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Udal ABH, Stray LL, Pripp AH, Stray T, Egeland J. The Utility of Neuromuscular Assessment to Identify ADHD Among Patients with a Complex Symptom Picture. J Atten Disord 2024; 28:1577-1588. [PMID: 39221625 PMCID: PMC11403920 DOI: 10.1177/10870547241273102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Diagnostic assessment of ADHD is challenging due to comorbid psychopathologies and symptoms overlapping with other psychiatric disorders. In this study, we investigate if a distinct pattern of neuromuscular dysregulation previously reported in ADHD, can help identifying ADHD in psychiatric patients with diverse and complex symptoms. METHOD We explored the impact of neuromuscular dysregulation, as measured by The Motor Function Neurologic Assessment (MFNU), on the likelihood of being diagnosed with ADHD, affective disorder, anxiety disorder, or personality disorder among adults (n = 115) referred to a psychiatric outpatient clinic. RESULTS Logistic regression revealed that neuromuscular dysregulation was significantly associated with ADHD diagnosis only (OR 1.15, p < .01), and not with affective-, anxiety-, or personality disorders. Sensitivity and specificity for ADHD at different MFNU scores is provided. CONCLUSIONS A test of neuromuscular dysregulation may promote diagnostic accuracy in differentiating ADHD from other psychiatric disorders in patients with an overlapping symptom picture. This may have important implications for clinical practice. More studies are needed.
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Affiliation(s)
| | - Liv Larsen Stray
- Department of Psychiatry, Sørlandet Hospital HF, Kristiansand, Norway
| | - Are Hugo Pripp
- Department of Biostatistics, Oslo University Hospital, Norway
| | - Torstein Stray
- Department of Psychiatry, Sørlandet Hospital HF, Kristiansand, Norway
| | - Jens Egeland
- Department of psychology, University of Oslo, Norway
- Vestfold Hospital Trust, Tønsberg, Norway
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Golimstok Á, Basalo MJG, Majul M, Berrios W, Rugiero M, Fernández MC, Eichel R. Adult Attention Deficit-Hyperactivity Disorder is associated with Lewy Body Disease and Cognitive Impairment: A prospective cohort Study With 15-year Follow-Up. Am J Geriatr Psychiatry 2024; 32:1063-1077. [PMID: 38697886 DOI: 10.1016/j.jagp.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES Past reports have suggested that attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for Lewy body disease (LBD). To confirm this relationship, we conducted the present study. DESIGN A prospective observational cohort study with a follow-up to 15 years. SETTING The subjects were recruited from cognitive neurology clinics, where they attended for a cognitive complaint or health check-up. PARTICIPANTS Two groups of subjects: ADHD adults and healthy subjects. MEASUREMENTS The risk of dementia and LBD was estimated with Kaplan-Meier analysis comparing for the presence or absence of ADHD with the log-rank test. Predictors of conversion were assessed through separate univariate and multivariate Cox regression analyses, adjusting for several variables. RESULTS The baseline sample consisted of 161 subjects with ADHD and 109 without ADHD. At the end of the follow-up, 31 subjects developed dementia, 27 cases in the ADHD group and 4 in comparison group. Dementia with Lewy bodies (DLB) was the most frequent type (N:20) of which 19 corresponded to the ADHD group. The incidence of non-amnestic-MCI in the ADHD group was higher representing 67.1 % of these subjects (N:108), and 17.4% (N:19) of healthy cases. The hazard ratios for dementia and LBD in the multivariate adjusted model were 3.33 (95% CI 1.0915 to 10.1699) and 54.54 (95% CI 7.4849 to 397.5028), respectively in the ADHD group. CONCLUSIONS This study showed that adult ADHD is independently associated with an increased risk of LBD, dementia, and na-MCI. Future studies should clarify this relationship to develop preventive measures for these patients.
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Affiliation(s)
- Ángel Golimstok
- Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina.
| | - María José García Basalo
- Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina
| | - Mariana Majul
- Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina
| | - Waleska Berrios
- Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina
| | - Marcelo Rugiero
- Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Maria Cecilia Fernández
- Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina
| | - Roni Eichel
- Department of Neurology (RE), Shaare Zedek Medical Center, Jerusalem, Israel; The School of Medicine (RE), The Hebrew University, Jerusalem, Israel
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Rotstein A. Adult-Onset Attention-Deficit/Hyperactivity Disorder and the Risk of Lewy Body Dementia: An Invited Commentary. Am J Geriatr Psychiatry 2024; 32:1078-1079. [PMID: 38664081 DOI: 10.1016/j.jagp.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 08/11/2024]
Affiliation(s)
- Anat Rotstein
- Department of Gerontology (AR), University of Haifa, Haifa, Israel.
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Schiavone N, Virta M, Leppämäki S, Launes J, Vanninen R, Tuulio-Henriksson A, Järvinen I, Lehto E, Hokkanen L. Childhood ADHD and subthreshold symptoms are associated with cognitive functioning at age 40-a cohort study on perinatal birth risks. Front Psychol 2024; 15:1393642. [PMID: 39268376 PMCID: PMC11391087 DOI: 10.3389/fpsyg.2024.1393642] [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] [Received: 02/29/2024] [Accepted: 06/21/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction In this prospective cohort study over 40 years we investigated the effect of childhood attention-deficit/hyperactivity disorder (ADHD) and subthreshold ADHD on cognitive performance in adulthood. Methods The cohort comprised individuals with mild perinatal risks. Childhood ADHD group (cADHD, n = 39) was compared to a group with subthreshold childhood attention or hyperactivity symptoms (cAP; n = 79), a group with similar perinatal risks but no ADHD symptoms (n = 255), and to controls without ADHD symptoms or perinatal risks (n = 69). The groups were assessed with multiple neuropsychological measures in domains of verbal reasoning, perceptual skills, memory, working memory, attention, executive functions, and speed. Group-level differences and frequencies of deficient functioning were analyzed. Results Overall, the groups' performance differed in all cognitive domains at age 40. Verbal reasoning, perceptual skills, memory, and speed had the largest effect sizes (0.51-0.62). The cADHD group's performance was lower than the other groups' on 13 out of 21 measures. The cAP group performed poorer than controls on five measures. In the cADHD group, 23% had three or more deficient cognitive domains, compared to 4-6% in the other groups. Discussion Childhood ADHD is associated with impaired cognitive functioning in adulthood on several cognitive domains whereas childhood subthreshold ADHD is linked to fewer cognitive deficits. Task complexity was linked to poorer performance within the ADHD group. Our results add to the scarce longitudinal evidence of cognitive outcomes related to childhood ADHD and subthreshold symptoms.
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Affiliation(s)
- Nella Schiavone
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Maarit Virta
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Jyrki Launes
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Ritva Vanninen
- Department of Clinical Radiology, Kuopio University hospital, Kuopio, Finland
- Clinical Radiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | | | - Ilkka Järvinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Eliisa Lehto
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Laura Hokkanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Freichel R, Zink N, Chang FY, Vera JD, Truong H, Michelini G, Loo SK, Lenartowicz A. Alpha event-related decreases during encoding in adults with ADHD - An investigation of sustained attention and working memory processes. Behav Brain Res 2024; 469:115003. [PMID: 38642862 DOI: 10.1016/j.bbr.2024.115003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Executive functioning deficits are central to established neuropsychological models of ADHD. Oscillatory activity, particularly the alpha rhythm (8-12 Hz) has been associated with cognitive impairments in ADHD. However, most studies to date examined such neural mechanisms underlying executive dysfunction in children and adolescents with ADHD, raising the question of whether and to what extent those ADHD-related working memory impairments are still present in adults. To this end, the current study aimed to investigate the role of alpha event-related decreases (ERD) during working memory processes in adults with and without ADHD. METHODS We collected electroencephalographic (EEG) data from 85 adults with a lifetime diagnosis of ADHD and 105 controls (aged 32-64), while they performed a continuous performance (CPT) and a spatial delayed response working memory task (SDRT). Time-frequency and independent component analysis (ICA) was used to identify alpha (8-12 Hz) clusters to examine group and condition effects during the temporal profile of sustained attention and working memory processes (encoding, maintenance, retrieval), loads (low and high) and trial type (go and nogo). RESULTS Individuals with ADHD exhibited higher reaction time-variability in SDRT, and slower response times in SDRT and CPT, despite no differences in task accuracy. Although working memory load was associated with stronger alpha ERD in both tasks and both groups (ADHD, controls), we found no consistent evidence for attenuated alpha ERD in adults with ADHD, failing to replicate effects reported in children. In contrast, when looking at the whole sample, the correlations of alpha power during encoding with inattention and hyperactivity-impulsivity symptoms were significant, replicating prior findings in children with ADHD, but suggesting an alternate source for these effects in adults. CONCLUSIONS Our results corroborate the robustness of alpha as a marker of visual attention and suggest that occipital alpha ERD normalizes in adulthood, but with unique contributions of centro-occipital alpha ERD, suggesting a secondary source. This implies that deviations in processes other than previously reported visuospatial cortex engagement may account for the persistent symptoms and cognitive deficits in adults with a history of ADHD.
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Affiliation(s)
- René Freichel
- Department of Psychology, University of Amsterdam, The Netherlands.
| | - Nicolas Zink
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States
| | - Fang Yu Chang
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States
| | - Juan Diego Vera
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States; Department of Psychology, University of California Los Angeles, Los Angeles, United States
| | - Holly Truong
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
| | - Giorgia Michelini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States; Department of Biological & Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Sandra K Loo
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
| | - Agatha Lenartowicz
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
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Mesfin W, Habtamu K. Challenges and coping mechanisms of parents of children with attention deficit hyperactivity disorder in Addis Ababa, Ethiopia: a qualitative study. BMC Psychol 2024; 12:354. [PMID: 38886856 PMCID: PMC11184847 DOI: 10.1186/s40359-024-01828-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 05/28/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has manifestations of inattention, hyperactivity, and impulsivity. It affects every facet of a child's life, including one's own emotions, family and school life, and social interaction. The few available studies on ADHD conducted in Ethiopia focus on teachers' awareness and the prevalence of ADHD. None of these studies has taken into account parents of children who have ADHD. The present study, therefore, aimed to find out the challenges and coping mechanisms of parents who have children with ADHD. METHODS A phenomenological qualitative study was conducted to explore the experiences of parents who have children with ADHD. The study was carried out in Addis Ababa, the capital city of Ethiopia. Fourteen parents and two healthcare providers were involved in the study. Participants were selected using a purposive sampling technique. In-depth interviews were conducted with parents of children with ADHD (n = 8) and healthcare providers (n = 2). One focus group discussion (FGD), consisting of six members, was also conducted with parents. A topic guide for conducting the interviews and FGD was developed. Interviews and the FGD were audio-recorded. The data were transcribed verbatim, translated into English, and then analyzed using a thematic analysis approach. RESULTS With regard to challenges of parents of children with ADHD, three themes emerged: social challenges, economic challenges and psychological challenges. Stigma is found to be the most common challenge. Other challenges included worry about the child's future, lack of social support, strained relationships with others, impact on their job, and marital conflict. Concerning coping mechanisms, two themes emerged: Inward and outward means of coping. The inward means of coping included prayer and developing an optimistic mindset whereas the outward means were family support, healthcare providers' guidance, and social avoidance. CONCLUSIONS The study found that parents of children with ADHD experience several aspects of psychological, social, and economic challenges. Support from healthcare professionals, family members, and the community at large is found to be useful for parents to cope with these challenges. Future research should focus on evaluating interventions that would help parents with ADHD cope with the challenges they experience.
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Affiliation(s)
- Wongelawit Mesfin
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, P.O.BOX: 1176, Addis Ababa, Ethiopia.
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Mishra S, Chaudhary V, Saraswathy KN, Shekhawat LS, Devi NK. Prevalence of adult attention deficit hyperactivity disorder in India: a systematic review and a cross-sectional study among young adults in Delhi-NCR. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02697-z. [PMID: 38832970 DOI: 10.1007/s00127-024-02697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE The epidemiology of adult attention deficit hyperactivity disorder (ADHD) is not well explored in India. The present study aims to systematically review the literature on the prevalence of adult ADHD in India and also estimate the prevalence and sociodemographic correlates of adult ADHD among the young adults in Delhi-NCR. METHODS For the systematic review, 494 articles were identified of which 10 were included in the review. Simultaneously, a cross-sectional study was conducted involving 1665 adults (18-25 years; mean age 19.92) of both sexes (69.1% females) from different colleges in Delhi-NCR, India. Data was collected using structured interviews and standardized diagnostic tool ASRS V1.1 was used for screening of ADHD. RESULT The systematic review revealed a high prevalence of adult ADHD ranging from 5.48 to 25.7% among general and specific populations of India. Further, in the cross-sectional study, 14% of participants were screened positive for ADHD. While factors like South Indian origin and higher maternal education were associated with an increased risk of adult ADHD, low socioeconomic status was found to be protective. CONCLUSION Considering the high prevalence of adult ADHD in India, there is an urgent need to increase awareness regarding adult ADHD and identify vulnerable populations to facilitate informed interventions.
