1
|
Granero R, Fernández-Aranda F, Valero-Solís S, del Pino-Gutiérrez A, Mestre-Bach G, Baenas I, Contaldo SF, Gómez-Peña M, Aymamí N, Moragas L, Vintró C, Mena-Moreno T, Valenciano-Mendoza E, Mora-Maltas B, Menchón JM, Jiménez-Murcia S. The influence of chronological age on cognitive biases and impulsivity levels in male patients with gambling disorder. J Behav Addict 2020; 9:383-400. [PMID: 32573467 PMCID: PMC8939415 DOI: 10.1556/2006.2020.00028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/04/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS Due to the contribution of age to the etiology of gambling disorder (GD), there is a need to assess the moderator effect of the aging process with other features that are highly related with the clinical profile. The objective of this study is to examine the role of the chronological age into the relationships between cognitive biases, impulsivity levels and gambling preference with the GD profile during adulthood. METHODS Sample included n = 209 patients aged 18-77 years-old recruited from a Pathological Gambling Outpatients Unit. Orthogonal contrasts explored polynomial patterns in data, and path analysis implemented through structural equation modeling assessed the underlying mechanisms between the study variables. RESULTS Compared to middle-age patients, younger and older age groups reported more impairing irrational beliefs (P = 0.005 for interpretative control and P = 0.043 for interpretative bias). A linear trend showed that as people get older sensation seeking (P = 0.006) and inability to stop gambling (P = 0.018) increase. Path analysis showed a direct effect between the cognitive bias and measures of gambling severity (standardized effects [SE] between 0.12 and 0.17) and a direct effect between impulsivity levels and cumulated debts due to gambling (SE = 0.22). CONCLUSION Screening tools and intervention plans should consider the aging process. Specific programs should be developed for younger and older age groups, since these are highly vulnerable to the consequences of gambling activities and impairment levels of impulsivity and cognitive biases.
Collapse
Affiliation(s)
- Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - S. Fabrizio Contaldo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Cristina Vintró
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Corresponding author. Department of Psychiatry, Bellvitge University Hospital, c/ Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona, 08907, Spain. Tel.: +34 93 260 79 88; fax: +34 93 260 76 58. E-mail:
| |
Collapse
|
2
|
Hemamy M, Heidari-Beni M, Askari G, Karahmadi M, Maracy M. Effect of Vitamin D and Magnesium Supplementation on Behavior Problems in Children with Attention-Deficit Hyperactivity Disorder. Int J Prev Med 2020; 11:4. [PMID: 32089804 PMCID: PMC7011463 DOI: 10.4103/ijpvm.ijpvm_546_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 07/22/2018] [Indexed: 01/11/2023] Open
Abstract
Background: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by the three main symptom domains including inattention, hyperactivity, and impulsivity. Recent findings suggested that nutrients might play an important role in the pathology of ADHD. The present study aimed to examine the effects of Vitamin D and magnesium supplementation on behavior problems in children with ADHD. Methods: This double-blind, randomized controlled clinical trial study was conducted on 66 children with ADHD in Clinic of Noor and Ali Asghar Hospital in Isfahan, Iran, in 2016. Children were randomly allocated to receive both Vitamin D (50,000 IU/week) and magnesium (6 mg/kg/day) supplements (n = 33) or placebos (n = 33) for 8 weeks. Conners’ Parent Rating Scale was used to evaluate children's behavior at baseline and at the end of the study. Results: After 8 weeks of Vitamin D consumption as well as magnesium, the serum levels of 25-hydroxy-Vitamin D3 and magnesium increased significantly in the intervention group compared with placebo group. Supplementation with Vitamin D and magnesium caused a significant decrease in conduct problems, social problems, and anxiety/shy scores; but it had no significant effect on psychosomatic problems score. Conclusions: Vitamin D and magnesium supplementation in children with ADHD was effective on conduct problems, social problems, and anxiety/shy scores compared with placebo intake, but it did not affect psychosomatic problem scores, significantly.
