1
|
Kato K, Tomiyama H, Murayama K, Mizobe T, Matsuo A, Nishida N, Matukuma K, Kang M, Sashikata K, Kikuchi K, Togao O, Nakao T. Reduced resting-state functional connectivity between insula and inferior frontal gyrus and superior temporal gyrus in hoarding disorder. Front Psychiatry 2024; 15:1399062. [PMID: 38966185 PMCID: PMC11223522 DOI: 10.3389/fpsyt.2024.1399062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
Background Hoarding disorder (HD) is characterized by cognitive control impairments and abnormal brain activity in the insula and anterior cingulate cortex (ACC) during disposal of personal items or certain executive function tasks. However, whether there are any changes in resting-state functional connectivity of the insula and ACC remains unclear. Methods A total of 55 subjects, including 24 patients with HD and 31 healthy controls (HCs), participated in the study. We acquired resting-state functional magnetic resonance imaging data and examined group differences in functional connectivity from the insula and ACC in whole-brain voxels. Results In patients with HD, functional connectivity was significantly lower between the right insula and right inferior frontal gyrus (IFG) and left superior temporal gyrus (STG) compared to HCs. There was no correlation between these connectivities and HD symptoms. Conclusions Although the clinical implication is uncertain, our results suggest that patients with HD have resting-state functional alterations between the insula and IFG and STG, corresponding with the results of previous fMRI studies. These findings provide new insight into the neurobiological basis of HD.
Collapse
Affiliation(s)
- Kenta Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keitaro Murayama
- Department of Neuropsychiatry, Kyushu University Hospital, Fukuoka, Japan
| | - Taro Mizobe
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Matsuo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nami Nishida
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kou Matukuma
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mingi Kang
- Graduate School of Human Environment Studies, Kyushu University, Fukuoka, Japan
| | - Kenta Sashikata
- Graduate School of Human Environment Studies, Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
2
|
Chen C, Zhang S, Hong H, Qiu S, Zhou Y, Zhao M, Pan M, Si F, Dong M, Li H, Wang Y, Liu L, Sonuga-Barke EJS, Qian Q. Psychometric properties of the Chinese version of the Quick Delay Questionnaire (C-QDQ) and ecological characteristics of reward-delay impulsivity of adults with ADHD. BMC Psychiatry 2024; 24:251. [PMID: 38566048 PMCID: PMC10988885 DOI: 10.1186/s12888-024-05706-2] [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: 10/23/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The Quick Delay Questionnaire (QDQ) is a short questionnaire designed to assess delay-related difficulties in adults. This study aimed to examine the reliability and validity of the Chinese version of the QDQ (C-QDQ) in Chinese adults, and explore the ecological characteristics of delay-related impulsivity in Chinese adults with attention-deficit/hyperactivity disorder (ADHD). METHODS Data was collected from 302 adults, including ADHD (n = 209) and healthy controls (HCs) (n = 93). All participants completed the C-QDQ. The convergent validity, internal consistency, retest reliability and confirmatory factor analysis (CFA) of the C-QDQ were analyzed. The correlations between C-QDQ and two laboratory measures of delay-related difficulties and Barratt Impulsiveness Scale-11 (BIS-11), the comparison of C-QDQ scores between ADHD subgroups and HCs were also analyzed. RESULTS The Cronbach's α of C-QDQ was between 0.83 and 0.89. The intraclass correlation coefficient of C-QDQ was between 0.80 and 0.83. The results of CFA of C-QDQ favoured the original two-factor model (delay aversion and delay discounting). Significant positive associations were found between C-QDQ scores and BIS-11 total score and performance on the laboratory measure of delay-related difficulties. Participants with ADHD had higher C-QDQ scores than HCs, and female ADHD reported higher scores on delay discounting subscale than male. ADHD-combined type (ADHD-C) reported higher scores on delay aversion subscale than ADHD-inattention type (ADHD-I). CONCLUSION The C-QDQ is a valid and reliable tool to measure delay-related responses that appears to have clinical utility. It can present the delay-related impulsivity of patients with ADHD. Compared to HCs, the level of reward-delay impulsivity was higher in ADHD.