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Affiliation(s)
- Sumit Mishra
- Department of Anthropology, University of Delhi, Delhi, 110007, India
| | - Vineet Chaudhary
- Department of Anthropology, University of Delhi, Delhi, 110007, India
| | | | - Lokesh Singh Shekhawat
- Department of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi, 110001, India
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Wang Y, Ma L, Wang J, Ding Y, Liu N, Men W, Tan S, Gao JH, Qin S, He Y, Dong Q, Tao S. The neural and genetic underpinnings of different developmental trajectories of Attention-Deficit/Hyperactivity Symptoms in children and adolescents. BMC Med 2024; 22:223. [PMID: 38831366 PMCID: PMC11149188 DOI: 10.1186/s12916-024-03449-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The trajectory of attention-deficit hyperactivity disorder (ADHD) symptoms in children and adolescents, encompassing descending, stable, and ascending patterns, delineates their ADHD status as remission, persistence or late onset. However, the neural and genetic underpinnings governing the trajectory of ADHD remain inadequately elucidated. METHODS In this study, we employed neuroimaging techniques, behavioral assessments, and genetic analyses on a cohort of 487 children aged 6-15 from the Children School Functions and Brain Development project at baseline and two follow-up tests for 1 year each (interval 1: 1.14 ± 0.32 years; interval 2: 1.14 ± 0.30 years). We applied a Latent class mixed model (LCMM) to identify the developmental trajectory of ADHD symptoms in children and adolescents, while investigating the neural correlates through gray matter volume (GMV) analysis and exploring the genetic underpinnings using polygenic risk scores (PRS). RESULTS This study identified three distinct trajectories (ascending-high, stable-low, and descending-medium) of ADHD symptoms from childhood through adolescence. Utilizing the linear mixed-effects (LME) model, we discovered that attention hub regions served as the neural basis for these three developmental trajectories. These regions encompassed the left anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC), responsible for inhibitory control; the right inferior parietal lobule (IPL), which facilitated conscious focus on exogenous stimuli; and the bilateral middle frontal gyrus/precentral gyrus (MFG/PCG), accountable for regulating both dorsal and ventral attention networks while playing a crucial role in flexible modulation of endogenous and extrinsic attention. Furthermore, our findings revealed that individuals in the ascending-high group exhibited the highest PRS for ADHD, followed by those in the descending-medium group, with individuals in the stable-low group displaying the lowest PRS. Notably, both ascending-high and descending-medium groups had significantly higher PRS compared to the stable-low group. CONCLUSIONS The developmental trajectory of ADHD symptoms in the general population throughout childhood and adolescence can be reliably classified into ascending-high, stable-low, and descending-medium groups. The bilateral MFG/PCG, left ACC/mPFC, and right IPL may serve as crucial brain regions involved in attention processing, potentially determining these trajectories. Furthermore, the ascending-high pattern of ADHD symptoms exhibited the highest PRS for ADHD.
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Affiliation(s)
- Yanpei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China.
| | - Leilei Ma
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Jiali Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Yuyin Ding
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Ningyu Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Weiwei Men
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Shuping Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, 100096, China
| | - Jia-Hong Gao
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Qi Dong
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Sha Tao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China.
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Browning L, Cannoy CN, Moses TEH, Lundahl LH, Ledgerwood DM, Greenwald MK. Attention-deficit/hyperactivity disorder combined subtype exacerbates opioid use disorder consequences: Mediation by impulsive phenotypes. Drug Alcohol Depend 2024; 259:111292. [PMID: 38640865 PMCID: PMC11111336 DOI: 10.1016/j.drugalcdep.2024.111292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/28/2024] [Accepted: 04/06/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is highly prevalent and associated with opioid use disorder (OUD). Yet, little is known about the mechanisms by which ADHD (which is a heterogeneous construct/diagnosis) might alter the trajectory of OUD outcomes in persons who use heroin. AIM We examined whether ADHD subtypes are related to heroin-use consequences and the extent to which the effects of ADHD on lifetime heroin-use consequences are mediated by two impulsivity factors that may be partly independent of ADHD: foreshortened time perspective and drug-use impulsivity. METHODS Individuals who reported regular heroin use (N=250) were screened using the Assessment of Hyperactivity and Attention (AHA), Impulsive Relapse Questionnaire (IRQ), Stanford Time Perception Inventory (STPI), and a comprehensive assessment of lifetime and current substance use and substance-related consequences. This secondary analysis examined whether ADHD or intermediate phenotypes predicted heroin-use consequences. RESULTS Relative to participants whose AHA scores indicated lifetime absence of ADHD (n=88), those with scores indicating persistent ADHD (childhood and adult, n=62) endorsed significantly more total lifetime heroin-use consequences despite comparable heroin-use severity. Likewise, there was a significant indirect effect of the combined ADHD subtype in childhood on lifetime heroin-use consequences. This effect was mediated by STPI scores indicating less future (and more hedonism in the present) temporal orientation and by IRQ scores indicating less capacity for delaying drug use. CONCLUSION The combined ADHD subtype is significantly associated with lifetime heroin-use consequences, and this effect is mediated through higher drug-use impulsivity (less capacity for delay) and lower future temporal orientation.
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Affiliation(s)
- Liam Browning
- Dept. of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ciara N Cannoy
- Dept. of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tabitha E H Moses
- Dept. of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Leslie H Lundahl
- Dept. of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - David M Ledgerwood
- Dept. of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mark K Greenwald
- Dept. of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
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10
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Girela-Serrano B, Miguélez-Fernández C, Abascal-Peiró S, Peñuelas-Calvo I, Jiménez-Muñoz L, Moreno M, Delgado-Gómez D, Bello HJ, Nicholls D, Baca-García E, Carballo JJ, Porras-Segovia A. Diagnostic trajectories of mental disorders in children and adolescents: a cohort study. Eur Child Adolesc Psychiatry 2024; 33:1481-1494. [PMID: 37422547 DOI: 10.1007/s00787-023-02254-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
Mental disorders in children and adolescents may follow different trajectories, such as remission, change of diagnosis, or addition of two or more comorbid diagnoses, showing a heterotypic pattern. This study aims to describe the main diagnostic trajectories across a broad range of mental disorder diagnostic categories, from childhood to adolescence and from adolescence to young adulthood in a clinical population. A prospective study was conducted among a clinical sample of children and adolescents who were aged 3-17 years at the face-to-face baseline interview. Electronic health records of these participants were reviewed 10 years later. The diagnostic stability over time was examined using the kappa coefficient, and factors associated with stability were explored using simple logistic regression. The study included a sample of 691 participants. The kappa coefficient for diagnostic stability across all diagnoses was 0.574 for the transition from childhood to adulthood, 0.614 from childhood to adolescence, and 0.733 from adolescence to adulthood. Neurodevelopmental diagnoses had the highest stability. Factors associated with higher diagnostic stability included family history of mental disorders, receiving psychopharmacological treatment, and symptom severity at baseline. We found a variable diagnostic stability across different diagnoses and age categories. The different life transitions represent complex periods that should not be overlooked from a clinical standpoint. An appropriate transition from child and adolescent mental health services to adult mental health services may have a positive impact on children and adolescents with mental disorders.
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Affiliation(s)
- Braulio Girela-Serrano
- Westminster Child and Adolescent Mental Health Service, Central and Northwest London NHS Foundation Trust, London, UK
- Division of Psychiatry, Imperial College London, London, UK
| | | | - Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - David Delgado-Gómez
- Department of Statistics, University Carlos III of Madrid, 28911, Leganés, Spain
| | - Hugo J Bello
- Department of Applied Mathematics, Universidad de Valladolid, Valladolid, Spain
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
| | - Enrique Baca-García
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
- CIBERSAM, Madrid, Spain
- Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alejandro Porras-Segovia
- Division of Psychiatry, Imperial College London, London, UK.
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain.
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11
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Solberg BS, Kvalvik LG, Instanes JT, Hartman CA, Klungsøyr K, Li L, Larsson H, Magnus P, Njølstad PR, Johansson S, Andreassen OA, Bakken NR, Bekkhus M, Austerberry C, Smajlagic D, Havdahl A, Corfield EC, Haavik J, Gjestad R, Zayats T. Maternal Fiber Intake During Pregnancy and Development of Attention-Deficit/Hyperactivity Disorder Symptoms Across Childhood: The Norwegian Mother, Father, and Child Cohort Study. Biol Psychiatry 2024; 95:839-848. [PMID: 38142720 DOI: 10.1016/j.biopsych.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Epidemiological studies suggest that maternal diet quality during pregnancy may influence the risk of neurodevelopmental disorders in offspring. Here, we investigated associations between maternal intake of dietary fiber and attention-deficit/hyperactivity disorder (ADHD) symptoms in early childhood. METHODS We used longitudinal data of up to 21,852 mother-father-child trios (49.2% female offspring) from MoBa (the Norwegian Mother, Father, and Child Cohort Study). The relationships between maternal fiber intake during pregnancy and offspring ADHD symptoms at ages 3, 5, and 8 years were examined using 1) multivariate regression (overall levels of ADHD symptoms), 2) latent class analysis (subclasses of ADHD symptoms by sex at each age), and 3) latent growth curves (longitudinal change in offspring ADHD symptoms). Covariates were ADHD polygenic scores in child and parents, total energy intake and energy-adjusted sugar intake, parental ages at birth of the child, and sociodemographic factors. RESULTS Higher maternal prenatal fiber intake was associated with lower offspring ADHD symptom scores at all ages (Bage3 = -0.14 [95% CI, -0.18 to -0.10]; Bage5 = -0.14 [95% CI, -0.19 to -0.09]; Bage8 = -0.14 [95% CI, -0.20 to -0.09]). Of the derived low/middle/high subclasses of ADHD symptoms, fiber was associated with lower risk of belonging to the middle subclass for boys and girls and to the high subclass for girls only (middle: odds ratioboys 0.91 [95% CI, 0.86 to 0.97]/odds ratiogirls 0.86 [95% CI, 0.81 to 0.91]; high: odds ratiogirls 0.82 [95% CI, 0.72 to 0.94]). Maternal fiber intake and rate of change in child ADHD symptoms across ages were not associated. CONCLUSIONS Low prenatal maternal fiber intake may increase symptom levels of ADHD in offspring during childhood, independently of genetic predisposition to ADHD, unhealthy dietary exposures, and sociodemographic factors.
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Affiliation(s)
- Berit Skretting Solberg
- Department of Biomedicine, University of Bergen, Norway; Child and Adolescent Psychiatric Outpatient Unit, Hospital Betanien, Bergen, Norway.
| | | | | | - Catharina A Hartman
- Interdisciplinary Center Psychiatry and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Lin Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål Rasmus Njølstad
- Department of Clinical Science, Mohn Center for Diabetes Precision Medicine, University of Bergen, Bergen, Norway; Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Stefan Johansson
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiciton, Oslo University Hospital, Oslo, Norway
| | - Nora Refsum Bakken
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Chloe Austerberry
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom; Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Dinka Smajlagic
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Alexandra Havdahl
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway; Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway; Nic Waals Institute, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Elizabeth C Corfield
- Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway; Nic Waals Institute, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Norway; Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Psychiatry, Research Department, Haukeland University Hospital, Bergen, Norway
| | - Rolf Gjestad
- Department of Psychiatry, Research Department, Haukeland University Hospital, Bergen, Norway; Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tetyana Zayats
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
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12
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Martin J. Why are females less likely to be diagnosed with ADHD in childhood than males? Lancet Psychiatry 2024; 11:303-310. [PMID: 38340761 DOI: 10.1016/s2215-0366(24)00010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
ADHD is less likely to be diagnosed in females than males, especially in childhood. Females also typically receive the diagnosis later than males and are less likely to be prescribed ADHD medication. Understanding why these sex differences in clinical care and treatment for ADHD occur is key to improving timely diagnosis in people affected by ADHD. This Personal View is a conceptual review synthesising literature on this topic. This publication considers potential biological explanations (eg, genetic factors), influence of diagnostic practices (eg, criteria suitability, diagnostic overshadowing, and sex-specific diagnostic thresholds), and sociocultural explanations (eg, sex differences in presentation and compensatory behaviours), for the observed sex differences in ADHD clinical practice. This Personal View also outlines future research directions for improving understanding of sex differences in recognition and diagnosis of ADHD.