Collapse
Affiliation(s)
- Mostafa Hemamy
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Karahmadi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Maracy
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
3
|
Inci SB, Ipci M, Akyol Ardıç U, Ercan ES. Psychiatric Comorbidity and Demographic Characteristics of 1,000 Children and Adolescents With ADHD in Turkey. J Atten Disord 2019; 23:1356-1367. [PMID: 27581245 DOI: 10.1177/1087054716666954] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective was to examine the frequency of comorbid disorders in children and adolescents with ADHD in Turkey and to evaluate the distribution of comorbidities according to the subtypes of ADHD and sociodemographic features. Method: The sample consisted of 1,000 children, 6 to 18 years of age, including 242 females and 758 males, from Ege University who were diagnosed with ADHD. Results: The overall prevalence rate of psychiatric comorbidity in the study was 56.3%. The most frequently observed comorbidity was oppositional defiant disorder with a rate of 37.4%. Conduct disorder, depressive disorder, obsessive-compulsive disorder, and anxiety disorder accompanied ADHD, respectively. The results revealed that 70.2% of the children with ADHD-Combine type had at least one psychiatric comorbidity. Oppositional defiant disorder, conduct disorder, depressive disorder, and obsessive-compulsive disorder accompanied ADHD-Combine type in 54.6%, 12.6%, 8.1%, and 8.8% of the participants, respectively. Conclusion: These findings provide valuable information about the comorbid disorders in children and adolescents with a very large clinical sample of ADHD children.
Collapse
|
4
|
Ramy H, El Sheikh M, Sultan M, Bassim R, Eid M, Ali R, El Missiry M. Risk factors influencing severity of attention deficit hyperactivity disorder in a sample of preparatory school students in Cairo. Clin Child Psychol Psychiatry 2018; 23:542-555. [PMID: 29451009 DOI: 10.1177/1359104518755218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. Severity of symptoms is associated with more behavioral problems, poor academic performance, and persistence of symptoms into adulthood. METHODS To examine the clinical and social correlates that may be identified as risk factors associated with ADHD severity in a sample of adolescent ADHD school students. A total of 925 students were recruited from two public and two private schools from eastern Cairo. They were interviewed using Conners-Wells Adolescent Self-Report-short version (CASS-S); students scoring more than 65 were further interviewed with Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version (K-SADS-PL) to confirm the diagnosis, then Conners-Wells Adolescent Self-Report-long version (CASS-L) to assess severity and Wechsler Intelligence Scale for Children (WISC) to ascertain intellectual ability. RESULTS About 10.3% of cases were severe, 5.7% were moderate, and 83.9% were mild. Severity was significantly associated with female gender, psychiatric comorbidity, family problems, conduct symptoms, and poor anger management. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ( DSM-IV) hyperactive-impulsive type was the only predictive factor of ADHD severity. CONCLUSIONS The diagnosis of hyperactive-impulsive subtype may predict the severity of ADHD symptoms.
Collapse
Affiliation(s)
- Hisham Ramy
- Institute of Psychiatry, Ain Shams University, Egypt
| | | | - Marwa Sultan
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Rasha Bassim
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Maissa Eid
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Ramy Ali
- Institute of Psychiatry, Ain Shams University, Egypt
| | | |
Collapse
|
5
|
Jacob L, Haro JM, Koyanagi A. Relationship between attention-deficit hyperactivity disorder symptoms and problem gambling: A mediation analysis of influential factors among 7,403 individuals from the UK. J Behav Addict 2018; 7:781-791. [PMID: 30238788 PMCID: PMC6426384 DOI: 10.1556/2006.7.2018.72] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Our goal was to examine the association between attention-deficit hyperactivity disorder (ADHD) symptoms and gambling problems, and to identify potential mediating factors of this association. METHODS This study used cross-sectional, community-based data from 7,403 people aged ≥16 years who participated in the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS) Screener. Problem gambling was assessed using a questionnaire based on the 10 DSM-IV diagnostic criteria for pathological gambling. Respondents were classified as having no problem, at-risk, or problem gambling. Logistic regression and