Collapse
Affiliation(s)
- Caili Chen
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Shiyu Zhang
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Haiheng Hong
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Sunwei Qiu
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Yi Zhou
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Mengjie Zhao
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Meirong Pan
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Feifei Si
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Min Dong
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Haimei Li
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China.
| | | | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China.
| |
Collapse
|
3
|
González-Saiz F, Trujols J, Vergara-Moragues E. Cocaine Effect Expectancies among Patients with Cocaine Use Disorder with and without Adult Attention Deficit Hyperactivity Disorder: Are There Any Relevant Differences? J Psychoactive Drugs 2024; 56:76-87. [PMID: 36480506 DOI: 10.1080/02791072.2022.2151951] [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: 04/25/2022] [Revised: 09/05/2022] [Accepted: 09/23/2022] [Indexed: 12/14/2022]
Abstract
Cocaine use could be modulated by drug expectancies based on previously experienced subjective effects. Some patients perceive a paradoxical calming effect after cocaine use. This study was performed to explore cocaine effect expectancies in patients diagnosed with cocaine use disorder, with and without co-occurring adult attention deficit hyperactivity disorder (ADHD). Secondly, we sought to empirically determine the presence of this paradoxical calming effect after cocaine use in patients with co-occurring adult ADHD to identify the individuals most at risk of cocaine use and relapse. Cross-sectional study using a consecutive sampling method of patients diagnosed with cocaine use disorder (n = 221) treated at public therapeutic communities in Andalusia (Spain). Participants completed a battery of instruments to assess the following variables: cocaine effect expectancies, paradoxical calming effect, adult ADHD, and other co-occurring psychiatric disorders. A multivariate binary logistic regression analysis showed that two variables, the paradoxical calming effect and antisocial personality disorder (ASPD), were independently associated with the probability of being diagnosed with adult ADHD (OR = 3.43, 95% CI = 1.88-6.26 and OR = 3.42, 95% CI = 1.30-8.95, respectively). The presence of a paradoxical calming reaction to cocaine and/or a diagnosis of ASPD in patients with cocaine use disorder increases the diagnostic suspicion of co-occurring adult ADHD.
Collapse
Affiliation(s)
- Francisco González-Saiz
- Community Mental Health Unit of Villamartin, Hospital Universitario de Jerez, Cádiz, Spain
- Department of Neuroscience, Area of Psychiatry, University of Cadiz, Cadiz, Spain
- CIBERSAM (Network of Biomedical Research Centres for Mental Health), Madrid, Spain
| | - Joan Trujols
- CIBERSAM (Network of Biomedical Research Centres for Mental Health), Madrid, Spain
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu I Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Esperanza Vergara-Moragues
- Department of Psychobiology and Behavioural Science. Complutense University of Madrid (UCM), Madrid, Spain
| |
Collapse
|
4
|
Adamis D, Kasianenko D, Usman M, Saleem F, Wrigley M, Gavin B, McNicholas F. Prevalence of Personality Disorders in Adults With Attention Deficit Hyperactivity Disorder (ADHD). J Atten Disord 2023; 27:658-668. [PMID: 36927130 DOI: 10.1177/10870547231161531] [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: 03/18/2023]
Abstract
OBJECTIVE To estimate the prevalence of PDs according to Millon's evolution-based model among adult ADHD outpatients. METHOD Cross-sectional study of consecutive patients referred to an adult ADHD clinic. PDs were evaluated with Millon Clinical Multiaxial Inventory-III (MCMI-III). RESULTS One-hundred-eighty-one participants had valid MCMI-III, of whom147 were diagnosed with ADHD. Mean age: 32.97, SD:11.56, females: 74 (50.3%). Among the 147 participants with ADHD, 29 (19.7%) did not meet criteria for any PD, 43 (29.3%) met the criteria for one PD, 34 (23.1%) for two PDs and the rest three or more. Most common PD was Dependent (n = 58) followed by Depressive (n = 45). Inattentive sub-type was associated with dependent PD, while combined type with antisocial, negativistic (passive/aggressive) and sadistic PD. CONCLUSION Particular personality profiles were more common with different ADHD subtypes. Given the developmental origins of PD, further research may help identify possible links with childhood difficulties.
