the degree to which the case's wish should be maintained, using sliding scales of 0-100. Results We included 560 laypersons and 585 psychiatrists. Neither cohort differed in most outcomes between the groups assigned to the male and female case vignettes. Among laypersons, the average score of seriousness was 58.8 in the female-vignette group and 58.6 in the male-vignette group (mean difference, 0.15; 95% confidence interval, -4.9 to 5.2). Among psychiatrists, the average score of seriousness was 53.9 in the female-vignette group and 53.7 in the male-vignette group (mean difference, 0.18; 95% confidence interval, -3.1 to 3.4). Similarly, between-group differences in the opinions on the degree to which the case's wish should be maintained were 1.2 in laypersons and 0.63 in psychiatrists. We found no significant interaction between the gender of the case and the respondent's gender in any of the outcomes. Conclusion Our results did not support the hypothesis that women were more likely to be pressured to prioritize family over work than men were when there was difficulty balancing work and family due to ADHD symptoms.
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Affiliation(s)
| | | | - Jane Pei-Chen Chang
- Department of Psychiatry, China Medical University Hospital, Taichung, TWN.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, GBR
| | - Marcus P J Tan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, GBR.,Department of Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, London, GBR
| | - Ryoma Kayano
- Center for International Collaborative Research, Nagasaki University, Nagasaki, JPN
| | - Yasuyuki Okumura
- Epidemiology, Initiative for Clinical Epidemiological Research, Tokyo, JPN
| | - Toru Horinouchi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, JPN
| | - Toshitaka Ii
- Department of Psychiatry, Aichi Medical University, Nagoya, JPN
| | - Toshihide Kuroki
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, JPN
| | - Tsuyoshi Akiyama
- Department of Neuropsychiatry, NTT Medical Center Tokyo, Tokyo, JPN
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Pain hypersensitivity in a pharmacological mouse model of attention-deficit/hyperactivity disorder. Proc Natl Acad Sci U S A 2022; 119:e2114094119. [PMID: 35858441 PMCID: PMC9335339 DOI: 10.1073/pnas.2114094119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Clinical evidence suggests that pain hypersensitivity develops in patients with attention-deficit/hyperactivity disorder (ADHD). However, the mechanisms and neural circuits involved in these interactions remain unknown because of the paucity of studies in animal models. We previously validated a mouse model of ADHD obtained by neonatal 6-hydroxydopamine (6-OHDA) injection. Here, we have demonstrated that 6-OHDA mice exhibit a marked sensitization to thermal and mechanical stimuli, suggesting that phenotypes associated with ADHD include increased nociception. Moreover, sensitization to pathological inflammatory stimulus is amplified in 6-OHDA mice as compared to shams. In this ADHD model, spinal dorsal horn neuron hyperexcitability was observed. Furthermore, ADHD-related hyperactivity and anxiety, but not inattention and impulsivity, are worsened in persistent inflammatory conditions. By combining in vivo electrophysiology, optogenetics, and behavioral analyses, we demonstrated that anterior cingulate cortex (ACC) hyperactivity alters the ACC-posterior insula circuit and triggers changes in spinal networks that underlie nociceptive sensitization. Altogether, our results point to shared mechanisms underlying the comorbidity between ADHD and nociceptive sensitization. This interaction reinforces nociceptive sensitization and hyperactivity, suggesting that overlapping ACC circuits may be targeted to develop better treatments.
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Maladaptive Personality Traits in a Group of Patients with Substance Use Disorder and ADHD. Medicina (B Aires) 2022; 58:medicina58070962. [PMID: 35888680 PMCID: PMC9323800 DOI: 10.3390/medicina58070962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: the comorbidity of personality disorders in patients who use psychoactive substances is common in psychiatric practice. The epidemiology of disharmonious personality traits in patients with ADHD and addictions in adulthood is still insufficiently researched. The study investigated the typology of personality traits in a group of adult patients consuming psychoactive substances, in whom symptoms of ADHD were identified. Materials and Methods: the study evaluates a group of 104 patients with chronic psychoactive substances abuse, in whom symptoms of ADHD were identified in early adulthood, in terms of comorbid personality traits. Results: statistically significant data have been obtained regarding the presence of clinical traits characteristic for cluster B personality disorders, the patients presenting lower levels of self-control, self-image instability, difficulties in the areas of social relationships and own identity integration. Conclusions: ADHD symptomatology precedes the clinical traits of personality disorders in patients with addictions, negatively influencing chronic evolution and quality of life.
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Sex Differences in Substance Use, Prevalence, Pharmacological Therapy, and Mental Health in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci 2022; 12:brainsci12050590. [PMID: 35624977 PMCID: PMC9139081 DOI: 10.3390/brainsci12050590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.
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Oliva F, Mangiapane C, Nibbio G, Berchialla P, Colombi N, Vigna-Taglianti FD. Prevalence of cocaine use and cocaine use disorder among adult patients with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. J Psychiatr Res 2021; 143:587-598. [PMID: 33199055 DOI: 10.1016/j.jpsychires.2020.11.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/15/2022]
Abstract
We conducted this systematic review and meta-analysis (registered with PROSPERO CRD42020142039) of the literature to estimate the lifetime prevalence of cocaine use and cocaine use disorder among adult patients with attention-deficit/hyperactivity disorder (ADHD). The literature search was performed on the electronic databases PubMed and PsychINFO without date or language restrictions. Additional studies were identified by hand searching of citations. Inclusion criteria were: studies involving adult patients with ADHD and reporting cocaine use and/or cocaine use disorders. Data were pooled in the meta-analyses using a generalized linear mixed model with random effects. Statistical heterogeneity was assessed using the Cochran Q test. Sensitivity analyses were conducted. Twelve studies were included in the review: six in the meta-analysis of cocaine use and nine in the meta-analysis of cocaine use disorder. The estimated prevalence of cocaine use was 26.0% (95% CI 0.18-0.35) and the estimated prevalence of cocaine use disorder was 10.0% (95% CI 0.08-0.13). Heterogeneity in both meta-analyses was high but decreased to non-significance in the meta-analysis on cocaine use disorder after excluding the outlier study. In conclusion, one out of four adult patients with ADHD use cocaine and one out of ten develop a lifetime cocaine use disorder. Since cocaine use can lead to more severe and complex disorders of impaired systemic functioning, adult patients with ADHD should be assessed for cocaine use disorder and promptly referred for treatment.