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Affiliation(s)
- Joanna Martin
- Centre for Neuropsychiatric Genetics and Genomics and Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
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13
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Nolan LJ, Higgs S. The role of irrational beliefs in the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and disordered eating in two general student samples. Appetite 2024; 195:107229. [PMID: 38246426 DOI: 10.1016/j.appet.2024.107229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/21/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
Attention deficit hyperactivity disorder (ADHD) symptoms are associated with disordered eating and negative mood. The purpose of this study was to examine whether irrational beliefs mediate this relationship along with previously reported mediators such as depression and impulsivity. Irrational beliefs trigger negative automatic thoughts which are believed, in cognitive behavior therapies, to be a source of psychopathology. Challenges brought about by symptoms of ADHD may lead to habitual emotion-eliciting thought patterns which, in turn, could lead to negative mood and disordered eating. Undergraduate students (N = 127) completed online questionnaires assessing ADHD symptoms and disordered eating and several potential mediators including irrational beliefs, depression, impulsivity, interoceptive accuracy, and reward responsiveness. The results, which were replicated in a second study (N = 254), indicated that irrational beliefs and depression mediated the relationship between ADHD symptoms and disordered eating. In the second study, impulsivity due to negative urgency was also a mediator. These findings support the theory that the symptoms of ADHD lead to enhancement of irrational beliefs, depression, and negative urgency which are linked to disordered eating.
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, NY, 10301, USA.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
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14
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Callen EF, Clay T, Alai J, Goodman DW, Adler LA, Faraone SV. The Role of Age in Adult ADHD Quality Care: A Longitudinal Analysis of Electronic Health Record Data. J Atten Disord 2024; 28:913-922. [PMID: 38156704 DOI: 10.1177/10870547231218042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Several studies have shown that Adult ADHD presents differently in younger and older adults. We sought to assess the difference in care between these two groups using previously identified quality measures (QMs). METHODS Using electronic health record data, we matched a younger group of ADHD patients to an older group. We then assessed the achievement of the QMs using probit models with and without interaction terms. RESULTS The majority of QMs shown an increase in achievement for both groups over time. However, significant differences in quality of care between younger and older adult ADHD patients persisted. By the end of the study period, with the exception of three QMs, younger patients achieved the QMs more. CONCLUSION While, in general, the quality of care for adult ADHD increased from 2010 to 2020, there were still differences in care between younger and older adult ADHD patients.
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Affiliation(s)
- Elisabeth F Callen
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - Tarin Clay
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - Jillian Alai
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - David W Goodman
- Johns Hopkins School of Medicine, Baltimore, MD, USA
- SUNY Upstate Medical University, Syracuse, USA
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15
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Xie T, Zhu B, Li HR, Xu JF, Mao Y. Educational attainment, income, and attention deficit hyperactivity disorder: A mediation analysis based on two-step Mendelian randomization. Soc Sci Med 2024; 345:116680. [PMID: 38394947 DOI: 10.1016/j.socscimed.2024.116680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/17/2023] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
Previous studies have reported the relationship between educational attainment and attention deficit hyperactivity disorder (ADHD). However, the mechanism of this relationship remains unknown. It is well known that educational attainment correlates with income. Therefore, based on summary data from a genome-wide association study we used two-step Mendelian randomization (MR) to explore the role of income between education and ADHD. The inverse variance weighted (IVW) method was used in our analysis. The IVW results suggested that educational attainment and income were protective factors against ADHD. Educational attainment affects ADHD through income [ADHD: Beta = -0.68, 95% confidence interval (CI) = -0.87, -0.49; female: Beta = -0.87, 95% CI = -1.28, -0.47; male: Beta = -1.01, 95% CI = -1.34, -0.68; childhood: Beta = -0.52, 95% CI = -0.74, -0.30; late-diagnosed: Beta = -0.78, 95% CI = -1.11, -0.47; persistent: Beta = -0.82, 95% CI = -1.33, -0.31]. Income also affected ADHD through educational attainment [female: Beta = -1.08, 95% CI = -1.35, -0.83; male: Beta = -1.16, 95% CI = -1.57, -0.77; persistent: Beta = -1.48, 95% CI = -2.09, -0.94]. In the final analysis, data with heterogeneity were analyzed using IVW random effects results. The mechanism is that income will mediate the relationship between educational attainment and ADHD.
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Affiliation(s)
- Tao Xie
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China.
| | - Hao-Ran Li
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Jin-Feng Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, 610041, China; West China School of Medicine, Sichuan University, Chengdu, 610041, China.
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
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16
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Custodio RJP, Hengstler JG, Cheong JH, Kim HJ, Wascher E, Getzmann S. Adult ADHD: it is old and new at the same time - what is it? Rev Neurosci 2024; 35:225-241. [PMID: 37813870 DOI: 10.1515/revneuro-2023-0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
Even though the number of studies aiming to improve comprehension of ADHD pathology has increased in recent years, there still is an urgent need for more effective studies, particularly in understanding adult ADHD, both at preclinical and clinical levels, due to the increasing evidence that adult ADHD is highly distinct and a different entity from childhood ADHD. This review paper outlines the symptoms, diagnostics, and neurobiological mechanisms of ADHD, with emphasis on how adult ADHD could be different from childhood-onset. Data show a difference in the environmental, genetic, epigenetic, and brain structural changes, when combined, could greatly impact the behavioral presentations and the severity of ADHD in adults. Furthermore, a crucial aspect in the quest to fully understand this disorder could be through longitudinal analysis. In this way, we will determine if and how the pathology and pharmacology of ADHD change with age. This goal could revolutionize our understanding of the disorder and address the weaknesses in the current clinical classification systems, improving the characterization and validity of ADHD diagnosis, specifically those in adults.
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Affiliation(s)
- Raly James Perez Custodio
- Networking Group Aging, Department of Ergonomics, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Ardeystrasse 67, Dortmund 44139, Germany
| | - Jan G Hengstler
- Systems Toxicology, Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Ardeystrasse 67, Dortmund 44139, Germany
| | - Jae Hoon Cheong
- Institute for New Drug Development, School of Pharmacy, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, South Korea
| | - Hee Jin Kim
- Uimyung Research Institute for Neuroscience, Department of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul 01795, South Korea
| | - Edmund Wascher
- Experimental Ergonomics, Department of Ergonomics, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Ardeystrasse 67, Dortmund 44139, Germany
| | - Stephan Getzmann
- Networking Group Aging, Department of Ergonomics, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Ardeystrasse 67, Dortmund 44139, Germany
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17
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Gimbach S, Vogel D, Fried R, Faraone SV, Banaschewski T, Buitelaar J, Döpfner M, Ammer R. ADHD medicine consumption in Europe after COVID-19: catch-up or trend change? BMC Psychiatry 2024; 24:112. [PMID: 38336744 PMCID: PMC10854136 DOI: 10.1186/s12888-024-05505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/06/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Although the COVID-19 pandemic and its implications have been associated with mental health services utilization and medication consumption, there is no longitudinal study on the long-term impact on ADHD medication use trends. METHODS This study examines the European ADHD medication consumption in 2020 to 2022 compared to the predicted consumption assuming the persistence of pre-pandemic trends. Predictions are calculated using Seasonal Autoregressive Integrated Moving Average (SARIMA) models. RESULTS While European ADHD medication sales recorded a drop in 2020, they returned to the predicted level in 2021, even slightly exceeding it. In 2022, we found a clear exceedance of the predicted level by 16.4% on average at country level. Furthermore, the increase in consumption growth in the post-pandemic period (2021-2022) compared to the pre-pandemic period (2014-2019) was significant in 26 of the 28 European countries under consideration. CONCLUSION There is strong evidence of a trend change in the ADHD medicine consumption growth throughout Europe after the COVID-19 pandemic.
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Affiliation(s)
- Sophie Gimbach
- Data Science Hub, MEDICE Arzneimittel Pütter GmbH & Co. KG, 58638, Iserlohn, Germany.
- Department of Statistics, TU Dortmund University, 44221, Dortmund, Germany.
| | - Daniel Vogel
- Data Science Hub, MEDICE Arzneimittel Pütter GmbH & Co. KG, 58638, Iserlohn, Germany
| | - Roland Fried
- Department of Statistics, TU Dortmund University, 44221, Dortmund, Germany
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Tobias Banaschewski
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, 6500 HB, The Netherlands
- Karakter Child and Adolescent Psychiatry, University Centre, Nijmegen, The Netherlands
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50969, Cologne, Germany
| | - Richard Ammer
- Data Science Hub, MEDICE Arzneimittel Pütter GmbH & Co. KG, 58638, Iserlohn, Germany
- Poliklinik und Innere Medizin, University Hospital Münster, 48149, Münster, Germany
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18
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Grevet EH, Bandeira CE, Vitola ES, de Araujo Tavares ME, Breda V, Zeni G, Teche SP, Picon FA, Salgado CAI, Karam RG, da Silva BS, Sibley MH, Rohde LA, Cupertino RB, Rovaris DL, Bau CHD. The course of attention-deficit/hyperactivity disorder through midlife. Eur Arch Psychiatry Clin Neurosci 2024; 274:59-70. [PMID: 36484846 DOI: 10.1007/s00406-022-01531-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
The course of ADHD from childhood up to young adulthood has been characterized in several studies. However, little is known about the course of symptoms into middle age and beyond. This study aims to evaluate predictors of ADHD trajectories in midlife based on three assessments. The follow-up sample comprised 323 adults with ADHD, evaluated at baseline and seven and thirteen years later, from the average ages of 34 up to 47 years old. ADHD status at reassessments was used to characterize trajectories. Demographics, ADHD features, comorbidities, and polygenic scores for ADHD and genetically correlated psychiatric disorders were evaluated to predict ADHD trajectories. Study retention rate was 67% at T2 (n = 216) and 62% at T3 (n = 199). Data from patients evaluated three times showed that 68.8% coursed stable, 25.5% unstable, and 5.7% remission trajectory of ADHD. Women, individuals with more severe syndromes, higher frequency of comorbidities at reassessments, and genetic liability to depression present a higher probability of a stable trajectory. Our findings shed light on midlife ADHD trajectories and their gender, genomic and clinical correlates.
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Affiliation(s)
- Eugenio Horacio Grevet
- Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratory of Developmental Psychiatry, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cibele Edom Bandeira
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Schneider Vitola
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Eduarda de Araujo Tavares
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vitor Breda
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory Zeni
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Stefania Pigatto Teche
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Almeida Picon
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Alberto Iglesias Salgado
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafael Gomes Karam
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Santos da Silva
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Margaret H Sibley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, USA
| | - Luis Augusto Rohde
- Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratory of Developmental Psychiatry, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renata Basso Cupertino
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Diego Luiz Rovaris
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas Universidade de Sao Paulo, São Paulo, Brazil
| | - Claiton Henrique Dotto Bau
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Laboratory of Developmental Psychiatry, Center of Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
- ADHD Outpatient Program, Clinical Research Center, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Department of Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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19
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Abstract
OBJECTIVE To hypothesise that a possible increased prevalence of adult-onset attention-deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD) may reflect mobile technology and digital media use being an aetiological factor. CONCLUSIONS Data and clinical observations support but do not prove the hypothesis.
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Affiliation(s)
- Gordon Parker
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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20
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Sanguineti C, Nisticò V, Folatti I, Santangelo G, Faggioli R, Bertani A, Gambini O, Demartini B. Toward an Increased Attention on ADHD Symptoms and Traits in Young Adults: Prevalence Data From Screening Tools in a Psychiatric Outpatient Clinic. J Atten Disord 2024; 28:151-160. [PMID: 37919945 DOI: 10.1177/10870547231201954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVE to analyze the prevalence of ADHD symptoms and traits in a heterogeneous clinical psychiatric sample of young adults (aged 18-24 years old), who referred to a specialized outpatient clinic for various psychiatric and psychological disturbances. METHOD 259 participants completed three validated self-report screening questionnaires for ADHD: the Wender Utah Rating Scale (WURS), the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 (ASRS-5), and the Conners' adult ADHD rating scale (CAARS). RESULTS 12.4% of our sample scored above the cut-off at both the WURS and the ASRS-5 and was considered at risk of ADHD. CONCLUSION the prevalence rate in our sample is higher than the one found in the adult general population (6.76%), and in the lower range of the one found in the adult clinical population (6.9%-38.8%). The potential role of sociodemographic (age, sex, gender identity, and employment) and comorbidity factors is discussed.