Collapse
Affiliation(s)
| | | | | | | | - Margo Wrigley
- National Clinical Programme for Adult ADHD, Dublin, Ireland
| | | | | |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Kölle M, Philipsen A, Mackert S. [Attention deficit hyperactivity disorder and substance use in adulthood-Guideline-conform diagnostics and treatment]. DER NERVENARZT 2023; 94:47-57. [PMID: 36633607 DOI: 10.1007/s00115-022-01422-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 01/13/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is the most frequent developmental disorder in childhood, adolescence and adulthood. Substance use disorders are a frequent comorbidity in ADHD. The many different forms and severities of these comorbidities necessitate individual strategies in the diagnostics and treatment. Principally, ADHD and addictive disorders should be treated together whenever possible. The more acute or severe the dependence disorder is, the less priority can be given to the topic of ADHD and the lower are the chances of carrying out valid diagnostics and simultaneous treatment at the beginning of the treatment of the addictive disorder. The less severe and acute the addictive disorder is, the quicker the diagnostics and, if necessary, treatment of ADHD can be initiated. In this continuing education article, the customary means for diagnostics and pharmacotherapy as well as the special features that must be considered with respect to comorbidities of both disorders are presented.
Collapse
Affiliation(s)
- Markus Kölle
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Alexandra Philipsen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Sarah Mackert
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| |
Collapse
|
7
|
Palma-Álvarez RF, Barta C, Carpentier PJ, Carruthers S, Crunelle CL, Demetrovics Z, Dom G, Faraone SV, Franck J, Johnson B, Kapitány-Fövény M, Kaye S, Konstenius M, Matthys F, Moggi F, Møller M, Schellekens A, Skutle A, van de Glind G, van Emmerik-van Oortmerssen K, Verspreet S, Schoevers RA, Wallhed S, Levin FR, Grau-López L, Casas M, van den Brink W, Ramos-Quiroga JA. Validity of the ADHD module of the Mini International Neuropsychiatric Interview PLUS for screening of adult ADHD in treatment seeking substance use disorder patients: ADHD screening with MINI-Plus. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:11-15. [PMID: 32561156 DOI: 10.1016/j.rpsm.2020.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aims to assess the validity of the ADHD module of the Mini-International Neuropsychiatric Interview (MINI-Plus) in patients with substance use disorders (SUD), using the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID) as the external criterion. METHOD A cross sectional international multi-center study in 10 countries was conducted in treatment seeking SUD patients. A sample of 1263 patients with both MINI-Plus and CAADID was analyzed to determine the psychometric properties of the MINI-Plus. RESULTS According to the CAADID, 179 patients (14.2%) met criteria for adult ADHD, whereas according to the MINI-Plus 227 patients (18.0%) were identified as having adult ADHD. Sensitivity of the MINI-Plus ADHD module was 74%, specificity was 91%, positive predictive value was 60% and negative predictive value was 96%. Kappa was 0.60. CONCLUSION The MINI-Plus has acceptable criterion validity for the screening of adult ADHD in treatment seeking SUD patients. SCIENTIFIC SIGNIFICANCE On the basis of the results, The MINI-Plus may be used for the screening of ADHD in SUD patients.