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Affiliation(s)
- F Oliva
- Department of Clinical and Biological Sciences, University of Torino, Italy
| | - C Mangiapane
- Department of Neurosciences "Rita Levi Montalcini", University of Torino, Italy
| | - G Nibbio
- Department of Psychiatry, Brescia University School of Medicine, Brescia, Italy
| | - P Berchialla
- Department of Clinical and Biological Sciences, University of Torino, Italy
| | - N Colombi
- Federated Library of Medicine "F. Rossi", University of Torino, Italy
| | - F D Vigna-Taglianti
- Department of Clinical and Biological Sciences, University of Torino, Italy; Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Torino, Italy.
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Pojanapotha P, Boonnag C, Siritikul S, Chalanunt S, Kuntawong P, Wongpakaran N, Wongpakaran T. Helpful family climate moderates the relationship between perceived family support of ADHD symptoms and depression: a conditional process model. BMC Psychol 2021; 9:112. [PMID: 34321085 PMCID: PMC8317368 DOI: 10.1186/s40359-021-00615-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Symptoms of attention deficit hyperactivity disorder (ADHD) are commonly comorbid with depression This study aimed to examine the relationship between ADHD symptoms and depression through perceived family support and to explore whether the magnitude of the relationship depended on the type of family climate of medical students. METHODS This cross-sectional study was conducted among 124 first year medical students in Thailand. Participants completed questionnaires on ADHD symptoms, depression, perceived family support, and 9 types of family climate. The questionnaires included the Adult ADHD Self-Report Scale Screener, Patient Health Questionnaire-9, and revised Thai Multidimensional Scale of Perceived Social Support. Mediational analysis was adopted to examine the mediating role of perceived family support in the relationship between ADHD symptoms and depression, while moderation analysis was applied to examine the extent of the relationship depending on family climate. RESULTS The relationship between ADHD symptoms and depression was moderate. Perceived family support partially mediated this relationship after controlling for age and sex. Among the types of family climate, only helpful family climate was a significant moderator of perceived family support and depression. The moderated mediation model increased the variance in depression from 17% by the mediation model to 21%. However, follow-up conditional mediational analysis showed that the indirect effect of ADHD symptoms on depression via perceived family support was not significant and that this effect did not vary linearly as a function of helpful family climate. CONCLUSION The findings of the study revealed that poor family support might be one risk of developing depression in the context of ADHD symptoms. Further study on providing intervention concerning family support among those with ADHD symptoms should be warranted. In addition, a study on helpful family climate in a larger sample size, in other populations, and in a longitudinal fashion for a more robust conclusion is encouraged.
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Affiliation(s)
- Pichaya Pojanapotha
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | | | | | | | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand.
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Adult attention-deficit hyperactivity disorder symptoms and psychological distress, hazardous drinking, and problem gambling: A population-based study. Psychiatry Res 2021; 301:113985. [PMID: 34023674 DOI: 10.1016/j.psychres.2021.113985] [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: 02/20/2020] [Accepted: 05/03/2021] [Indexed: 11/22/2022]
Abstract
Recognition of ADHD in the adult population is relatively recent. Epidemiological research examining the mental health impact of ADHD in adulthood is thus limited. The objective of this study was to examine whether adult ADHD symptoms are associated with psychological distress, hazardous drinking, and problem gambling, after controlling for traumatic brain injury and sociodemographic characteristics. We analyzed data from a population-based survey administered in 2015 and 2016 to adults aged 18 years and over in Ontario, Canada (N = 3,817). Logistic regression was used to construct unadjusted and multivariable models for each of the three focal relationships. In the unadjusted models, ADHD symptoms were significantly related to psychological distress (OR = 9.3; 95% CI:6.1, 14.0) and hazardous drinking (OR = 2.1; 95% CI: 1.3, 3.4), but not to problem gambling (OR = 1.5; 0.5, 4.3). After adjustment, ADHD symptoms were significantly related to psychological distress (OR = 7.1; 95% CI: 4.6, 11.1), but not hazardous drinking (OR = 1.4; 95% CI: 0.8, 2.5) or problem gambling (OR = 0.6; 95% CI: 0.2, 2.5). This study further highlights the importance of clinicians assessing for concomitant ADHD and psychological distress in adults.