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Affiliation(s)
- Claudio Sanguineti
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italy
| | - Veronica Nisticò
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italy
- Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, Italy
- Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Italy
| | - Irene Folatti
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italy
| | - Giulia Santangelo
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italy
| | - Raffaella Faggioli
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Angelo Bertani
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Orsola Gambini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italy
- Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Italy
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Benedetta Demartini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italy
- Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Italy
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
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21
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Buitelaar J. Controversies about ADHD: Early or also late-onset? Neurodevelopmental or also stress-related? Eur Neuropsychopharmacol 2023; 77:1-3. [PMID: 37659132 DOI: 10.1016/j.euroneuro.2023.08.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/15/2023] [Indexed: 09/04/2023]
Affiliation(s)
- Jan Buitelaar
- Dept Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, P.O. Box 9101 (204), 6500 HB Nijmegen, the Netherlands.
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22
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Jurek L, Montègue S, Larrieu A, Icard C, Rolland B. Compared Profile of Late-Onset Versus Childhood-Onset ADHD: A Case-Control Study Among Treatment-Seeking Adult Patients. J Atten Disord 2023; 27:1630-1637. [PMID: 37565344 DOI: 10.1177/10870547231191756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To compare the characteristics of childhood-onset versus late-onset Attention Deficit Hyperactivity Disorder (ADHD) in a sample of treatment-seeking patients. METHOD Among total of 101 adult patients who were recently diagnosed for ADHD, using the Diagnostic Interview for Adult ADHD (DIVA 2.0), 56 subjects exhibited childhood-onset ADHD, versus 45 displayed late-onset ADHD. Both groups were compared according to their sociodemographic, clinical, and neuropsychological features, providing crude (OR) and adjusted odds ratios (aOR), and their 95% confidence intervals [95% CI]. RESULTS Compared to late-onset ADHD, patients with childhood-onset had a lower educational score, (OR = 0.52; 95% CI [0.35, 0.76]), a greater score of impulsivity (aOR = 1.09; 95% CI [1.03, 1.16]), an increased number of hyperactive-impulsive ADHD symptoms (aOR = 1.9; 95% CI [1.46, 2.47]), and higher rates childhood trauma (aOR = 1.07; 95% CI [1.01, 1.13]), cannabis use disorder (aOR = 1.07; 95% CI [1.01, 1.13]), and working memory impairment. No difference was observed concerning age, sex, psychiatric symptoms, quality of life, and autonomy. CONCLUSION Childhood-onset adult ADHD displayed a more severe profile, relative to late-onset ADHD.
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Affiliation(s)
- Lucie Jurek
- Centre Hospitalier Le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
| | | | | | | | - Benjamin Rolland
- Centre Hospitalier Le Vinatier, Bron, France
- Hospices Civils de Lyon, Lyon, France
- Centre de Recherche en Neurosciences de Lyon, Bron, France
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23
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Shakeshaft A, Heron J, Blakey R, Riglin L, Smith GD, Stergiakouli E, Tilling K, Thapar A. Co-development of attention deficit hyperactivity disorder and autistic trait trajectories from childhood to early adulthood. J Child Psychol Psychiatry 2023; 64:1596-1607. [PMID: 37350028 PMCID: PMC7615536 DOI: 10.1111/jcpp.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and autism, defined as traits or disorders, commonly co-occur. Developmental trajectories of ADHD and autistic traits both show heterogeneity in onset and course, but little is known about how symptom trajectories co-develop into adulthood. METHODS Using data from a population cohort, the Avon Longitudinal Study of Parents and Children, we examined correlations between ADHD and autistic traits across development, using the Social Communication Disorders Checklist and ADHD subscale of the Strengths and Difficulties Questionnaire. We modelled joint developmental trajectories of parent-reported ADHD and autistic traits between 4 and 25 years, then characterised trajectory classes based on sociodemographic, perinatal, psychopathology, cognition and social functioning variables and tested for associations with neurodevelopmental/psychiatric polygenic scores (PGS). RESULTS Three classes of trajectories were identified; a typically developing majority with low-stable ADHD-autistic traits (87%), a male-predominant subgroup with child/adolescent-declining traits (6%) and a subgroup with late-emerging traits (6%). ADHD-autistic trait correlations were greatest in young adulthood for the two nontypically developing classes. There were higher rates of emotional and conduct problems, low IQ, childhood seizures and poor social functioning in the declining and late-emerging classes compared to the low-stable class. Emotional, conduct and peer problems were more prevalent during childhood in the childhood/adolescent-declining class compared to other classes, but were more prevalent in young adulthood in the late-emerging class. Neurodevelopmental/psychiatric PGS also differed: both nontypically developing classes showed elevated ADHD PGS compared to the low-stable group, and the late-emerging group additionally showed elevated schizophrenia PGS and decreased executive function PGS, whereas the declining group showed elevated broad depression PGS. CONCLUSIONS Distinct patterns of ADHD-autism co-development are present across development in the general population, each with different characterising factors and genetic signatures as indexed by PGS.
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Affiliation(s)
- Amy Shakeshaft
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Jon Heron
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rachel Blakey
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - George Davey Smith
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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24
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Lundervold AJ, Sørensen L, Posserud MB, Hysing M. Low Persistence of Inattention Symptoms From Childhood to Adolescence: A Population-Based Study. J Atten Disord 2023; 27:1532-1539. [PMID: 37496456 PMCID: PMC10552345 DOI: 10.1177/10870547231187147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To investigate the persistence of dimensional measures of inattention in a population-based, gender-balanced sample of adolescents with parent reports of inattention from childhood and self-reports of inattention in adolescence. METHOD Adolescents, 16-19 years old, completed the Adult ADHD Self Report Scale. Their parents completed the Swanson, Nolan, and Pelham Rating Scale-4th Edition when they were 7-9 and 11-13 years old. RESULTS More severe inattention in boys than girls in childhood shifted to a female predominance in adolescence. The correlation between reports of inattention in childhood and adolescence was weak, with parent reports explaining only ~5% of the variance in the inattention score reported in adolescence. CONCLUSION The weak association between inattention in childhood and adolescence is consistent with the emerging challenges associated with being an adolescent, but the impact of shifts in informants, gender and age on symtpom presentations should be investigated in future studies.
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Affiliation(s)
| | | | - Maj-Britt Posserud
- University of Bergen, Norway
- Haukeland University Hospital, Bergen, Norway
| | - Mari Hysing
- University of Bergen, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
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25
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Levine SZ, Rotstein A, Kodesh A, Sandin S, Lee BK, Weinstein G, Schnaider Beeri M, Reichenberg A. Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia. JAMA Netw Open 2023; 6:e2338088. [PMID: 37847497 PMCID: PMC10582792 DOI: 10.1001/jamanetworkopen.2023.38088] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/02/2023] [Indexed: 10/18/2023] Open
Abstract
Importance Evidence that adult attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk of dementia is scarce and inconsistent, and potential sources of bias are untested. Objective To examine the association between adult ADHD and the risk of dementia. Design, Setting, and Participants This prospective national cohort study consisted of 109 218 members of a nonprofit Israeli health maintenance organization born between 1933 and 1952 who entered the cohort on January 1, 2003, without an ADHD or dementia diagnosis and were followed up to February 28, 2020. Participants were aged 51 to 70 years in 2003. Statistical analysis was conducted from December 2022 to August 2023. Exposure Adult ADHD was a time-varying covariate, classified as present from the age of the first diagnosis (using the International Classification of Diseases, Ninth Revision, and the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision); otherwise, absent. Main Outcome and Measures Cox regression models were fitted to quantify the association between adult ADHD and the risk of incident dementia with hazard ratios (HRs) and their 95% CIs unadjusted and in the primary analysis, using inverse probability weights, adjusted for 18 sources of potential confounding. In 14 complementary analyses, subgroup and sensitivity analyses were implemented. Results At the beginning of the follow-up, the sample of 109 218 participants had a mean (SD) age of 57.7 (5.5) years, 56 474 participants (51.7%) were female, and 52 744 (48.3%) were male. During follow-up, 730 participants (0.7%) received a diagnosis of adult ADHD, and 7726 (7.1%) received a diagnosis of dementia. Dementia occurred among 96 of 730 participants (13.2%) with adult ADHD and 7630 of 108 488 participants (7.0%) without adult ADHD. In the primary analysis, compared with the absence of adult ADHD, the presence of adult ADHD was statistically significantly (P < .001) associated with an increased dementia risk (unadjusted HR, 3.62 [95% CI, 2.92-4.49; P < .001]; adjusted HR, 2.77 [95% CI, 2.11-3.63; P < .001]). Twelve of the 14 complementary analyses did not attenuate the conclusions based on the results of the primary analysis. There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild. Conclusions and Relevance In this cohort study of individuals born between 1933 and 1952 and followed up in old age, adult ADHD was associated with an increased risk of dementia. Policy makers, caregivers, patients, and clinicians may wish to monitor reliably for ADHD in old age.
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Affiliation(s)
| | - Anat Rotstein
- Department of Gerontology, University of Haifa, Haifa, Israel
| | - Arad Kodesh
- Mental Health, Meuhedet Health Services, Tel Aviv, Israel
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian K. Lee
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | | | - Michal Schnaider Beeri
- The Herbert and Jacqueline Krieger Klein Alzheimer’s Research Center, Brain Health Institute, Rutgers University, Piscataway, New Jersey
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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26
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Cervin M. Developmental signs of ADHD and autism: a prospective investigation in 3623 children. Eur Child Adolesc Psychiatry 2023; 32:1969-1978. [PMID: 35748938 PMCID: PMC10533573 DOI: 10.1007/s00787-022-02024-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/03/2022] [Indexed: 12/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are neurodevelopmental disorders with an early onset. Guidelines recommend a careful evaluation of developmental history when assessing the disorders, but it is unclear how children with ADHD and ASD differ from their peers growing up. In this study, physical, family, psychological, social, and educational information were examined in 3623 ethnically diverse children that were prospectively followed from birth to age 15 as part of the Fragile Families and Child Wellbeing Study. Fifteen-thousand variables were screened, and 506 variables included in the final analyses. Accuracy of the most indicative information to predict ADHD and ASD diagnoses in adolescence was evaluated. Adolescents with ADHD (n = 627) and ASD (n = 91) differed from their peers on a plethora of developmental signs, with signs closely related to the core symptoms of the disorders after age 5 being most indicative of the disorders. Predictive models correctly identified 66% of individuals with ADHD and 81% of those with ASD, but 62-88% of identified cases were false positives. The mean proportion of developmental deviations was 18.7% in the ADHD group, 20.0% in the ASD group, and 15.6% in peers; youth with both ADHD and ASD (n = 50) deviated on 21.8% of all developmental signs and had more pronounced deviations than those with ADHD or ASD alone. ADHD and ASD are characterized by broad and non-specific developmental deviations. Developmental information alone cannot be used to accurately predict diagnostic status in adolescence and false positives are likely if the diagnostic process relies heavily on such information. Developmental deviations are part of normal development and common in children without ADHD and ASD. Etiological heterogeneity and considerable temporal fluctuation in the core characteristics of ADHD and ASD may explain the lack of distinct developmental patterns.
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Affiliation(s)
- Matti Cervin
- Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Sofiavägen 2D, 22241, Lund, Sweden.