mediation analyses were conducted to analyze the association between ADHD symptoms (i.e., ASRS score ≥14) and problem gambling and the role of several variables in this association. RESULTS The prevalence of at-risk (5.3% vs. 2.4%) and problem gambling (2.4% vs. 0.6%) was higher in individuals with ADHD symptoms than in those without ADHD symptoms. ADHD symptoms were significantly associated with both at-risk (OR = 2.15; 95% CI = 1.22-3.79) and problem gambling (OR = 3.57; 95% CI = 1.53-8.31) when adjusted for age, sex, and ethnicity. Common mental disorders (CMDs; i.e., depression and anxiety disorders) (mediated percentage = 22.4%), borderline personality disorder (BPD) traits (22.1%), stressful life events (13.2%), stress at work or home (12.6%), alcohol dependence (11.8%), and impulsivity (11.2%) were significant mediators in the ADHD-gambling association. DISCUSSION AND CONCLUSIONS Overall, ADHD symptoms were positively associated with problem gambling. CMDs, BPD traits, and stressful life events were important mediators in this relationship.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France,Corresponding author: Dr. Louis Jacob; Faculty of Medicine, University of Paris 5, 15 rue de l’École de Médecine, Paris 75006, France; Phone: +33 6 27 88 37 06; E-mail:
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
6
|
Analysis of shared homozygosity regions in Saudi siblings with attention deficit hyperactivity disorder. Psychiatr Genet 2018; 27:131-138. [PMID: 28452824 PMCID: PMC5495552 DOI: 10.1097/ypg.0000000000000173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIM Genetic and clinical complexities are common features of most psychiatric illnesses that pose a major obstacle in risk-gene identification. Attention deficit hyperactivity disorder (ADHD) is the most prevalent child-onset psychiatric illness, with high heritability. Over the past decade, numerous genetic studies utilizing various approaches, such as genome-wide association, candidate-gene association, and linkage analysis, have identified a multitude of candidate loci/genes. However, such studies have yielded diverse findings that are rarely reproduced, indicating that other genetic determinants have not been discovered yet. In this study, we carried out sib-pair analysis on seven multiplex families with ADHD from Saudi Arabia. We aimed to identify the candidate chromosomal regions and genes linked to the disease. PATIENTS AND METHODS A total of 41 individuals from multiplex families were analyzed for shared regions of homozygosity. Genes within these regions were prioritized according to their potential relevance to ADHD. RESULTS We identified multiple genomic regions spanning different chromosomes to be shared among affected members of each family; these included chromosomes 3, 5, 6, 7, 8, 9, 10, 13, 17, and 18. We also found specific regions on chromosomes 8 and 17 to be shared between affected individuals from more than one family. Among the genes present in the regions reported here were involved in neurotransmission (GRM3, SIGMAR1, CHAT, and SLC18A3) and members of the HLA gene family (HLA-A, HLA-DPA1, and MICC). CONCLUSION The candidate regions identified in this study highlight the genetic diversity of ADHD. Upon further investigation, these loci may reveal candidate genes that enclose variants associated with ADHD. Although most ADHD studies were conducted in other populations, our study provides insight from an understudied, ethnically interesting population.
Collapse
|
7
|
Mackenzie GB, Wonders E. Rethinking Intelligence Quotient Exclusion Criteria Practices in the Study of Attention Deficit Hyperactivity Disorder. Front Psychol 2016; 7:794. [PMID: 27303350 PMCID: PMC4886698 DOI: 10.3389/fpsyg.2016.00794] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/11/2016] [Indexed: 11/16/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is associated with lower than average intelligence quotient (IQ) scores. However, research done on this disorder often excludes participants based on lower than average IQ’s (i.e., between 70 and 85). The purpose of this paper is to alert researchers to the consequences of excluding participants based on IQ’s within this range and to highlight the importance of providing a clear rationale when choosing to exclude participants based on IQ. Next, we offer recommendations for researching ADHD and their relative benefits and drawbacks of these approaches. Overall this paper emphasizes that including participants who have lower than average IQ in research on ADHD may promote a more realistic understanding of the condition and in turn improve our ability to treat it.