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Hamad AF, Alessi-Severini S, Mahmud S, Brownell M, Kuo IF. Prenatal antibiotic exposure and risk of attention-deficit/hyperactivity disorder: a population-based cohort study. CMAJ 2021; 192:E527-E535. [PMID: 32575031 DOI: 10.1503/cmaj.190883] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Abnormal microbiota composition induced by prenatal exposure to antibiotics has been proposed as a potential contributor to the development of attention-deficit/hyperactivity disorder (ADHD). We examined the association between prenatal antibiotic exposure and risk of ADHD. METHODS We conducted a population-based retrospective cohort study of children born in Manitoba, Canada, between 1998 and 2017 and their mothers. We defined exposure as the mother having filled 1 or more antibiotic prescriptions during pregnancy. The outcome was diagnosis of ADHD in the offspring, as identified in administrative databases. We estimated hazard ratios (HRs) using Cox proportional hazards regression in the overall cohort, in a separate cohort matched on high-dimensional propensity scores and in a sibling cohort. RESULTS In the overall cohort, consisting of 187 605 children, prenatal antibiotic dispensation was associated with increased risk of ADHD (HR 1.22, 95% confidence interval [CI] 1.18-1.26). Similar results were observed in the matched cohort of 129 674 children (HR 1.20, 95% CI 1.15-1.24) but not in the sibling cohort (HR 1.06, 95% CI 0.99-1.13). Two negative-control analyses indicated a positive association with ADHD despite the lack of a reasonable biological mechanism, which suggested that the observed association between prenatal antibiotic dispensation and risk of ADHD was likely due to confounding. INTERPRETATION In our study, prenatal antibiotic exposure was not associated with increased risk of ADHD in children. Although the risk was higher in the overall and matched cohorts, it was likely overestimated because of unmeasured confounding. Future studies are warranted to examine other factors affecting microbiota composition in association with risk of ADHD.
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Affiliation(s)
- Amani F Hamad
- College of Pharmacy (Hamad, Alessi-Severini, Mahmud, Kuo), Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine (Alessi-Severini, Brownell), and Department of Community Health Sciences, Max Rady College of Medicine (Mahmud, Brownell), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Silvia Alessi-Severini
- College of Pharmacy (Hamad, Alessi-Severini, Mahmud, Kuo), Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine (Alessi-Severini, Brownell), and Department of Community Health Sciences, Max Rady College of Medicine (Mahmud, Brownell), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Salaheddin Mahmud
- College of Pharmacy (Hamad, Alessi-Severini, Mahmud, Kuo), Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine (Alessi-Severini, Brownell), and Department of Community Health Sciences, Max Rady College of Medicine (Mahmud, Brownell), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Marni Brownell
- College of Pharmacy (Hamad, Alessi-Severini, Mahmud, Kuo), Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine (Alessi-Severini, Brownell), and Department of Community Health Sciences, Max Rady College of Medicine (Mahmud, Brownell), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - I Fan Kuo
- College of Pharmacy (Hamad, Alessi-Severini, Mahmud, Kuo), Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine (Alessi-Severini, Brownell), and Department of Community Health Sciences, Max Rady College of Medicine (Mahmud, Brownell), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
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Ren Y, Fang X, Fang H, Pang G, Cai J, Wang S, Ke X. Predicting the Adult Clinical and Academic Outcomes in Boys With ADHD: A 7- to 10-Year Follow-Up Study in China. Front Pediatr 2021; 9:634633. [PMID: 34408992 PMCID: PMC8367416 DOI: 10.3389/fped.2021.634633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood and causes adverse effects on social functioning. The present study aimed to widely investigate the predictors, particularly childhood intelligence quotient (IQ) and family environment factors, on adult clinical and academic outcomes in boys with ADHD. Methods: A total of 101 boys with ADHD in a Chinese Han ADHD cohort were followed up 7-10 years later. Baseline ADHD symptoms were evaluated using the parent version of the ADHD Rating Scale-IV (ADHD-RS-IV) and the Chinese version of the Conners' Parent Rating Scale-Revised (CPRS-48). The intelligence of the child was tested by the China-Wechsler Intelligence Scale for Children (C-WISC), and family function was assessed by the Family Environment Scale-Chinese Edition (FES-CV). Adult ADHD persistence was defined using DSM-IV criteria for ADHD, and academic outcome fell into two categories: higher academic level group (studying in senior middle school or above) and lower academic level group (studying in vocational secondary schools or below). Results: Stepwise multiple logistic regression analysis revealed that the father's character, impulsive-hyperactive index as measured by the CPRS-48, and intellectual-cultural index as measured by the FES-CV independently predicted clinical outcomes in adults, with an AUC of 0.770 (p < 0.001, 95% CI = 0.678-0.863). The corresponding sensitivity and specificity were 0.743 and 0.727, respectively. The father's education level, family economic level, and verbal IQ (VIQ) on the C-WISC independently predicted adult academic outcomes, with an AUC of 0.870 (p < 0.001, 95% CI = 0.796-0.944). The corresponding sensitivity and specificity were 0.813 and 0.783, respectively. Conclusion: Initial ADHD symptom severity and IQ, father's character and education level, and family atmosphere and function affect adult clinical and academic outcomes. Addressing these areas early may help to improve the prognosis of ADHD into adulthood.