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27
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Conway CC, Kotov R, Krueger RF, Caspi A. Translating the hierarchical taxonomy of psychopathology (HiTOP) from potential to practice: Ten research questions. AMERICAN PSYCHOLOGIST 2023; 78:873-885. [PMID: 36227328 PMCID: PMC10097839 DOI: 10.1037/amp0001046] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a novel diagnostic system grounded in empirical research into the architecture of mental illness. Its basic units are continuous dimensions-as opposed to categories-that are organized into a hierarchy according to patterns of symptom co-occurrence observed in quantitative studies. Previous HiTOP discussions have focused on existing evidence regarding the model's structure and ability to account for neurobiological, social, cultural, and clinical variation. The present article looks ahead to the next decade of applied research and clinical practice using the HiTOP rubric. We highlight 10 topics where HiTOP has the potential to make significant breakthroughs. Research areas include genetic influences, environmental contributions, neural mechanisms, real-time dynamics, and lifespan development of psychopathology. We also discuss development of novel assessments, forecasting methods, and treatments. Finally, we consider implications for clinicians and educators. For each of these domains, we propose directions for future research and venture hypotheses as to what HiTOP will reveal about psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Roman Kotov
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert F. Krueger
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA
- Social, Genetic, and Developmental Psychiatry Research Centre, King’s College London, London, United Kingdom
- PROMENTA Center, University of Oslo, Oslo, Norway
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28
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Tallberg P, Rastam M, Hallin AL, Perrin S, Gustafsson P. A longitudinal investigation of parental ratings and performance metrics for executive functioning and symptom severity in clinically referred youth with ADHD. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:259-271. [PMID: 36126650 DOI: 10.1080/21622965.2022.2093113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There remains a knowledge gap concerning the persistence of attention deficit hyperactivity disorder (ADHD) over the longer term. The current study aimed to investigate the change in parent-rated, and performance-based metrics of executive functioning (EF) and the relationship between these EF metrics and ADHD symptoms in individuals with ADHD from childhood/adolescence to young adulthood. This was done by examining possible improvements in parent-rated EF and performance-based measures of inattention and inhibition over a three-year interval and their relationship to ADHD outcomes in 137 clinically referred youth with ADHD (mean age = 12.4 years, SD = 3.1). Participants' parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Swanson-Nolan-Pelham Scale at baseline and follow-up. Participants completed the Conners' Continuous Performance Test, Version II (CPT II) at baseline and follow-up. Statistical analyses were performed with Linear Mixed Models. The sex- and age-standardized measures Commission and Hit reaction time (RT) subscales of the CPT II and parent-rated metacognitive, and behavior regulation composites of the BRIEF were largely stable between measuring points. CPT Omissions, Hit RT standard error (reaction time variability), and parent-rated ADHD symptom scores improved slightly. BRIEF composites and reaction time variability were related to ADHD symptoms using longitudinal data. Overall, behavioral aspects of EF, as observed by parents in the home context, appear to play a significant role in the trajectory of childhood ADHD.
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Affiliation(s)
- Pia Tallberg
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Maria Rastam
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Psychiatry and Neurochemistry, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Anne-Li Hallin
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
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29
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Wechsler DL, Rijsdijk FV, Adamo N, Eilertsen EM, Ahmadzadeh YI, Badini I, Hannigan LJ, Ystrom E, McAdams TA. Assessing aetiological overlap between child and adult attention-deficit hyperactivity disorder symptoms in an extended family design. BJPsych Open 2023; 9:e169. [PMID: 37671545 PMCID: PMC10617499 DOI: 10.1192/bjo.2023.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 06/19/2023] [Accepted: 07/26/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Several longitudinal studies have cast doubt on the aetiological overlap between child and adult attention-deficit hyperactivity disorder (ADHD). However, a lack of genetically sensitive data following children across adulthood precludes direct evaluation of aetiological overlap between child and adult ADHD. AIMS We circumvent the existing gap in longitudinal data by exploring genetic overlap between maternal (adult) and offspring (child) ADHD and comorbid symptoms in an extended family cohort. METHOD Data were drawn from the Norwegian Mother, Father and Child Cohort Study, a Norwegian birth registry cohort of 114 500 children and their parents. Medical Birth Registry of Norway data were used to link extended families. Mothers self-reported their own ADHD symptoms when children were aged 3 years; reported children's ADHD symptoms at age 5 years; and children's ADHD, oppositional defiant disorder (ODD), conduct disorder, anxiety and depression symptoms at age 8 years. Genetic correlations were derived from Multiple-Children-of-Twins-and-Siblings and extended bivariate twin models. RESULTS Phenotypic correlations between adult ADHD symptoms and child ADHD, ODD, conduct disorder, anxiety and depression symptoms at age 8 years were underpinned by medium-to-large genetic correlations (child ADHD: rG = 0.55, 95% CI 0.43-0.93; ODD: rG = 0.80, 95% CI 0.46-1; conduct disorder: rG = 0.44, 95% CI 0.28-1; anxiety: rG = 0.72, 95% CI 0.48-1; depression: rG = 1, 95% CI 0.66-1). These cross-generational adult-child genetic correlations were of a comparable magnitude to equivalent child-child genetic correlations with ADHD symptoms at age 5 years. CONCLUSIONS Our findings provide genetically sensitive evidence that ADHD symptoms in adulthood share a common genetic architecture with symptoms of ADHD and four comorbid disorders at age 8 years. These findings suggest that in the majority of cases, ADHD symptoms in adulthood are not aetiologically distinct from in childhood.
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Affiliation(s)
- Daniel L. Wechsler
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Fruhling V. Rijsdijk
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Psychology, Faculty of Social Sciences, Anton de Kom University, Suriname
| | - Nicoletta Adamo
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Espen M. Eilertsen
- PROMENTA Research Centre, University of Oslo, Norway; and Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Yasmin I. Ahmadzadeh
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Isabella Badini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Laurie J. Hannigan
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; and Medical Research Council Integrative Epidemiology Unit, University of Bristol, UK
| | - Eivind Ystrom
- PROMENTA Research Centre, University of Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; and School of Pharmacy, University of Oslo, Norway
| | - Tom A. McAdams
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and PROMENTA Research Centre, University of Oslo, Norway
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30
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Mustonen A, Rodriguez A, Scott JG, Vuori M, Hurtig T, Halt A, Miettunen J, Alakokkare A, Niemelä S. Attention deficit hyperactivity and oppositional defiant disorder symptoms in adolescence and risk of substance use disorders-A general population-based birth cohort study. Acta Psychiatr Scand 2023; 148:277-287. [PMID: 37431766 PMCID: PMC10953420 DOI: 10.1111/acps.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/29/2023] [Accepted: 06/12/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Externalizing symptoms are associated with risk of future substance use disorder (SUD). Few longitudinal studies exist using general population-based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms. AIMS/OBJECTIVES We aimed to study the associations between adolescent ADHD symptoms and subsequent SUD and additionally examine whether the risk of SUD is influenced by comorbid oppositional defiant disorder (ODD) symptoms. METHODS The Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33 years (n = 6278, 49.5% male). ADHD/ODD-case status at age 16 years was defined using parent-rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut-off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD/ODD case status. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD/ODD case statuses and subsequent SUD. RESULTS In all, 552 participants (8.8%) presented with ADHD case status at the age of 16 years, and 154/6278 (2.5%) were diagnosed with SUD during the follow-up. ADHD case status was associated with SUD during the follow-up (HR = 3.84, 95% CI 2.69-5.50). After adjustments for sex, family structure, and parental psychiatric disorder and early substance use the association with ADHD case status and SUD remained statistically significant (HR = 2.60, 95% CI 1.70-3.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms. CONCLUSIONS ADHD in adolescence was associated with incident SUD in those with and without symptoms of ODD. The association of ADHD and SUD persisted even after adjustment for a wide range of potential confounds. This emphasizes the need to identify preventative strategies for adolescents with ADHD so as to improve health outcomes.
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Affiliation(s)
- Antti Mustonen
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
- Department of PsychiatrySeinäjoki Central HospitalSeinäjokiFinland
- Research Unit of Population HealthUniversity of OuluOuluFinland
| | - Alina Rodriguez
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial CollegeLondonUK
- Centre for Psychiatry and Mental HealthQueen Mary UniversityLondonUK
| | - James G. Scott
- Child Health Research CentreThe University of QueenslandSouth BrisbaneQueenslandAustralia
- Child and Youth Mental HealthChildren's Health QueenslandSouth BrisbaneQueenslandAustralia
| | - Miika Vuori
- Research Center for Child Psychiatry, INVEST Research FlagshipUniversity of TurkuTurkuFinland
- The Finnish Institute for Health and WelfareHelsinkiFinland
| | - Tuula Hurtig
- Research Unit of Clinical Medicine, PsychiatryUniversity of OuluOuluFinland
- Clinic of Child PsychiatryOulu University HospitalOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | - Anu‐Helmi Halt
- Research Unit of Clinical Medicine, PsychiatryUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Department of PsychiatryOulu University HospitalOuluFinland
| | - Jouko Miettunen
- Research Unit of Population HealthUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | | | - Solja Niemelä
- Department of PsychiatryUniversity of TurkuTurkuFinland
- Addiction Psychiatry Unit, Department of PsychiatryTurku University HospitalTurkuFinland
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31
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Wiebe A, Aslan B, Brockmann C, Lepartz A, Dudek D, Kannen K, Selaskowski B, Lux S, Ettinger U, Philipsen A, Braun N. Multimodal assessment of adult attention-deficit hyperactivity disorder: A controlled virtual seminar room study. Clin Psychol Psychother 2023; 30:1111-1129. [PMID: 37209018 DOI: 10.1002/cpp.2863] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/29/2023] [Indexed: 05/21/2023]
Abstract
In the assessment of adult attention-deficit hyperactivity disorder (ADHD) symptoms, the diagnostic value of neuropsychological testing is limited. Partly, this is due to the rather low ecological validity of traditional neuropsychological tests, which usually present abstract stimuli on a computer screen. A potential remedy for this shortcoming might be the use of virtual reality (VR), which enables a more realistic and complex, yet still standardized test environment. The present study investigates a new VR-based multimodal assessment tool for adult ADHD, the virtual seminar room (VSR). Twenty-five unmedicated ADHD patients, 25 medicated ADHD patients, and 25 healthy controls underwent a virtual continuous performance task (CPT) in the VSR with concurrent visual, auditive, and audiovisual distractions. Simultaneously, head movements (actigraphy), gaze behaviour (eye tracking), subjective experience, electroencephalography (EEG), and functional near-infrared spectroscopy (fNIRS) were recorded. Significant differences between unmedicated patients with ADHD and healthy controls were found in CPT performance, head actigraphy, distractor gaze behaviour, and subjective experience. Moreover, CPT performance parameters demonstrated potential utility for assessing medication effects within the ADHD population. No group differences were found in the Theta-Beta-Ratio (EEG) or dorsolateral-prefrontal oxy-haemoglobin (fNIRS). Overall, the results are very promising regarding the potential of the VSR as an assessment tool for adult ADHD. In particular, the combined assessment of CPT, actigraphy, and eye tracking parameters appears to be a valid approach to more accurately capture the heterogeneous symptom presentation of the disorder.
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Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Behrem Aslan
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Charlotte Brockmann
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Lepartz
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Dominika Dudek
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | | | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
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32
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He Q, Keding TJ, Zhang Q, Miao J, Russell JD, Herringa RJ, Lu Q, Travers BG, Li JJ. Neurogenetic mechanisms of risk for ADHD: Examining associations of polygenic scores and brain volumes in a population cohort. J Neurodev Disord 2023; 15:30. [PMID: 37653373 PMCID: PMC10469494 DOI: 10.1186/s11689-023-09498-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND ADHD polygenic scores (PGSs) have been previously shown to predict ADHD outcomes in several studies. However, ADHD PGSs are typically correlated with ADHD but not necessarily reflective of causal mechanisms. More research is needed to elucidate the neurobiological mechanisms underlying ADHD. We leveraged functional annotation information into an ADHD PGS to (1) improve the prediction performance over a non-annotated ADHD PGS and (2) test whether volumetric variation in brain regions putatively associated with ADHD mediate the association between PGSs and ADHD outcomes. METHODS Data were from the Philadelphia Neurodevelopmental Cohort (N = 555). Multiple mediation models were tested to examine the indirect effects of two ADHD PGSs-one using a traditional computation involving clumping and thresholding and another using a functionally annotated approach (i.e., AnnoPred)-on ADHD inattention (IA) and hyperactivity-impulsivity (HI) symptoms, via gray matter volumes in the cingulate gyrus, angular gyrus, caudate, dorsolateral prefrontal cortex (DLPFC), and inferior temporal lobe. RESULTS A direct effect was detected between the AnnoPred ADHD PGS and IA symptoms in adolescents. No indirect effects via brain volumes were detected for either IA or HI symptoms. However, both ADHD PGSs were negatively associated with the DLPFC. CONCLUSIONS The AnnoPred ADHD PGS was a more developmentally specific predictor of adolescent IA symptoms compared to the traditional ADHD PGS. However, brain volumes did not mediate the effects of either a traditional or AnnoPred ADHD PGS on ADHD symptoms, suggesting that we may still be underpowered in clarifying brain-based biomarkers for ADHD using genetic measures.