Collapse
Affiliation(s)
- Genevieve B Mackenzie
- Attention Deficit Hyperactivity Disorder and Literacy Laboratory, Ontario Institute for Studies in Education, University of Toronto Toronto, ON, Canada
| | - Elif Wonders
- The Connections Laboratory, Department of Education and Counselling Psychology, McGill University Montreal, QC, Canada
| |
Collapse
|
8
|
Minahim D, Rohde LA. Attention deficit hyperactivity disorder and intellectual giftedness: a study of symptom frequency and minor physical anomalies. BRAZILIAN JOURNAL OF PSYCHIATRY 2016; 37:289-95. [PMID: 26692428 DOI: 10.1590/1516-4446-2014-1489] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 12/30/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the presence of symptoms of attention deficit and hyperactivity disorder (ADHD) in intellectually gifted adults and children. METHODS Two cross-sectional studies were performed in children and adults whose intelligence quotient (IQ) had been previously evaluated using Raven's Progressive Matrices (RPM) test. Seventy-seven adults displaying IQ scores above the 98th percentile were assessed using the Adult Self-Report Scale (ASRS-18) for signs of ADHD and a modified Waldrop scale for minor physical anomalies (MPAs). Thirty-nine children (grades 1-5) exhibiting IQ scores above the 99th percentile, as well as an equally matched control group, were assessed for ADHD by teachers using the Swanson, Nolan and Pelham IV Rating Scale (SNAP-IV) as used in the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA-SNAP-IV). RESULTS In gifted adults, the frequency of ADHD-positive cases was 37.8%, and the total MPA score was significantly associated with ADHD (p < 0.001). In children, the ADHD-positive case frequency was 15.38% in the gifted group and 7.69% in the control group (odds ratio [OR] = 2.18, p = 0.288). CONCLUSIONS The high frequency of ADHD symptoms observed, both in gifted adults and in gifted (and non-gifted) children, further supports the validity of this diagnosis in this population. Furthermore, the significant association between MPAs and ADHD suggests that a neurodevelopmental condition underlies these symptoms.
Collapse
Affiliation(s)
- Daniel Minahim
- Graduate Program in Psychiatry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luis A Rohde
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
9
|
Miguel CS, Martins PA, Moleda N, Klein M, Chaim-Avancini T, Gobbo MA, Alves TM, Silva MA, Louzã MR. Cognition and impulsivity in adults with attention deficit hyperactivity disorder with and without cocaine and/or crack dependence. Drug Alcohol Depend 2016; 160:97-104. [PMID: 26853151 DOI: 10.1016/j.drugalcdep.2015.12.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/20/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Substance use disorder (SUD) is a common comorbidity in adults with attention deficit-hyperactivity disorder (ADHD). However,there have been few studies on cognitive profiles of these patients. Impulsivity is also commonly increased in both disorders. The central aim of this study was to compare cognition and impulsivity in subjects who had ADHD and cocaine dependence (ADHD+COC group) to those with ADHD only (ADHD-noSUD group). We hypothesized that the ADHD+COC group would show more marked cognitive dysfunction and greater impulsivity than their counterparts with ADHD only. METHODS A total of 70 adult patients diagnosed with ADHD according to (DSM-IV-TR) criteria were enrolled; 36 with ADHD+COC and 34 with ADHD-noSUD. All study participants were evaluated with a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; the Adult ADHD Self-Report Scale; the Addiction Severity Index; the Alcohol, Smoking and Substance Involvement Screening Test; the Barratt Impulsiveness Scale; and a comprehensive neurocognitive battery. RESULTS Compared to individuals with ADHD-noSUD, ADHD+COC individuals had significantly lower mean IQ and higher motor impulsivity. On average, the ADHD+COC group also performed more poorly on tasks assessing verbal skills, vigilance, implicit learning during decision making, and ADHD-noSUD performed more poorly on selective attention, information processing, and visual search. CONCLUSIONS Our results support the integrative theory of ADHD based on the cognitive and affective neuroscience model, and suggests that ADHD-noSUD patients have impairments in cognitive regulation, while ADHD+COC patients have impairments in both cognitive and affective regulation.