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Affiliation(s)
- Yanling Ren
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xinyu Fang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Hui Fang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Gaofeng Pang
- The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jing Cai
- The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Suhong Wang
- The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiaoyan Ke
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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Todesco S, Chao T, Schmid L, Thiessen KA, Schütz CG. Changes in Loss Sensitivity During Treatment in Concurrent Disorders Inpatients: A Computational Model Approach to Assessing Risky Decision-Making. Front Psychiatry 2021; 12:794014. [PMID: 35153861 PMCID: PMC8831914 DOI: 10.3389/fpsyt.2021.794014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent studies have employed computational modeling to characterize deficits in aspects of decision-making not otherwise detected using traditional behavioral task outcomes. While prospect utility-based modeling has shown to differentiate decision-making patterns between users of different drugs, its relevance in the context of treatment has yet to be examined. This study investigated model-based decision-making as it relates to treatment outcome in inpatients with co-occurring mental health and substance use disorders. METHODS 50 patients (Mage = 38.5, SD = 11.4; 16F) completed the Cambridge Gambling Task (CGT) within 2 weeks of admission (baseline) and 6 months into treatment (follow-up), and 50 controls (Mage = 31.9, SD = 10.0; 25F) completed CGT under a single outpatient session. We evaluated 4 traditional CGT outputs and 5 decisional processes derived from the Cumulative Model. Psychiatric diagnoses and discharge data were retrieved from patient health records. RESULTS Groups were similar in age, sex, and premorbid IQ. Differences in years of education were included as covariates across all group comparisons. All patients had ≥1 mental health diagnosis, with 80% having >1 substance use disorder. On the CGT, patients showed greater Deliberation Time and Delay Aversion than controls. Estimated model parameters revealed higher Delayed Reward Discounting, and lower Probability Distortion and Loss Sensitivity in patients relative to controls. From baseline to follow-up, patients (n = 24) showed a decrease in model-derived Loss Sensitivity and Color Choice Bias. Lastly, poorer Quality of Decision-Making and Choice Consistency, and greater Color Choice Bias independently predicted higher likelihood of treatment dropout, while none were significant in relation to treatment length of stay. CONCLUSION This is the first study to assess a computational model of decision-making in the context of treatment for concurrent disorders. Patients were more impulsive and slower to deliberate choice than controls. While both traditional and computational outcomes predicted treatment adherence in patients, findings suggest computational methods are able to capture treatment-sensitive aspects of decision-making not accessible via traditional methods. Further research is needed to confirm findings as well as investigate the relationship between model-based decision-making and post-treatment outcomes.
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Affiliation(s)
- Stefanie Todesco
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Thomas Chao
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Laura Schmid
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Karina A Thiessen
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Christian G Schütz
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada.,BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority (PHSA), Vancouver, BC, Canada
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Prevalence of attention-deficit/hyperactivity disorder in older adults: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 118:282-289. [DOI: 10.1016/j.neubiorev.2020.07.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/26/2022]
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12
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Conduct disorder and attention-deficit/hyperactivity disorder as risk factors for prescription opioid use. Drug Alcohol Depend 2020; 213:108103. [PMID: 32559668 DOI: 10.1016/j.drugalcdep.2020.108103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Existing studies of attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and substance use or substance use disorders have produced mixed results, with some identifying a direct link between ADHD and general or disordered substance use and others suggesting that comorbid CD may explain this relationship. Insufficient research has addressed the issue, which is particularly relevant in the context of the opioid crisis. This study examined the association of probable ADHD and childhood CD with self-reported opioid use in a general-population sample. METHOD The 2011-2013 cycles of the CAMH Monitor, a cross-sectional survey of adults (18+ years) from Ontario, Canada provided data from 6074 respondents. Binary logistic regressions were conducted of self-reported medical, non-medical, and any prescription opioid use in the previous 12 months, assessing demographic characteristics, perceived physical and mental health, and probable ADHD, childhood (before age 15 years) symptoms of CD, or their combination. RESULTS Adjusting for potential covariates, probable ADHD alone was not associated with prescription opioid use. Childhood symptoms of CD significantly predicted non-medical use (OR = 2.10, 95% CI = 1.10, 4.03). ADHD and CD symptoms combined significantly predicted medical (OR = 3.27, 95% CI = 1.20, 8.91), non-medical (OR = 4.73, 95% CI = 1.05, 21.30), and any (OR = 3.02, 95% CI = 1.13, 8.11) prescription opioid use, although a low base rate of non-medical use may have negatively affected model fit. CONCLUSIONS Previous findings relating ADHD to opioid use could be explained, in part, by the high rate of comorbidity between ADHD and CD. These data support prevention and treatment programs targeting individuals with comorbid ADHD and CD symptoms.
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13
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Arruda MA, Arruda R, Guidetti V, Bigal ME. ADHD Is Comorbid to Migraine in Childhood: A Population-Based Study. J Atten Disord 2020; 24:990-1001. [PMID: 28587507 DOI: 10.1177/1087054717710767] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Recurrent headaches and ADHD are prevalent in the pediatric population. Herein, we assess if ADHD is comorbid to headaches overall, to headache subtypes (e.g., migraine), and to headache frequency. Method: Informed consent and analyzable data were obtained for 5,671 children aged 5 to 12 years (65.9% of the target sample). Parents and teachers were interviewed using validated questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Relative risks were modeled using univariate and multivariate analyses. Results: As contrasted to nonheadache controls, the prevalence of ADHD was significantly higher in children with migraine (p < .001) but not in those with tension-type headaches. In children with migraine, risk of ADHD increased as a function of headache frequency (p < .05). Conclusion: Migraine and frequent migraine are comorbid to ADHD. Future studies should focus on the impact of the association on the burden to the children and their families.
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14
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Mehta TR, Gurung P, Nene Y, Fayyaz M, Bollu PC. Sleep and ADHD: A review article. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2019. [DOI: 10.1007/s40474-019-00178-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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15
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Hamad AF, Alessi-Severini S, Mahmud SM, Brownell M, Kuo IF. Antibiotic Exposure in the First Year of Life and the Risk of Attention-Deficit/Hyperactivity Disorder: A Population-Based Cohort Study. Am J Epidemiol 2019; 188:1923-1931. [PMID: 31497848 DOI: 10.1093/aje/kwz178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/27/2019] [Accepted: 08/07/2019] [Indexed: 01/02/2023] Open
Abstract
Early childhood antibiotic exposure induces changes in gut microbiota reportedly associated with the development of attention-deficit/hyperactivity disorder (ADHD). We conducted a population-based cohort study to examine the association between antibiotic use in the first year of life and ADHD risk. We included children born in Manitoba, Canada, between 1998 and 2017. Exposure was defined as having filled 1 or more antibiotic prescriptions during the first year of life. ADHD diagnosis was identified in hospital abstracts, physician visits, or drug dispensations. Risk of developing ADHD was estimated using Cox proportional hazards regression in a high-dimensional propensity score-matched cohort (n = 69,738) and a sibling cohort (n = 67,671). ADHD risk was not associated with antibiotic exposure in the matched-cohort (hazard ratio = 1.02, 95% confidence interval: 0.97, 1.08) or in the sibling cohort (hazard ratio = 0.96, 95% confidence interval: 0.89, 1.03). In secondary analyses of the matched cohort, ADHD risk increase was observed in those exposed to 4 or more antibiotic courses or a duration longer than 3 weeks. These associations were not observed in the sibling cohort. We concluded that antibiotic exposure in the first year of life does not pose an ADHD risk on a population level.