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Affiliation(s)
- Quanfa He
- Department of Psychology, University of, Wisconsin-Madison, 1202 W. Johnson Street, Madison, WI, 53706, USA
- Waisman Center, University of Wisconsin-Madison, Madison, USA
| | | | - Qi Zhang
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, USA
| | - Jiacheng Miao
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, USA
| | - Justin D Russell
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Ryan J Herringa
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, USA
- Department of Statistics, University of Wisconsin-Madison, Madison, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, Madison, USA
- Department of Kinesiology, University of Wisconsin-Madison, Madison, USA
| | - James J Li
- Department of Psychology, University of, Wisconsin-Madison, 1202 W. Johnson Street, Madison, WI, 53706, USA.
- Waisman Center, University of Wisconsin-Madison, Madison, USA.
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, USA.
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33
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Dobrosavljevic M, Larsson H, Cortese S. The diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) in older adults. Expert Rev Neurother 2023; 23:883-893. [PMID: 37725058 DOI: 10.1080/14737175.2023.2250913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION There is a striking knowledge gap on ADHD in older adults, and the diagnosis as well as treatment for ADHD in this age group. AREAS COVERED The authors first review the literature on the prevalence, functional impairment, and health comorbidities of ADHD across the lifespan. Next, they address the diagnostic criteria for ADHD in adults according to the DSM/ICD, available screening/diagnostic tools, differential diagnosis, and the validity of diagnostic criteria for ADHD in older adults. Finally, the authors focus on empirical evidence on the prevalence rates, medication response, and safety of pharmacological treatment of ADHD in older adults, and national and international clinical guidelines on the treatment of ADHD in this age group. EXPERT OPINION It is expected that future editions of the DSM and ICD will provide specifiers to the standard ADHD criteria, to better inform the diagnosis of ADHD in older adults. It is also expected that the increasing number of epidemiological studies will provide rigorous estimates on the prevalence, incidence, and burden of ADHD in older adults. One may expect an increasing number of RCTs assessing the efficacy/effectiveness and tolerability/safety of pharmacological as well as non-pharmacological interventions which will inform future guidelines on ADHD in older adults.
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Affiliation(s)
- Maja Dobrosavljevic
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Life and Environmental Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham, UK
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York, NY, USA
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34
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Bertschy G, Martz E, Weibel S, Weiner L. Psychopathological Dissection of Bipolar Disorder and ADHD: Focussing on Racing Thoughts and Verbal Fluency . Neuropsychiatr Dis Treat 2023; 19:1153-1168. [PMID: 37197328 PMCID: PMC10184890 DOI: 10.2147/ndt.s401330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/27/2023] [Indexed: 05/19/2023] Open
Abstract
In the present study, we propose a review and a synthesis of the work of our group about the phenomenology and the cognitive mechanisms of racing thoughts in bipolar disorder (BD) and ADHD. Contrary to the mainstream idea according to which racing thoughts are pathognomonic of BD, our work suggests that racing thoughts are enhanced in ADHD compared to hypomanic episodes of BD, whereas in euthymic episodes of BD self-reported racing thoughts are similar to the rates reported by healthy controls. Using verbal fluency tasks, we found many similarities between bipolar and ADHD subjects with one clear difference: lexical search strategy in hypomania is based on phonemic similarities rather than semantic-relatedness. However, this distinction observed in this cognitive task is certainly difficult to grasp during a clinical interview aiming to differentiate mild hypomania from combined ADHD presentation. The main landmark to distinguish them remains the episodic nature of bipolar disorders as opposed to the lifelong presentation of ADHD symptoms, a dichotomous view that is not so clear-cut in clinical practice.
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Affiliation(s)
- Gilles Bertschy
- Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France
- INSERM U1114, Strasbourg, F-67000, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, F-67000, France
| | | | - Sebastien Weibel
- Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France
- INSERM U1114, Strasbourg, F-67000, France
| | - Luisa Weiner
- Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France
- Laboratoire de Psychologie des Cognitions, Strasbourg, F-67000, France
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, F-67000, France
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35
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Adamis D, Fox N, de M de Camargo APP, Saleem F, Gavin B, McNicholas F. Prevalence of attention deficit hyperactivity disorder in an adult mental health service in the Republic of Ireland. Int J Psychiatry Med 2023; 58:130-144. [PMID: 35654762 DOI: 10.1177/00912174221106826] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Attention Deficit Hyperactivity Disorder (ADHD) is well recognised in childhood. However, recognition that it commonly persists into adulthood is relatively recent. This study is the 2nd phase of a two-phase epidemiological investigation of the prevalence of adult ADHD in outpatients in Ireland. METHOD In phase-1, 634 participants were screened with Adult ADHD Self-Report Scale (ASRS) and Wender Utah Rating Scale (WURS). Those scoring positive in both scales have been invited to participate in the 2nd phase where the scales Conners' Adult ADHD Diagnostic Interview (CAADID), Mini International Neuropsychiatric Interview (MINI), and Global Assessment of Functioning (GAF) were administered, plus clinical evaluation based in DSM-5. RESULTS 131 were eligible, 110 participated (84.0%). Using the CAADID (DSM-IV criteria) 71 were diagnosed with ADHD. Projecting to the total sample (N = 634) the prevalence was 13.25%, CI:95%:10.71-16.14. Converting the DSM-IV criteria to DSM-5, 89 had ADHD (prevalence:16.72%, CI: 13.9-19.86). Using clinical evaluation, 86 were diagnosed with ADHD (prevalence:16.09%, CI:13.31-19.18). Only 3 cases were diagnosed before with ADHD. Comorbidity was higher in those with ADHD, with the median number of additional diagnoses 2 (min 0 max 8, IQR 3) Also, they had significantly higher rates of depression and recurred depression. Agreement between DSM-IV and DSM-5 was high (rho = 0.90, p < .0001). CONCLUSIONS High rates of undiagnosed ADHD were found to be present among AMHS attendees. Clinicians in AMHS need to be knowledgeable and alert to possible ADHD among their caseloads, and offer appropriate intervention. Interventions are urgently required to increase the detection and treatment of adult ADHD.
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Affiliation(s)
- Dimitrios Adamis
- School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland.,603698Sligo Mental Health Services, Sligo, Ireland.,Research and Academic Institute of Athens, Greece
| | - Naoimh Fox
- 603698Sligo Mental Health Services, Sligo, Ireland.,Adult mental health in Newcastle upon Tyne, Newcastle, UK
| | - Ana Paula P de M de Camargo
- 603698Sligo Mental Health Services, Sligo, Ireland.,Professor in Psychology Dublin Business School, Dublin, Ireland
| | | | - Blánaid Gavin
- School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
| | - Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland.,CHI, Crumlin, Lucena SJOG, Dublin, Ireland
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36
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Hoffmann MS, Evans-Lacko S, Collishaw S, Knapp M, Pickles A, Shearer C, Maughan B. Parent- and teacher-reported associations from adolescent bifactor models of psychopathology: an outcome-wide association study of 26 outcomes in mid-life. J Child Psychol Psychiatry 2023; 64:397-407. [PMID: 36151972 DOI: 10.1111/jcpp.13707] [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] [Accepted: 08/31/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescent mental health problems have lasting impacts on health and social functioning later in life. Evidence to date mostly comes from studies of specific diagnostic categories/dimensions, but hierarchical models can elucidate associations with general as well as specific dimensions of psychopathology. We provide evidence on long-term outcomes of general and specific dimensions of adolescent psychopathology using both parent and teacher reports. METHODS Parents and teachers from the Isle of Wight study completed Rutter behaviour scales when participants were 14-15 years old (n = 2,275), assessing conduct, emotional and hyperactivity problems. Metric-invariant bifactor models for parents and teachers were used to test domain-specific and domain-general associations with 26 self-reported psychosocial outcomes at mid-life (age 44-45 years, n = 1,423). Analyses examined the individual and joint contributions of parent and teacher reports of adolescent psychopathology. All analyses were adjusted for covariates (gender, IQ and family social class) and weighted to adjust for the probability of nonresponse. RESULTS Parent- and teacher-reported general factors of psychopathology (GFP) were associated with 15 and 12 outcomes, respectively, across the socioeconomic, relationship, health and personality domains, along with an index of social exclusion. Nine outcomes were associated with both parent- and teacher-reported GFP, with no differences in the strength of the associations across reporters. Teacher-reported specific factors (conduct, emotional and hyperactivity) were associated with 21 outcomes, and parent-reported specific factors were associated with seven. Five outcomes were associated with the same specific factors from both reporters; only one showed reporter differences in the strength of the associations. CONCLUSIONS These findings confirm the relevance of the GFP and the utility of teacher as well as parent reports of adolescent mental health in predicting psychosocial outcomes later in the life course.
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Affiliation(s)
- Mauricio Scopel Hoffmann
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.,Department of Neuropsychiatry, Universidade Federal de Santa Maria, Santa Maria, Brazil.,Graduation program in Psychiatry and Behavioural Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christina Shearer
- Child and Adolescent Mental Health Service, South West London and St George's Mental Health NHS Trust, London, UK
| | - Barbara Maughan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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37
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Torenvliet C, Groenman AP, Radhoe TA, Agelink van Rentergem JA, Van der Putten WJ, Geurts HM. A longitudinal study on cognitive aging in autism. Psychiatry Res 2023; 321:115063. [PMID: 36709700 DOI: 10.1016/j.psychres.2023.115063] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
Longitudinal studies on cognitive aging in autism are scarce, and largely underpowered, yet essential to obtain more conclusive results on cognitive changes in autism during adulthood. In the largest longitudinal study on cognition thus far, we aimed to get more insight into cognitive aging in autism. As pre-registered, we computed reliable change indices (RCIs) and multilevel models to estimate cognitive changes in 128 autistic, and 112 non-autistic adults (range: 24-85 yrs.) over two to three timepoints (average interval: 3.5 yrs.). Participants were tested on 15 outcome measures, covering verbal memory, visual (working) memory, prospective memory, theory of mind, fluency, response speed, inhibition, planning, and switching. RCIs showed no significant differences between groups (autism/no-autism) in changes over time. Using multilevel models, most tasks showed sensitivity to cross-sectional age-related effects, and/or longitudinal changes, with worse performance at older age, and later timepoints. However, effects were not significantly different between the autism and no-autism group. This lack of group differences was substantiated by additional Bayesian analyses. In sum, the current study provides evidence for parallel (similar) cognitive aging in autism. Specifically, autistic individuals diagnosed in adulthood, without intellectual disability, do not seem at risk for accelerated cognitive decline.
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Affiliation(s)
- C Torenvliet
- Dutch Autism and ADHD Research Center, Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | - A P Groenman
- Dutch Autism and ADHD Research Center, Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Research Institute Child Development and Education, University of Amsterdam, the Netherlands
| | - T A Radhoe
- Dutch Autism and ADHD Research Center, Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - J A Agelink van Rentergem
- Dutch Autism and ADHD Research Center, Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - W J Van der Putten
- Dutch Autism and ADHD Research Center, Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Leo Kannerhuis, autism clinic (Youz/Parnassia Group), Amsterdam, the Netherlands
| | - H M Geurts
- Dutch Autism and ADHD Research Center, Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Leo Kannerhuis, autism clinic (Youz/Parnassia Group), Amsterdam, the Netherlands
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38
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Müller M, Turner D, Barra S, Rösler M, Retz W. ADHD and associated psychopathology in older adults in a German community sample. J Neural Transm (Vienna) 2023; 130:313-323. [PMID: 36617378 PMCID: PMC10033550 DOI: 10.1007/s00702-022-02584-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is still a neglected disorder in older adults. The aim of the present study was to examine the prevalence and symptomatology of ADHD and associated psychopathology in adults aged 40-80 years in a German community sample. We examined 539 participants in two age groups: (1) 40-59 years old (n = 256) and (2) 60-80 years old (n = 283). To assess ADHD in both childhood and adulthood as well as current psychopathological impairments, we used self-report instruments and corresponding observer reports. We examined group differences between age groups and between ADHD and non-ADHD groups. The prevalence of ADHD in the total sample was 2.6% with no significant differences between the two age groups (40-59 years: 3.1% vs. 60-80 years: 2.1%). Although differences emerged in impulsivity/emotional lability and self-concept problems, overall ADHD symptom ratings did not differ between the age groups. The ADHD group showed more psychopathological peculiarities compared to individuals without ADHD with medium-to-large effect sizes. Self-reports and observer reports showed good concordance in the assessment of ADHD and comorbid psychopathological symptoms. Regarding current ADHD symptomatology, in 92.1%, self-report was corroborated by observer's information. Our findings underline that ADHD symptoms are relevant across the lifespan. Augmenting self-reports with observer reports could increase the assessment quality of ADHD. For successful treatment, clinicians should also focus on additional psychopathological impairments and comorbidities in older adults with ADHD.