Collapse
Affiliation(s)
- Carmen S Miguel
- Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil.
| | - Paula A Martins
- Program for Early Evaluation and Treatment of Psychosis, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil
| | - Nathalya Moleda
- Mackenzie Presbyterian University, Rua da Consolação, 930, 01302-907 São Paulo, SP, Brazil
| | - Margarete Klein
- Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil
| | - Tiffany Chaim-Avancini
- (LIM-21, Laboratory for Medical Research 21), specializing in Neuroimaging, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785, 05403-010 São Paulo, SP, Brazil
| | - Maria A Gobbo
- Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil
| | - Tania M Alves
- Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil
| | - Maria A Silva
- Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil
| | - Mario R Louzã
- Research Program for Attention Deficit Hyperactivity Disorder in Adults, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil; Program for Early Evaluation and Treatment of Psychosis, Department of Psychiatry, University of São Paulo School of Medicine, Rua Dr. Ovídio Pires de Campos, 785-3° Andar, 05403-010 São Paulo, SP, Brazil
| |
Collapse
|
10
|
Moran LV, Masters GA, Pingali S, Cohen BM, Liebson E, Rajarethinam R, Ongur D. Prescription stimulant use is associated with earlier onset of psychosis. J Psychiatr Res 2015; 71:41-7. [PMID: 26522870 PMCID: PMC4630672 DOI: 10.1016/j.jpsychires.2015.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/14/2015] [Accepted: 09/17/2015] [Indexed: 10/23/2022]
Abstract
A childhood history of attention deficit hyperactivity disorder (ADHD) is common in psychotic disorders, yet prescription stimulants may interact adversely with the physiology of these disorders. Specifically, exposure to stimulants leads to long-term increases in dopamine release. We therefore hypothesized that individuals with psychotic disorders previously exposed to prescription stimulants will have an earlier onset of psychosis. Age of onset of psychosis (AOP) was compared in individuals with and without prior exposure to prescription stimulants while controlling for potential confounding factors. In a sample of 205 patients recruited from an inpatient psychiatric unit, 40% (n = 82) reported use of stimulants prior to the onset of psychosis. Most participants were prescribed stimulants during childhood or adolescence for a diagnosis of ADHD. AOP was significantly earlier in those exposed to stimulants (20.5 vs. 24.6 years stimulants vs. no stimulants, p < 0.001). After controlling for gender, IQ, educational attainment, lifetime history of a cannabis use disorder or other drugs of abuse, and family history of a first-degree relative with psychosis, the association between stimulant exposure and earlier AOP remained significant. There was a significant gender × stimulant interaction with a greater reduction in AOP for females, whereas the smaller effect of stimulant use on AOP in males did not reach statistical significance. In conclusion, individuals with psychotic disorders exposed to prescription stimulants had an earlier onset of psychosis, and this relationship did not appear to be mediated by IQ or cannabis.
Collapse
Affiliation(s)
- Lauren V. Moran
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School,Correspondence to Dr. Lauren Moran, McLean Hospital, Admissions Building, 115 Mill Street, Belmont, MA 02478, Office: (617) 855-3395,
| | - Grace A. Masters
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School
| | - Samira Pingali
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School
| | - Bruce M. Cohen
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School
| | - Elizabeth Liebson
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School
| | - R.P. Rajarethinam
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School
| | - Dost Ongur
- McLean Hospital, Psychotic Disorders Division, Belmont, Massachusetts; Harvard Medical School
| |
Collapse
|
11
|
Baweja R, Mattison RE, Waxmonsky JG. Impact of Attention-Deficit Hyperactivity Disorder on School Performance: What are the Effects of Medication? Paediatr Drugs 2015; 17:459-77. [PMID: 26259966 DOI: 10.1007/s40272-015-0144-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) affects an estimated 5-7 % of schoolchildren worldwide. School functioning and academic achievement are frequently impaired by ADHD and represent one of the main reasons children start ADHD medication. Multiple potential causal pathways exist between ADHD and impaired school performance. In this review, we decompose school performance into three components and assess the impact of ADHD and its treatments on academic performance (assessed by grade point average [GPA], time on-task, percentage of work completed as well as percent completed correctly), academic skills (as measured by achievement tests and cognitive measures), and academic enablers (such as study skills, motivation, engagement, classroom behavior and interpersonal skills). Most studies examined only the short-term effects of medication on school performance. In these, ADHD medications have been observed to improve some aspects of school performance, with the largest impact on measures of academic performance such as seatwork productivity and on-task performance. In a subset of children, these benefits may translate into detectable improvements in GPA and achievement testing. However, limited data exists to support whether these changes are sustained over years. Optimizing medication effects requires periodic reassessment of school performance, necessitating a collaborative effort involving patients, parents, school staff and prescribers. Even with systematic reassessment, behavioral-based treatments and additional school-based services may be needed to maximize academic performance for the many youth with ADHD and prominent impairments in school performance.