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Affiliation(s)
- Amani F Hamad
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Silvia Alessi-Severini
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- the Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M Mahmud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marni Brownell
- the Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - I fan Kuo
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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16
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Đào GJ, Brunelle C, Speed D. Impact of Substance Use and Mental Health Comorbidity on Health Care Access in Canada. J Dual Diagn 2019; 15:260-269. [PMID: 31282295 DOI: 10.1080/15504263.2019.1634856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Psychological disorders and substance use comorbidity is associated with greater symptomatology and a worse prognosis. Previous research has highlighted discrepancies in the level of use of health care services in individuals experiencing comorbidity compared to those with mental disorders or substance use disorders alone. The purpose of the current study was to compare mental health service use (i.e., access, number of professionals accessed, helpfulness of services received, and number of hours of services received) among individuals with mental disorders, substance use disorders, and comorbid disorders. Methods: Participants consisted of respondents to the 2012 Canadian Community Health Survey-Mental Health (N = 25,133). The researchers used a mixture of binary logistic regressions, Poisson regressions, linear regressions, and ordinal logistic regression to explore the impact of demographic variables, psychological distress, and clinical categories on health care access. Results: The mental disorders group, OR = 0.52, p = .008, 95% CI [0.32, 0.85], d = 0.36, and the substance use disorders group, OR = 0.31, p = .001, 95% CI [0.16, 0.60], d = 0.65, were significantly less likely than the comorbid group to report having accessed a professional in the past year. There were no significant differences in the perceived level of helpfulness for interventions received or in the time spent in professional consultation when comparing the substance use disorders and mental disorders groups to the comorbid group. Conclusions: Although the level of access to health care was low overall, those with concurrent disorders were more likely to access mental health services than those with substance use disorders or mental disorders only. The findings of this study reveal various treatment gaps, especially in those experiencing substance use disorders, and reaffirm the importance of improving treatment accessibility for these individuals.
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Affiliation(s)
- Grace J Đào
- Class of 2021, Dalhousie University, Saint John, New Brunswick, Canada
| | - Caroline Brunelle
- Department of Psychology, University of New Brunswick, Saint John, New Brunswick, Canada
| | - David Speed
- Department of Psychology, University of New Brunswick, Saint John, New Brunswick, Canada
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17
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Romo L, Julien Sweerts S, Ordonneau P, Blot E, Gicquel L. Road accidents in young adults with ADHD: Which factors can explain the occurrence of injuries in drivers with ADHD and how to prevent it? APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:372-377. [PMID: 31311322 DOI: 10.1080/23279095.2019.1640697] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Some 1.35 million people die and more than 50 million are injured or disabled from road accidents annually across the globe. Driving is a complex task with multiple complex cognitive functions, including perception, motor coordination, and executive function. Thus, driving can be a significant challenge for patients suffering from attention-deficit hyperactivity disorder (ADHD), a common neurodevelopmental disorder with cognitive symptoms such as inattention, impulsivity, and executive dysfunction. Undoubtedly, risk of car accidents is higher in people with ADHD. The aim of this article is to explore factors that could explain the occurrence of road accidents in patients with ADHD and to highlight prevention points. Indeed, reduction of risky driving is an important priority for public health.
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Affiliation(s)
- Lucia Romo
- EA 4430 Clipsyd, Paris Nanterre University, Nanterre Cedex, France.,Clinique des Maladies Mentales et de l'Encéphale (CMME) Sainte Anne Hospital Center, INSERM unit U-894, Paris, France
| | | | - Pauline Ordonneau
- University Center of Child and Adolescent Psychiatry, Research Unit, Henri Laborit Hospital Center, Poitiers University, Poitiers, France
| | - Emilie Blot
- University Center of Child and Adolescent Psychiatry, Research Unit, Henri Laborit Hospital Center, Poitiers University, Poitiers, France
| | - Ludovic Gicquel
- University Center of Child and Adolescent Psychiatry, Research Unit, Henri Laborit Hospital Center, Poitiers University, Poitiers, France
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18
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Hayashi W, Suzuki H, Saga N, Arai G, Igarashi R, Tokumasu T, Ota H, Yamada H, Takashio O, Iwanami A. Clinical Characteristics of Women with ADHD in Japan. Neuropsychiatr Dis Treat 2019; 15:3367-3374. [PMID: 31824160 PMCID: PMC6900462 DOI: 10.2147/ndt.s232565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 11/23/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Although gender differences have been reported in various aspects of adult attention-deficit hyperactivity disorder (ADHD), such as prevalence, comorbidities, and social functioning, there have been few such studies conducted in Japan. Our research investigated gender differences in sociodemographic and clinical characteristics of adults with ADHD in a Japanese clinical sample. Due to unique Japanese cultural ideals and expectations of women's behavior that are in opposition to ADHD symptoms, we hypothesized that women with ADHD experience more difficulties and present more dysfunctions than men. We tested the following hypotheses: first, women with ADHD have more comorbidities than men with ADHD; second, women with ADHD experience more social hardships than men, such as having less full-time employment and being more likely to be divorced. PATIENTS AND METHODS The subjects were 335 outpatients with a DSM-5 ADHD diagnosis, who visited our ADHD specialty clinic at Showa University Karasuyama Hospital in central Tokyo between April 2015 and March 2016. Sociodemographic and clinical characteristics were collected, and gender differences were compared. RESULTS Results fully supported our hypotheses: women had a significantly higher psychiatric comorbidity rate, were significantly less likely to be a full-time employee, and were significantly more likely to be divorced than men with ADHD. CONCLUSION Consistent with research in other countries, women with ADHD have greater impairments than men with ADHD in Japan. The importance of understanding gender differences of ADHD-diagnosed adults within a sociocultural context is highlighted.