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Affiliation(s)
- Marcus Müller
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
| | - Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steffen Barra
- Institute for Forensic Psychology and Psychiatry, Saarland University, Homburg, Germany
| | - Michael Rösler
- Institute for Forensic Psychology and Psychiatry, Saarland University, Homburg, Germany
| | - Wolfgang Retz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Institute for Forensic Psychology and Psychiatry, Saarland University, Homburg, Germany
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39
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Migueis DP, Lopes MC, Casella E, Soares PV, Soster L, Spruyt K. Attention deficit hyperactivity disorder and restless leg syndrome across the lifespan: A systematic review and meta-analysis. Sleep Med Rev 2023; 69:101770. [PMID: 36924608 DOI: 10.1016/j.smrv.2023.101770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/12/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
This systematic review aims to assess the association between attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched for original articles that reported prevalence data on ADHD and RLS until January 24th, 2023. Two independent reviewers evaluated the quality of the articles using the National Institutes of Health assessment tool. Among the 208 articles identified between 1996 and 2022, 29 were included. In large general population studies, 2.6-15.3% of participants met the RLS criteria, of which 3.2-17.4% presented with ADHD. In the ADHD group, RLS symptoms ranged from 11 to 42.9% in children and 20-33.0% in adults. This suggests a strong co-occurrence between RLS and ADHD. A common characteristic of these conditions is sleep fragmentation, as discussed in the reviewed papers. Although large-scale studies with comparable diagnostic criteria across the lifespan are required, our findings may advocate a possible common physiological pathway, including sleep fragmentation and dopaminergic system impairment.
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Affiliation(s)
- D P Migueis
- Antonio Pedro University Hospital, Fluminense Federal University, Niterói, Brazil.
| | - M C Lopes
- Child and Adolescent Affective Disorder Program (PRATA), Department and Institute of Psychiatry at University of Sao Paulo Medical School, Sao Paulo, Brazil; Children Institute, HCFMUSP, Brazil.
| | - E Casella
- Children Institute, HCFMUSP, Brazil.
| | - P V Soares
- Rio de Janeiro State University, Neurology Departament, Brazil.
| | - L Soster
- Children Institute, HCFMUSP, Brazil.
| | - K Spruyt
- Université de Paris, NeuroDiderot, INSERM, 75019, Paris, France.
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40
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Wendt FR, Garcia-Argibay M, Cabrera-Mendoza B, Valdimarsdóttir UA, Gelernter J, Stein MB, Nivard MG, Maihofer AX, Nievergelt CM, Larsson H, Mattheisen M, Polimanti R, Meier SM. The Relationship of Attention-Deficit/Hyperactivity Disorder With Posttraumatic Stress Disorder: A Two-Sample Mendelian Randomization and Population-Based Sibling Comparison Study. Biol Psychiatry 2023; 93:362-369. [PMID: 36335070 PMCID: PMC10496427 DOI: 10.1016/j.biopsych.2022.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are associated, but it is unclear if this is a causal relationship or confounding. We used genetic analyses and sibling comparisons to clarify the direction of this relationship. METHODS Linkage disequilibrium score regression and 2-sample Mendelian randomization were used to test for genetic correlation (rg) and bidirectional causal effects using European ancestry genome-wide association studies of ADHD (20,183 cases and 35,191 controls) and 6 PTSD definitions (up to 320,369 individuals). Several additional variables were included in the analysis to verify the independence of the ADHD-PTSD relationship. In a population-based sibling comparison (N = 2,082,118 individuals), Cox regression models were fitted to account for time at risk, a range of sociodemographic factors, and unmeasured familial confounders (via sibling comparisons). RESULTS ADHD and PTSD had consistent rg (rg range, 0.43-0.52; p < .001). ADHD genetic liability was causally linked with increased risk for PTSD (β = 0.367; 95% CI, 0.186-0.552; p = 7.68 × 10-5). This result was not affected by heterogeneity, horizontal pleiotropy (Mendelian randomization Egger intercept = 4.34 × 10-4, p = .961), or other phenotypes and was consistent across PTSD datasets. However, we found no consistent associations between PTSD genetic liability and ADHD risk. Individuals diagnosed with ADHD were at a higher risk for developing PTSD than their undiagnosed sibling (hazard ratio = 2.37; 95% CI, 1.98-3.53). CONCLUSIONS Our findings add novel evidence supporting the need for early and effective treatment of ADHD, as patients with this diagnosis are at significantly higher risk to develop PTSD later in life.
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Affiliation(s)
- Frank R Wendt
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut; Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | | | - Brenda Cabrera-Mendoza
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Unnur A Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Murray B Stein
- Department of Psychiatry, UC San Diego School of Medicine, University of California, San Diego, La Jolla, California; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Michel G Nivard
- Department of Biological Psychology, Faculty of Behaviour and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Adam X Maihofer
- Department of Psychiatry, UC San Diego School of Medicine, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California; Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Caroline M Nievergelt
- Department of Psychiatry, UC San Diego School of Medicine, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California; Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Mattheisen
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany; Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Renato Polimanti
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
| | - Sandra M Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada.
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ADHD Follow-Up in Adulthood among Subjects Treated for the Disorder in a Child and Adolescent Mental Health Service from 1995 to 2015. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020338. [PMID: 36837537 PMCID: PMC9966311 DOI: 10.3390/medicina59020338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Background and Objectives: ADHD is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity and can persist in adulthood. The aim of this study is to deepen knowledge about adult ADHD follow-up. Materials and Methods: This observational study consists of one retrospective part aimed at collecting records of children and adolescents treated for ADHD in the Children and Adolescent Mental Health Service (CAMHS) from 1995 to 2015 and, successively, at identifying their adult follow-up in Adult Mental Health Service (AMHS); the second part consists of ADHD scale administration, Diagnostic Interview for ADHD in Adults (DIVA 2-0) and Adult Self Rating Scale (ASRSv1.1), for the subjects currently being treated at AMHS who agreed to participate in the study. Results: We observed that among the 55 patients treated at CAMHS between 1995 and 2015 for ADHD and subsequently at the AMHS, none presented a diagnosis of ADHD; instead, they were treated for Intellectual Dysfunction (33%), Borderline Personality Disorder (15%) and Anxiety Disorders (9%), and two individuals were also diagnosed with comorbid substance/alcohol abuse (4%). Of the 55 patients, only 25 (45%) were treated at AMHS during the study period. Though we asked for their informed consent to administer the questionnaires, we were able to test only seven patients. The ASRS-V1.1 score showed that 43% of patients reported symptoms of ADHD persistence in adulthood. For DIVA 2.0, 57% of individuals reported scores indicating the persistence of the ADHD inattention component, and 43% the persistence of both ADHD dimensions. Conclusions: ADHD cannot be considered a disorder confined to childhood/adolescence but instead is a chronic and complex condition that can persist into adulthood. The very small size of our final sample may account for both the high ADHD dropout rate over the long follow-up period and the difficult transition from child to adult health care in ADHD treatment. Our investigation suggests the need for specific training in the diagnosis and treatment of adult ADHD and the implementation of transition protocols between minor and adult services to improve long-term treatments.
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Dinu LM, Singh SN, Baker NS, Georgescu AL, Singer BF, Overton PG, Dommett EJ. The Effects of Different Exercise Approaches on Attention Deficit Hyperactivity Disorder in Adults: A Randomised Controlled Trial. Behav Sci (Basel) 2023; 13:bs13020129. [PMID: 36829357 PMCID: PMC9952527 DOI: 10.3390/bs13020129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) results in significant functional impairment. Current treatments, particularly for adults, are limited. Previous research indicates that exercise may offer an alternative approach to managing ADHD, but research into different types of exercise and adult populations is limited. The aim of this study was to examine the effects of acute exercise (aerobic cycling vs mind-body yoga exercises) on symptoms of ADHD in adults. Adults with ADHD (N = 82) and controls (N = 77) were randomly allocated to 10 min of aerobic (cycling) or mind-body (Hatha yoga) exercise. Immediately before and after exercise, participants completed the Test of Variables of Attention task, Delay Discounting Task, and Iowa Gambling Task to measure attention and impulsivity. Actigraphy measured movement frequency and intensity. Both groups showed improved temporal impulsivity post-exercise, with cycling beneficial to all, whilst yoga only benefited those with ADHD. There were no effects of exercise on attention, cognitive or motor impulsivity, or movement in those with ADHD. Exercise reduced attention and increased movement in controls. Exercise can improve temporal impulsivity in adult ADHD but did not improve other symptoms and worsened some aspects of performance in controls. Exercise interventions should be further investigated.
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Affiliation(s)
- Larisa M. Dinu
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Samriddhi N. Singh
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Neo S. Baker
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Alexandra L. Georgescu
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Bryan F. Singer
- School of Psychology, Sussex Addiction Research & Intervention Centre, Sussex Neuroscience, University of Sussex, Brighton BN1 9RH, UK
| | - Paul G. Overton
- Department of Psychology, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
| | - Eleanor J. Dommett
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
- Correspondence:
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Vňuková M, Ptáček R, Děchtěrenko F, Weissenberger S, Ptáčková H, Braaten E, Raboch J, Anders M, Klicperová-Baker M, Goetz M. Prevalence of ADHD Symptomatology in Adult Population in the Czech Republic: A National Study. J Atten Disord 2023; 27:447-454. [PMID: 36691347 DOI: 10.1177/10870547221147547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND ADHD is a common neurodevelopmental disorder frequently diagnosed between the ages 7 and 10 years. We measured ADHD symptomatology in a representative sample of the Czech population. MATERIAL AND METHODS Data collection was performed in January 2019 through the European National Panel. The respondents completed a demographic questionnaire focusing on ADHD history and a standardized questionnaire, the Adult ADHD Self-Report Scale (ASRS) screener for ADHD symptomatology in adulthood. RESULTS From the sample of 1,518 respondents, 3% of the respondents reported having been diagnosed with ADHD/hyperkinetic disorder in their lifetime. According to ASRS scoring, 119 respondents were classified as suspected ADHD. Overall, more males than females reported ADHD symptomatology. Age was also significantly associated with ASRS. Education status yielded no significant results. CONCLUSION Our study documents that the prevalence of ADHD symptomatology in adults is comparable with that in Western countries despite the different historical and health care backgrounds.
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Affiliation(s)
- Martina Vňuková
- First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Radek Ptáček
- First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | | | - Simon Weissenberger
- First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | | | - Ellen Braaten
- 2nd Faculty of Medicine of Charles University in Prague, Prague, Czech Republic
| | - Jiří Raboch
- First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Martin Anders
- First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | | | - Michal Goetz
- 2nd Faculty of Medicine of Charles University in Prague, Prague, Czech Republic
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Liu YS, Cao B, Chokka PR. Screening for Adulthood ADHD and Comorbidities in a Tertiary Mental Health Center Using EarlyDetect: A Machine Learning-Based Pilot Study. J Atten Disord 2023; 27:324-331. [PMID: 36367134 PMCID: PMC9850394 DOI: 10.1177/10870547221136228] [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] [Indexed: 11/13/2022]
Abstract
Screening for adult Attention-Deficit/Hyperactivity Disorder (ADHD) and differentiating ADHD from comorbid mental health disorders remains to be clinically challenging. A screening tool for ADHD and comorbid mental health disorders is essential, as most adult ADHD is comorbid with several mental health disorders. The current pilot study enrolled 955 consecutive patients attending a tertiary mental health center in Canada and who completed EarlyDetect assessment, with 45.2% of patients diagnosed with ADHD. The best ADHD classification model using composite scoring achieved a balanced accuracy of 0.788, showing a 2.1% increase compared to standalone ADHD screening, detecting four more patients with ADHD per 100 patients. The classification model including ADHD with comorbidity was also successful (balanced accuracy = 0.712). The results suggest the novel screening method can improve ADHD detection accuracy and inform the risk of ADHD with comorbidity, and may further inform specific comorbidity including MDD and BD.
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Affiliation(s)
- Yang S. Liu
- University of Alberta, Edmonton,
Canada,Chokka Center for Integrative Health,
Edmonton, AB, Canada
| | - Bo Cao
- University of Alberta, Edmonton,
Canada,Bo Cao, Department of Psychiatry,
University of Alberta, Edmonton, AB, T6G 2B7, Canada.
| | - Pratap R. Chokka
- University of Alberta, Edmonton,
Canada,Chokka Center for Integrative Health,
Edmonton, AB, Canada,Pratap R. Chokka, Chokka Center for
Integrative Health, 301 - 2603 Hewes Way NW, Edmonton, AB T6L 6W6, Canada.