Collapse
Affiliation(s)
- Raman Baweja
- Department of Psychiatry, Penn State University College of Medicine, 500 University Drive, H073, Hershey, PA, 17033-0850, USA.
| | - Richard E Mattison
- Department of Psychiatry, Penn State University College of Medicine, 500 University Drive, H073, Hershey, PA, 17033-0850, USA
| | - James G Waxmonsky
- Department of Psychiatry, Penn State University College of Medicine, 500 University Drive, H073, Hershey, PA, 17033-0850, USA
| |
Collapse
|
12
|
Abstract
Whereas the adverse impact of attention-deficit/hyperactivity disorder (ADHD) on emotional and psychosocial well-being has been well investigated, its impact on physical health has not. The main aim of this study was to assess the impact of ADHD on lifestyle behaviors and measures of adverse health risk indicators. Subjects were 100 untreated adults with ADHD and 100 adults without ADHD of similar age and sex. Unhealthy lifestyle indicators included assessments of bad health habits, frequency of visits to healthcare providers, and follow through with recommended prophylactic tests. Assessments of adverse health risk indicators included measurements of cardiovascular and metabolic parameters, weight, body mass index, and waist circumference. No differences were identified in health habits between subjects with and without ADHD, but robust differences were found in a wide range of adverse health risk indicators. ADHD is associated with an adverse impact in health risk indicators well known to be associated with high morbidity and mortality.
Collapse
|
13
|
McCarthy H, Skokauskas N, Frodl T. Identifying a consistent pattern of neural function in attention deficit hyperactivity disorder: a meta-analysis. Psychol Med 2014; 44:869-880. [PMID: 23663382 DOI: 10.1017/s0033291713001037] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The neurobiological underpinnings of attention deficit hyperactivity disorder (ADHD) are inconclusive. Activation abnormalities across brain regions in ADHD compared with healthy controls highlighted in task-based functional magnetic resonance imaging (fMRI) studies are heterogeneous. To identify a consistent pattern of neural dysfunction in ADHD, a meta-analysis of fMRI studies using Go/no-go, Stop and N-back tasks was undertaken. METHOD Several databases were searched using the key words: 'ADHD and fMRI' and 'ADHD and fMRI task'. In all, 20 studies met inclusion criteria comprising 334 patients with ADHD and 372 healthy controls and were split into N-back, Stop task and Go/no-go case-control groups. Using Signed Differential Mapping each batch was meta-analysed individually and meta-regression analyses were used to examine the effects of exposure to methylphenidate (MPH), length of MPH wash-out period, ADHD subtype, age and intelligence quotient (IQ) differences upon neural dysfunction in ADHD. RESULTS Across all tasks less activity in frontal lobe regions compared with controls was detected. Less exposure to treatment and lengthier wash-out times resulted in less left medial frontal cortex activation in N-back and Go/no-go studies. Higher percentage of combined-type ADHD resulted in less superior and inferior frontal gyrus activation. Different IQ scores between groups were linked to reduced right caudate activity in ADHD. CONCLUSIONS Consistent frontal deficits imply homogeneous cognitive strategies involved in ADHD behavioural control. Our findings suggest a link between fMRI results and the potentially normalizing effect of treatment and signify a need for segregated examination and contrast of differences in sample characteristics in future studies.
Collapse
Affiliation(s)
- H McCarthy
- Department of Psychiatry, Integrated Neuroimaging, Trinity College Dublin, Dublin, Republic of Ireland
| | - N Skokauskas
- Department of Psychiatry, Integrated Neuroimaging, Trinity College Dublin, Dublin, Republic of Ireland
| | - T Frodl
- Department of Psychiatry, Integrated Neuroimaging, Trinity College Dublin, Dublin, Republic of Ireland
| |
Collapse
|