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Affiliation(s)
- Wakaho Hayashi
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Hirohisa Suzuki
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa 224-8503, Japan
| | - Nobuyuki Saga
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Gosuke Arai
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Reiko Igarashi
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Takahiro Tokumasu
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa 224-8503, Japan
| | - Haruhisa Ota
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Hiroki Yamada
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Osamu Takashio
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
| | - Akira Iwanami
- Department of Psychiatry, Showa University School of Medicine, Setagaya-ku, Tokyo 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, Setagaya-ku, Tokyo 157-8577, Japan
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19
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Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry 2018; 56:14-34. [DOI: 10.1016/j.eurpsy.2018.11.001] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022] Open
Abstract
AbstractBackground Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
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20
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Kitazawa M, Yoshimura M, Murata M, Sato-Fujimoto Y, Hitokoto H, Mimura M, Tsubota K, Kishimoto T. Associations between problematic Internet use and psychiatric symptoms among university students in Japan. Psychiatry Clin Neurosci 2018; 72:531-539. [PMID: 29652105 DOI: 10.1111/pcn.12662] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/01/2018] [Accepted: 04/02/2018] [Indexed: 12/15/2022]
Abstract
AIM Research on the adverse effects of Internet use has gained importance recently. However, there is currently insufficient data on Japanese young adults' Internet use, so we conducted a survey targeting Japanese university students to research problematic Internet use (PIU). We also investigated the relationship between PIU and multiple psychiatric symptoms. METHODS A paper-based survey was conducted at five universities in Japan. Respondents were asked to fill out self-report scales regarding their Internet dependency using the Internet Addiction Test (IAT). Sleep quality, attention-deficit hyperactivity disorder (ADHD) tendency, depression, and anxiety symptom data were also collected based on respective self-reports. RESULTS There were 1336 responses and 1258 were included in the analysis. The mean IAT score (± SD) was 37.87 ± 12.59; and 38.2% of participants were classified as PIU, and 61.8% as non-PIU. The trend level for young women showed that they were more likely to be classified as PIU than young men (40.6% and 35.2% respectively, P = 0.05). Compared to the non-PIU group, the PIU group used the Internet longer (P < 0.001), had significantly lower sleep quality (P < 0.001), had stronger ADHD tendencies (P < 0.001), had higher Depression scores (P < 0.001), and had higher Trait-Anxiety scores (P < 0.001). Based on multiple logistic regression analyses, the factors that contributed to an increased risk of PIU were: being female (odds ratio [OR] = 1.52), being older (OR = 1.17), having poor sleep quality (OR = 1.52), having ADHD tendencies (OR = 2.70), having depression (OR = 2.24), and having anxiety tendencies (OR = 1.43). CONCLUSION We found a high PIU prevalence among Japanese young adults. The factors that predicted PIU were: female sex, older age, poor sleep quality, ADHD tendencies, depression, and anxiety.
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Affiliation(s)
- Momoko Kitazawa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Michitaka Yoshimura
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mayu Murata
- Department of Student Affairs, Mie University, Mie, Japan
| | | | - Hidefumi Hitokoto
- Department of Culture, Faculty of Humanities, Fukuoka University, Fukuoka, Japan.,Kokoro Research Center, Kyoto University, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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21
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Kolla NJ, van der Maas M, Erickson PG, Mann RE, Seeley J, Vingilis E. Attention deficit hyperactivity disorder and arrest history: Differential association of clinical characteristics by sex. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 58:150-156. [PMID: 29853005 DOI: 10.1016/j.ijlp.2018.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/05/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is often cited as a risk factor for criminality. However, many studies do not take other criminogenic variables into account when reporting on this relationship. It is even less clear whether models that include ADHD as a potential risk factor for criminality consider the importance of sex differences. To answer this question, we collected data from a telephone population survey sampling adults over the age of 18 years in the province of Ontario, Canada (final sample size = 5196). Respondents were screened for ADHD using the Adult ADHD Self-Report Version 1.1 Screener (ASRS-V1.1) and four extra items. Problematic drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT), while cannabis misuse was evaluated using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The Antisocial Personality Disorder Scale from the Mini-International Neuropsychiatric Interview provided a measure of previous conduct disorder symptoms and the 12-item General Health Questionnaire screening procedure was used to gauge general distress. History of arrest was self-reported. Three separate logistic regression analyses (entire sample, male only, and female only) were applied to estimate the association of the foregoing variables with arrest history. In the combined sample, conduct disorder symptoms, problem alcohol use, and problem cannabis use all predicted history of arrest. With regard to the male sample, conduct disorder symptoms, elevated AUDIT and ASSIST scores, and general distress were associated with an arrest history. For the female subsample, only conduct disorder symptoms and problematic cannabis use showed a relationship with criminality. To summarize, ADHD did not predict history of arrest for either subsample or the combined sample. When comparing males and females, conduct disorder symptoms and cannabis misuse exerted stronger effects on history of arrest for females than males. These results suggest that the relative importance and type of clinical risk factors for arrest may differ according to sex. Such information could be useful for crime prevention policies and correctional programs that take into account differences in experience by sex.