Collapse
Affiliation(s)
- Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | | | - Susan Carruthers
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Cleo L Crunelle
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; Toxicological Center, Antwerp University, Antwerp, Belgium
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geert Dom
- Antwerp University (UA), Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium; Psychiatric Center Mutiversum, Boechout, Belgium
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical Center, Syracuse, NY, USA
| | - Johan Franck
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brian Johnson
- Departments of Psychiatry and of Anesthesia, SUNY Upstate Medical Center, Syracuse, NY, USA
| | - Máté Kapitány-Fövény
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary; Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Sharlene Kaye
- National Drug and Alcohol Research Center, University of New South Wales, Sydney, Australia
| | - Maija Konstenius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Frieda Matthys
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Merete Møller
- Department for Substance Abuse Treatment, Østfold Hospital Trust, Norway
| | - Arnt Schellekens
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behavior, Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | | | | | - Katelijne van Emmerik-van Oortmerssen
- Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sara Wallhed
- Stockholm Centre for Dependency Disorders, Sweden
| | - Frances R Levin
- Columbia University, the New York State Psychiatric Institute, New York, NY, USA
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miguel Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wim van den Brink
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| |
Collapse
|
8
|
Buitelaar JK, van de Loo-Neus GHH, Hennissen L, Greven CU, Hoekstra PJ, Nagy P, Ramos-Quiroga A, Rosenthal E, Kabir S, Man KKC, Ic W, Coghill D. Long-term methylphenidate exposure and 24-hours blood pressure and left ventricular mass in adolescents and young adults with attention deficit hyperactivity disorder. Eur Neuropsychopharmacol 2022; 64:63-71. [PMID: 36209558 DOI: 10.1016/j.euroneuro.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/04/2022]
Abstract
Young people with attention deficit hyperactivity disorder (ADHD) are now being treated with psychostimulant medication for longer than was previously the case and are increasingly likely to remain on methylphenidate into adolescence and adulthood. This study was designed to determine whether the long-term use of methylphenidate (MPH, immediate release or extended release) increases blood pressure and left ventricular mass (LVM) identified by echocardiography in adolescents and young adults with ADHD aged 12-25 years. In a five-site cross-sectional design two groups were compared for 24- hour blood pressure and heart rate (HR) registrations and LVM: 1) adolescents and young adults with ADHD who had been treated with MPH for > 2 years (N=162, age mean (SD) 15.6 (3.0)), and 2) adolescents and young adults with ADHD who had never been treated with methylphenidate (N=71, age mean 17.4 (4.2)). The analyses were controlled for propensity scores derived from age, sex, height, weight, and 19 relevant background variables. A blood pressure indicative of hypertension (>95th percentile) was observed in 12.2% (95% confidence interval 7.3 - 18.9%) of the participants in the MPH treated group and in 9.6% (95%CI 3.2 - 21.0%) of the MPH naïve group, with overlapping intervals. The 24-hour recorded systolic blood pressure (SBP) and HR were significantly higher during daytime in medicated individuals with ADHD than in those with unmedicated ADHD, but were similar in both groups during the night. 24-hour diastolic blood pressure (DBP) did not differ between both groups during either daytime or at night. LVM, corrected for body-surface area (LVMBSA), also did not differ between the two groups (p=0.20, controlling for confounders). Further, MPH daily dose and duration of treatment were unrelated to LVMBSA, SBP, and DBP. Long-term MPH use in adolescents and young adults with ADHD is associated with small but significant increases of SBP and HR during daytime. Given the current sample size, the proportions of hypertension do not differ significantly between MPH treated and MPH-naïve individuals with ADHD. Future studies with larger samples, longer treatment duration, and/or with within-subject designs are necessary. The results do, however, further support recommendations that highlight the importance of monitoring blood pressure and HR during MPH treatment.
Collapse
Affiliation(s)
- J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
| | - G H H van de Loo-Neus
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - L Hennissen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - C U Greven
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - P J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry & Accare Child Study Center, Groningen, Netherlands
| | - P Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary; Bethesda Children's Hospital, Budapest, Hungary
| | - A Ramos-Quiroga
- Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Rosenthal
- Evelina London Children's Hospital, London, UK
| | - S Kabir
- Evelina London Children's Hospital, London, UK
| | - K K C Man
- Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Wong Ic
- Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - D Coghill
- Departments of Paediatrics and Psychiatry, University of Melbourne, Australia
| |
Collapse
|
9
|
The Use of Brexpiprazole Combined With a Stimulant in Adults With Treatment-Resistant Attention-Deficit/Hyperactivity Disorder. J Clin Psychopharmacol 2022; 42:445-453. [PMID: 35977005 DOI: 10.1097/jcp.0000000000001592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This is the first controlled pharmacologic study in either adults or children with uncomplicated, treatment-resistant attention-deficit/hyperactivity disorder (ADHD). This study augmented stimulant therapy with the atypical antipsychotic brexpiprazole. The Food and Drug Administration preapproved primary outcome measure (Conners' Adult ADHD Rating Scale [CAARS]) showed no drug-placebo differences. Often studies showing no efficacy on the prestudy, defined primary outcome variable go unpublished. While this is decried, publishing studies with equivocal results remains rare. This reanalysis highlights trends in secondary measures having implications for treatment and research regarding treatment resistant ADHD. METHODS Initially, 559 stimulant-naive and 174 prior stimulant nonresponders received methylphenidate osmotic-release oral system, dexmethylphenidate hydrochloride, lisdexamfetamine, or mixed amphetamine salts. After 5 weeks, 168 stimulant-naive patients and 68 prior stimulant nonresponders who failed treatment were randomized to brexpiprazole or placebo in a 2:1 ratio while the remaining were on the stimulant. Outcome was measured with the CAARS, Montgomery-Asberg Depression Rating Scale, Beck Depression Inventory, Clinical Global Impression, and the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). The WRAADDS contains 2 factors: attention and emotional dysregulation. RESULTS Stimulant-naive patients showed no improvement with adjunctive brexpiprazole. Prior stimulant nonresponders displayed no brexpiprazole effect on the CAARS, Montgomery-Asberg Depression Rating Scale, or Beck Depression Inventory. In contrast, the WRAADDS detected a trend in treatment benefit, primarily through emotional dysregulation symptoms. Adverse effects on brexpiprazole and placebo were equivalent. CONCLUSIONS Brexpiprazole might be effective in ADHD adults who are nonresponders to 2 or more stimulants. Future trials in treatment-resistant ADHD should use a 1:1 randomization and use a measure of ADHD symptoms that includes emotional dysregulation.