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45
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Xu Y, Chung H, Shu M, Liu Y, Zhang Y, Qiu H. Dose titration of osmotic release oral system methylphenidate in children and adolescents with attention-deficit hyperactivity disorder: a retrospective cohort study. BMC Pediatr 2023; 23:38. [PMID: 36683085 PMCID: PMC9869580 DOI: 10.1186/s12887-023-03850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Osmotic release oral system methylphenidate (OROS-MPH) is one of the most commonly used medication for attention-deficit hyperactivity disorder (ADHD), however, real-world knowledge on OROS-MPH dose titration has been limited. This study aims to summarize and visualise the OROS-MPH titration patterns in children and adolescents with ADHD in the United States (US) and Japan. METHODS This retrospective cohort study used the US IBM® MarketScan® Commercial Claims and Encounters database from 2000 to 2019 and the Japan Medical Data Centre database from 2008 to 2019. New OROS-MPH users with ADHD were identified and split into child (6 to < 13 years) and adolescent (13 to < 18 years) groups according to age at OROS-MPH initiation/reinitiation. Patient characteristics and OROS-MPH treatment patterns were described. OROS-MPH dose titration pathways were visualised by Sankey diagrams. RESULTS We included 98,973 children and 62,002 adolescents in the US cohort, and 4595 children and 1508 adolescents in the Japanese cohort. In Japanese cohort, 91.9% of children and 77.9% of adolescents initiated OROS-MPH at the lowest dose (18 mg/day), whereas US patients had a broader distribution of initial doses (e.g., 18-54 mg/day). The US patients had higher daily dose of OROS-MPH than Japanese patients. Overall, a minority (< 40%) of the OROS-MPH users underwent dose titration, and different titration patterns were observed between the US and Japanese patients. CONCLUSIONS Different treatment and titration patterns of OROS-MPH were observed in the two countries. Additional real-world studies about clinical reasoning underlying dose selection are needed to support clinical decision-making.
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Affiliation(s)
- Youran Xu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Beijing, China
| | - Hsingwen Chung
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Titusville, NJ USA
| | - Meng Shu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Shanghai, China
| | - Yanfang Liu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Singapore, Singapore
| | - Yongjing Zhang
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Shanghai, China
| | - Hong Qiu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Titusville, NJ USA
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da Silva BS, Grevet EH, Silva LCF, Ramos JKN, Rovaris DL, Bau CHD. An overview on neurobiology and therapeutics of attention-deficit/hyperactivity disorder. DISCOVER MENTAL HEALTH 2023; 3:2. [PMID: 37861876 PMCID: PMC10501041 DOI: 10.1007/s44192-022-00030-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/29/2022] [Indexed: 10/21/2023]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition characterized by developmentally inappropriate symptoms of inattention and/or hyperactivity/impulsivity, which leads to impairments in the social, academic, and professional contexts. ADHD diagnosis relies solely on clinical assessment based on symptom evaluation and is sometimes challenging due to the substantial heterogeneity of the disorder in terms of clinical and pathophysiological aspects. Despite the difficulties imposed by the high complexity of ADHD etiology, the growing body of research and technological advances provide good perspectives for understanding the neurobiology of the disorder. Such knowledge is essential to refining diagnosis and identifying new therapeutic options to optimize treatment outcomes and associated impairments, leading to improvements in all domains of patient care. This review is intended to be an updated outline that addresses the etiological and neurobiological aspects of ADHD and its treatment, considering the impact of the "omics" era on disentangling the multifactorial architecture of ADHD.
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Affiliation(s)
- Bruna Santos da Silva
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
- Department of Genetics and Graduate Program in Genetics and Molecular Biology, Instituto de Biociências, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas Universidade de Sao Paulo, São Paulo, Brazil
- Laboratory of Physiological Genomics of Mental Health (PhysioGen Lab), Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Eugenio Horacio Grevet
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
- Department of Psychiatry and Graduate Program in Psychiatry and Behavioral Sciences, Faculdade de Medicina, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Luiza Carolina Fagundes Silva
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
- Department of Psychiatry and Graduate Program in Psychiatry and Behavioral Sciences, Faculdade de Medicina, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - João Kleber Neves Ramos
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas Universidade de Sao Paulo, São Paulo, Brazil
- Laboratory of Physiological Genomics of Mental Health (PhysioGen Lab), Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Diego Luiz Rovaris
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas Universidade de Sao Paulo, São Paulo, Brazil
- Laboratory of Physiological Genomics of Mental Health (PhysioGen Lab), Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Claiton Henrique Dotto Bau
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
- Department of Genetics and Graduate Program in Genetics and Molecular Biology, Instituto de Biociências, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
- Department of Psychiatry and Graduate Program in Psychiatry and Behavioral Sciences, Faculdade de Medicina, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
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Ando M, Momo K, Hida N, Yamazaki T, Taki I, Nagai T, Yoshio T, Kurosawa M. Assessment of Diagnosis Timing of Attention-Deficit/Hyperactivity Disorder in Working-Age Workers with Psychiatric Diseases Using Large Claims Data. Biol Pharm Bull 2023; 46:1211-1216. [PMID: 37661400 DOI: 10.1248/bpb.b23-00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a common developmental disorder. This study aims to clarify the timing of diagnosis of ADHD in working-age workers with psychiatric comorbidities using large claims data in Japan. Based on a literature survey, we identified 10 typical comorbidities of ADHD. Among 3064162 participants with social insurance, 215060 working-age workers who were diagnosed with the 10 typical comorbidities of ADHD were included. Cohort 1 consisted of 96994 patients with the index date set as the earliest date of diagnosis of a comorbidity within the 12-month screening and 12-month observation periods. In cohort 2, 107436 patients were included, and the first date of diagnosis of each comorbidity was used as the index month. In cohort 1, 0.19% of the patients were diagnosed with ADHD after being diagnosed with a typical comorbidity. In cohort 2, 4 out of 4 patients with ADHD and obsessive-compulsive disorders were diagnosis ADHD after obsessive-compulsive disorders. Pervasive developmental disorders were the highest comorbidity of ADHD for 62 out of 566 (11.0%) patients. This is the first study to determine the proportion of ADHD with typical comorbidities in working-age workers in Japan. Our findings highlight the need for timely diagnosis of ADHD to improve patients' QOL.
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Affiliation(s)
- Mutsumi Ando
- Department of Clinical Pharmacy Division of Clinical Research and Development, School of Pharmacy, Showa University
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University
- Department of Pharmacy, Showa University Karasuyama Hospital
| | - Kenji Momo
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University
| | - Noriko Hida
- Department of Clinical Pharmacy Division of Clinical Research and Development, School of Pharmacy, Showa University
| | - Taigi Yamazaki
- Department of Clinical Pharmacy Division of Clinical Research and Development, School of Pharmacy, Showa University
| | - Iori Taki
- Department of Clinical Pharmacy Division of Clinical Research and Development, School of Pharmacy, Showa University
| | - Tsutomu Nagai
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University
- Department of Pharmacy, Showa University Karasuyama Hospital
| | - Takashi Yoshio
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University
- Department of Pharmacy, Showa University Karasuyama Hospital
| | - Masahiro Kurosawa
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University
- Department of Pharmacy, Showa University Karasuyama Hospital
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Longitudinal investigation in children and adolescents with ADHD and healthy controls: A 2-year ERP study. Int J Psychophysiol 2023; 183:117-129. [PMID: 36356923 DOI: 10.1016/j.ijpsycho.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
Cross-sectional group comparisons have shown altered neurocognitive and neurophysiological profiles in individuals with attention-deficit/hyperactivity disorder (ADHD). We report a two-year longitudinal observational study of ADHD children and adolescents (N = 239) regarding ADHD symptoms, behavioral metrics, and event-related potentials (ERP) and compared them to healthy controls (N = 91). The participants were assessed up to five times with a cued Go/NoGo task while ERPs were recorded. We fitted the trajectories of our variables of interest with univariate and bivariate latent growth curve models. At baseline, the ADHD group had increased reaction time variability, higher number of omission and commission errors, and attenuated CNV and P3d amplitudes compared to controls. The task performance in terms of behavioral metrics improved in both groups over two years; however, with differential patterns: the decrease in reaction time and omission errors were stronger in the control group, and the reduction of commission errors was more substantial in the ADHD group. The cueP3, CNV, and N2d amplitudes changed slightly over two years, with negligible differences between both groups. Furthermore, the parent-rated symptom burden in the ADHD group decreased by 22 % (DSM-5-based questionnaire). We did not identify any associations between the changes in symptoms and the changes in the behavioral or neurophysiological metrics. The lack of association between the changes in symptoms and the behavioral or ERP metrics supports the trait liability hypothesis, which claims that the neurocognitive deficits are independent of symptom alleviation. Furthermore, the change in symptom burden was substantial, questioning the stability of the reported ADHD symptoms.
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Guan K, Shan C, Guo A, Gao X, Li X. Ghrelin regulates hyperactivity-like behaviors via growth hormone signaling pathway in zebrafish ( Danio rerio). Front Endocrinol (Lausanne) 2023; 14:1163263. [PMID: 37065761 PMCID: PMC10102434 DOI: 10.3389/fendo.2023.1163263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION Ghrelin is originally identified as the endogenous ligand for the growth hormone secretagogue receptor (GHSR) and partially acts by stimulating growth hormone (GH) release. Our previous studies have identified GHRELIN as a novel susceptibility gene for human attention-deficit hyperactivity disorder (ADHD), and ghrelin-depleted zebrafish (Danio rerio) display ADHD-like behaviors. However, the underlying molecular mechanism how ghrelin regulates hyperactivity-like behaviors is not yet known. RESULTS Here, we performed RNA-sequencing analysis using adult ghrelin Δ/Δ zebrafish brains to investigate the underlying molecular mechanisms. We found that gh1 mRNA and genes related to the gh signaling pathway were significantly reduced at transcriptional expression levels. Quantitative polymerase chain reaction (qPCR) was performed and confirmed the downregulation of gh signaling pathway-related genes in ghrelin Δ/Δ zebrafish larvae and the brain of adult ghrelin Δ/Δ zebrafish. In addition, ghrelin Δ/Δ zebrafish displayed hyperactive and hyperreactive phenotypes, such as an increase in motor activity in swimming test and a hyperreactive phenotype under light/dark cycle stimulation, mimicking human ADHD symptoms. Intraperitoneal injection of recombinant human growth hormone (rhGH) partially rescued the hyperactivity and hyperreactive-like behaviors in ghrelin mutant zebrafish. CONCLUSION Our results indicated that ghrelin may regulate hyperactivity-like behaviors by mediating gh signaling pathway in zebrafish. And the protective effect of rhGH on ghrelin Δ/Δ zebrafish hyperactivity behavior provides new therapeutic clues for ADHD patients.
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Affiliation(s)
- Kaiyu Guan
- Department of Clinical Psychology, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang, China
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, China
| | - Chunyan Shan
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, China
| | - Anqi Guo
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, China
| | - Xiang Gao
- Central Laboratory, Scientific Research Department, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- *Correspondence: Xi Li, ; Xiang Gao,
| | - Xi Li
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, China
- *Correspondence: Xi Li, ; Xiang Gao,
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Rhodes JD. An Examination of the Role of Sluggish Cognitive Tempo as a Moderator of the Relationship Between ADHD and Nicotine Use. J Atten Disord 2023; 27:220-227. [PMID: 36264077 DOI: 10.1177/10870547221130454] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVE ADHD is a neurodevelopmental disorder characterized by executive dysfunction and functional impairments including nicotine consumption. Sluggish cognitive tempo (SCT) has been associated with ADHD and posited as an independent construct. The present study hypothesized that SCT would moderate the relationships between ADHD and nicotine-related behaviors. METHOD Participants (n = 309) were recruited using Mechanical Turk and completed measures of ADHD symptoms, SCT, and smoking history. RESULTS ADHD was associated with age of initiation of smoking and more severe withdrawal symptoms for both combustible and electronic cigarettes. SCT significantly moderated the relationship between ADHD and withdrawal symptom severity (both electronic and combustible cigarettes). CONCLUSION The results of the present study suggest that SCT plays an important role in the complex relationship between ADHD and smoking withdrawal. Future research should further explore the construct of SCT to better understand its role in psychopathology and intervention strategies.
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