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Affiliation(s)
- Nathan J Kolla
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Violence Prevention Neurobiological Research Unit (CAMH), Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.
| | - Mark van der Maas
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | | | - Robert E Mann
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Jane Seeley
- Department of Family Medicine, University of Western Ontario, London, Ontario, Canada
| | - Evelyn Vingilis
- Department of Family Medicine, University of Western Ontario, London, Ontario, Canada
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22
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Piggott T, Harrington D, Mann R, Hamilton HA, Donnelly PD, Manson H. Youth violence victims and perpetrators in Ontario: identifying a high-risk group and a focus for public health prevention. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2018; 109:195-203. [PMID: 29981038 PMCID: PMC6964471 DOI: 10.17269/s41997-018-0061-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 01/20/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Bullying and violence are common experiences and pose significant lifelong burdens of disease for youth. This study identifies upstream determinants of youth violence and examines the shared characteristics of victims and perpetrators. METHODS Multivariable multinomial logistic regression modeling analyzed a subsample of 5403 students who participated in the 2015 Ontario Student Drug Use and Health Survey to estimate the likelihood that students with various risk profiles were victims and perpetrators. RESULTS Risk factors associated with an increased likelihood of being both a victim and a perpetrator, compared to neither, included harmful alcohol use, potential problem drug use, psychological distress, traumatic brain injury, problem video game playing, fighting, and carrying a weapon in the past 12 months. Many risk factors were more strongly associated with both victimization and perpetration relative to reporting either alone. CONCLUSION This study demonstrates an association between risk factors of interest to public health for students reporting both victimization and perpetration. This group may warrant further targeted public health interventions to prevent violence alongside existing public health programs addressing other health risk behaviours.
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Affiliation(s)
- Thomas Piggott
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 100 Main St W, Suite 2006, Hamilton, ON, L8P1H6, Canada.
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada.
| | - Daniel Harrington
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Robert Mann
- Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, ON, M5T 3M7, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
| | - Hayley A Hamilton
- Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, ON, M5T 3M7, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
| | - Peter D Donnelly
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada
| | - Heather Manson
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, ON, M5T 3M7, Canada
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23
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Osland S, Hirsch L, Pringsheim T. Smoking, alcohol and drug use in youth and adults with attention-deficit hyperactivity disorder. BJPsych Open 2017; 3:141-146. [PMID: 28546869 PMCID: PMC5437375 DOI: 10.1192/bjpo.bp.116.004317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/31/2017] [Accepted: 04/10/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous research suggests a relationship between attention-deficit hyperactivity disorder (ADHD) and smoking, alcohol and illicit drug use, however most studies have focused on adolescents or young adults, or clinically ascertained samples. AIMS To analyse population-based data on the relationship between ADHD and at-risk health behaviours in adolescents and adults. METHOD Data were derived from a Statistics Canada population-based health survey. The association between the diagnosis of ADHD and smoking, alcohol use, and illicit drug use was examined. RESULTS Individuals with ADHD started smoking at a younger age. They consumed more alcoholic drinks on drinking days, and women with ADHD were more likely to engage in binge drinking. Women over the age of 25 and men with ADHD were more likely to meet alcohol-dependence lifetime criteria. People with ADHD were at a greater risk of drug misuse and dependence. CONCLUSIONS People with ADHD are more likely to partake in at-risk behaviours. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
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Affiliation(s)
- Sydney Osland
- , BSc, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Mathison, Centre for Mental Health Research and Education, Calgary, Alberta, Canada
| | - Lauren Hirsch
- , MSc, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tamara Pringsheim
- , MD, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada
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24
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Weyandt LL, Oster DR, Gudmundsdottir BG, DuPaul GJ, Anastopoulos AD. Neuropsychological functioning in college students with and without ADHD. Neuropsychology 2017; 31:160-172. [PMID: 27831696 PMCID: PMC5280458 DOI: 10.1037/neu0000326] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD. METHOD The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed. RESULTS Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. CONCLUSION College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University
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25
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Stickley A, Koyanagi A, Takahashi H, Kamio Y. ADHD symptoms and pain among adults in England. Psychiatry Res 2016; 246:326-331. [PMID: 27750114 DOI: 10.1016/j.psychres.2016.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 09/21/2016] [Accepted: 10/02/2016] [Indexed: 12/16/2022]
Abstract
Prior research has produced conflicting findings on the association between attention-deficit/hyperactivity disorder (ADHD) and pain, while studies among community-dwelling adults are lacking. This study examined the association between ADHD symptoms and pain in the general adult population, and the extent to which this association is influenced by comorbid common mental disorders (CMDs). Data came from the 2007 Adult Psychiatric Morbidity Survey which included a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) Screener was used to obtain information on ADHD symptoms, while pain was assessed by the degree to which it interfered with work activity in the previous month. The Clinical Interview Schedule Revised (CIS-R) was used to evaluate six categories of CMDs. In a binary logistic regression analysis adjusted for socio-demographic factors and physical health conditions, an ADHD symptom score ≥14 was strongly associated with extreme pain (odds ratio [OR]: 3.15, 95% confidence interval [CI]: 2.09-4.74). The OR was attenuated greatly after further adjustment for CMDs (OR: 1.64, 95% CI: 1.05-2.58) but remained statistically significant. Adults with ADHD symptoms have higher odds for experiencing pain. CMDs are influential in this association but do not fully explain it.