Collapse
|
10
|
López-Toro E, Wolf CJH, González RA, van den Brink W, Schellekens A, Vélez-Pastrana MC. Network Analysis of DSM Symptoms of Substance Use Disorders and Frequently Co-Occurring Mental Disorders in Patients with Substance Use Disorder Who Seek Treatment. J Clin Med 2022; 11:jcm11102883. [PMID: 35629008 PMCID: PMC9145186 DOI: 10.3390/jcm11102883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Substance use disorders (SUD) often co-occur with other psychiatric conditions. Research on SUD and comorbid disorders generally flows from a categorical diagnostic or dimensional latent variable perspective, where symptoms are viewed as independent indicators of an underlying disorder. In contrast, the current study took a network analysis perspective to examine the relationships between DSM symptoms of SUD, ADHD, conduct disorder (CD), depression (MDD), and borderline personality disorder (BPD). In addition, we explored possible gender differences in the network structures of these symptoms. Method: In a sample of 722 adult treatment-seeking patients with SUD from the International ADHD in Substance Use Disorders Prevalence Study (IASP) we estimated the network structure for 41 symptoms of SUD, ADHD, CD, MDD, and BPD. We described the structure of symptom networks and their characteristics for the total sample, and we compared the symptom networks for males and females. Results: Network analyses identified seven clusters of symptoms, largely corresponding with the DSM diagnostic categories. There were some connections between clusters, mainly between some hyperactivity symptoms and CD and depressive symptoms. ADHD hyperactivity was most central in the symptom network. Invariance tests revealed no significant gender differences in the structure of symptom networks. Conclusions: The current findings support the categorical DSM classification of mental disorders in treatment-seeking patients with SUD. Future network analyses should include a broader range of symptoms and prospectively explore changes in the symptoms network of patients during treatment.
Collapse
Affiliation(s)
- Edith López-Toro
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
| | - Casper J. H. Wolf
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - Rafael A. González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK;
- Centre for Psychiatry, Imperial College London, London W12 0NN, UK
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, Location Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - María C. Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
- Correspondence: ; Tel.: +1-787-725-6500
| | | |
Collapse
|
11
|
Abnormal white matter structure in hoarding disorder. J Psychiatr Res 2022; 148:1-8. [PMID: 35081485 DOI: 10.1016/j.jpsychires.2022.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/23/2021] [Accepted: 01/13/2022] [Indexed: 11/23/2022]
Abstract
Although preliminary neuroimaging research suggests that patients with hoarding disorder (HD) show widespread abnormal task-related activity in the brain, there has been no research on alterations in the white matter tracts in these patients. The aim of this study was to investigate the characteristics of the major white matter tracts in patients with HD. Tract-based spatial statistics were used to search for white matter tract abnormalities throughout the brain in 25 patients with HD and 36 healthy controls. Post hoc analysis of regions of interest was performed to detect correlations with clinical features. Compared with the controls, patients with HD showed decreased fractional anisotropy and increased radial diffusivity in anatomically widespread white matter tracts. Post hoc analysis of regions of interest revealed a significant negative correlation between the severity of hoarding symptoms and fractional anisotropy in the left anterior limb of the internal capsule and a positive correlation between the severity of these symptoms and radial diffusivity in the right anterior thalamic radiation. Patients with HD showed a broad range of alterations in the frontal white matter tracts, including the frontothalamic circuit, frontoparietal network, and frontolimbic pathway. The findings of this study indicate associations between frontal white matter abnormalities related to the severity of hoarding symptoms in HD and the cortical regions involved in cognitive dysfunction. The insights provided would be useful for understanding the neurobiological basis of HD.