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Affiliation(s)
- Andrew Stickley
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Hidetoshi Takahashi
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
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Abstract
OBJECTIVE We evaluated whether the association between Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Seasonal Affective Disorder (SAD) was mediated by the circadian rhythm. METHOD Data of 2239 persons from the Netherlands Study of Depression and Anxiety (NESDA) were used. Two groups were compared: with clinically significant ADHD symptoms (N = 175) and with No ADHD symptoms (N = 2064). Sleep parameters were sleep-onset and offset times, mid sleep and sleep duration from the Munich Chronotype Questionnaire. We identified the prevalence of probable SAD and subsyndromal SAD using the Seasonal Pattern Assessment Questionnaire (SPAQ). Clinically significant ADHD symptoms were identified by using a T score>65 on the Conners Adult ADHD Rating Scale. RESULTS The prevalence of probable SAD was estimated at 9.9% in the ADHD group (vs. 3.3% in the No ADHD group) and of probable s-SAD at 12.5% in the ADHD group (vs 4.6% in the No ADHD group). Regression analyses showed consistently significant associations between ADHD symptoms and probable SAD, even after adjustment for current depression and anxiety, age, sex, education, use of antidepressants and benzodiazepines (B = 1.81, p < 0.001). Late self-reported sleep onset was an important mediator in the significant relationship between ADHD symptoms and probable SAD, even after correction for confounders (total model effects: B = 0.14, p ≤ 0.001). CONCLUSION Both seasonal and circadian rhythm disturbances are significantly associated with ADHD symptoms. Delayed sleep onset time in ADHD may explain the increase in SAD symptoms. Treating patients with SAD for possible ADHD and delayed sleep onset time may reduce symptom severity in these complex patients.
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Galland D, Tisserant I, Notardonato L. ["Attention deficit hyperactivity disorder in forensic psychiatry: A review"]. Encephale 2016; 43:268-272. [PMID: 27637873 DOI: 10.1016/j.encep.2016.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/18/2016] [Accepted: 04/25/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is one of the most common and challenging childhood neurobehavioral disorders. ADHD may have behavioral consequences and involvements in minor and serious crimes. Our work aims to establish links between ADHD and forensic psychiatry. METHODS A review of international scientific literature concerning the relationship between ADHD and forensic psychiatry was conducted using the PudMed electronic database. We used the Mesh terms: "attention deficit hyperactivity disorder" and "forensic psychiatry". We also used the "related articles" function of PubMed, the bibliography of selected articles and the Google Scholar database to identify possible additional papers. RESULTS The prevalence of ADHD in prison populations may vary but remain higher than those found in the general population. Violence committed by a person with ADHD seems to be against other persons rather than property offences. Reactive-impulsive violence seems to be more prevalent than pro-active instrumental violence. The existence of ADHD does not appear as a risk factor of recidivism. The violence risk may be increased by the occurrence of comorbidities as conduct disorders and mental deficiency. There may exist a preferential association between ADHD and antisocial personality disorder or substance abuse which both increase the risk of violence. DISCUSSION To put in perspective forensic psychiatry and ADHD allowed us to identify typology of violence, epidemiological aspect of ADHD in a prison environment and comorbidities involved in the risk of violence. This research permits to precise elements of prevention, diagnosis and assistance in the management of violent behaviour in ADHD and in expert practice.
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Affiliation(s)
- D Galland
- EPSM des Flandres, 790, route de Locre, 59270 Bailleul, France.
| | - I Tisserant
- EPSM des Flandres, 790, route de Locre, 59270 Bailleul, France
| | - L Notardonato
- EPSM des Flandres, 790, route de Locre, 59270 Bailleul, France
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28
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Ilie G, Vingilis ER, Mann RE, Hamilton H, Toplak M, Adlaf EM, Kolla N, Ialomiteanu A, van der Mass M, Asbridge M, Vingilis-Jaremko L, Rehm J, Cusimano MD. The association between traumatic brain injury and ADHD in a Canadian adult sample. J Psychiatr Res 2015; 69:174-9. [PMID: 26343610 DOI: 10.1016/j.jpsychires.2015.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/03/2015] [Accepted: 08/06/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study describes the association between lifetime traumatic brain injury (TBI) and attention deficit and hyperactivity disorder (ADHD) among Canadian adults. METHOD A cross-sectional sample of 3993 Ontario adults aged 18 or older were surveyed by Computer Assisted Telephone Interviewing (CATI) throughout 2011 and 2012 as part of the CAMH Monitor, a rolling survey assessing the health, mental health and substance use of Ontario adults. TBI was defined as trauma to the head that resulted in loss of consciousness for at least five minutes or overnight hospitalization. ADHD was measured by the 6-item ASRS screener for adult ADHD, and self-reported history of diagnosed ADHD. RESULTS Among adults with a history of TBI, 6.6% (95% CI: 4.7, 9.4) screened ADHD positive, and 5.9% (95% CI: 3.6, 9.5) reported having been diagnosed with ADHD in their lifetime. Adults with lifetime TBI had significantly greater odds of scoring positive on the ADHD/ASRS screen (OR = 2.49, 95% CI: 1.54, 4.04), and of reporting a history of diagnosed ADHD (OR = 2.64, 95% CI: 1.40, 4.98) than without TBI, when holding values of sex, age, and education constant. CONCLUSION Significant positive associations between lifetime TBI and both current and past ADHD were observed among adults in this population. More research to understand these associations, and their significance for the etiology and management of TBI and ADHD, is needed.
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Affiliation(s)
- Gabriela Ilie
- Division of Neurosurgery, St. Michael Hospital, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada.
| | - Evelyn R Vingilis
- Population and Community Health Unit, Department of Family Medicine, University of Western Ontario, London, Canada
| | - Robert E Mann
- Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Hayley Hamilton
- Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Maggie Toplak
- Department of Psychology, York University, LaMarsh Centre for Child and Youth Research, Toronto, Canada
| | - Edward M Adlaf
- Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nathan Kolla
- Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | | | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | | | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Michael D Cusimano
- Division of Neurosurgery, St. Michael Hospital, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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