Collapse
|
12
|
Fadeuilhe C, Daigre C, Grau-López L, Richarte V, Palma-Álvarez RF, Corrales M, Sáez B, Baz M, Ramos-Quiroga JA. The impact of insomnia disorder on adult attention-deficit/hyperactivity disorder severity: A six-month follow-up study. Psychiatry Res 2022; 308:114349. [PMID: 34998087 DOI: 10.1016/j.psychres.2021.114349] [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: 06/15/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES The longitudinal relationship between insomnia disorder and adult attention-deficit/hyperactivity disorder (ADHD) has been scarcely investigated. This study aimed to evaluate the relationship between the remission of insomnia disorder and adult ADHD clinical severity, psychiatric and medical comorbidities, and the health-related quality of life (HRQoL) in a 6-month follow-up. METHODS Ninety-two adult patients with ADHD and insomnia disorder (52.2% males; mean age 39.5 ± 11.0 years) were comprehensively assessed at baseline, 3 months, and 6 months of a follow-up period. The evaluation included semi-structured interviews (for ADHD and comorbidity assessment), the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of ADHD and insomnia disorder was performed according to DSM-5 criteria. At baseline and follow-up, psychoeducation/sleep hygiene and, if necessary, pharmacological were prescribed for insomnia. RESULTS Eighty-seven patients completed the 6-month follow-up. Insomnia disorder remission was reported in 72.4% of cases and was related to a greater improvement in ADHD symptoms and severity throughout the follow-up period. Additionally, an improvement in psychiatric comorbidities and better HRQoL were associated with insomnia disorder remission. CONCLUSION The current study highlights that the treatment of insomnia disorder in ADHD adult patients may have an important role in the outcome of ADHD therapeutic approaches by reducing their severity.
Collapse
Affiliation(s)
- C Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - C Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R F Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B Sáez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M Baz
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
13
|
Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model. J Affect Disord 2021; 293:97-108. [PMID: 34175595 DOI: 10.1016/j.jad.2021.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/08/2021] [Accepted: 06/13/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Adult attention-deficit/hyperactivity disorder (ADHD) is associated with impaired executive function (EF), depressive/anxiety symptoms, and poor quality of life (QoL). In this study, we aimed to investigate correlations among these variables and to build a simple or serial mediation model for exploring the mechanisms between adult ADHD and QoL. METHODS This was a cross-sectional study. The sample included 223 participants with ADHD and 54 healthy volunteers. Participants were required to complete the following scales: ADHD Rating Scale (ADHD-RS), Brief Version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Correlations among EF, depressive/anxiety symptoms and QoL were analyzed using Pearson correlation. The simple and serial mediation models were analyzed using PROCESS (version 3.3). RESULTS The correlations between EF and QoL, depressive/anxiety symptoms and QoL, and depressive/anxiety symptoms and EF were statistically significant. In ADHD adults with comorbidities, the correlation coefficients were between -0.19 and -0.47, -0.20 and -0.62, 0.28 and 0.50, respectively. In simple mediation models, EF and depressive/anxiety symptoms were significant mediators respectively between ADHD and QoL, respectively. In a serial two-mediator model, ADHD could affect QoL indirectly via EF and then via depressive/anxiety symptoms significantly. LIMITATIONS The average age was young, the degree of education was high, and only self-reported scales were relied on. CONCLUSIONS There is a mutual effect between EF and emotional symptoms. This was the first study to build a serial two-mediator model between ADHD and QoL, suggesting the importance of EF and depressive/anxiety symptoms.
Collapse
|
14
|
Zamani L, Shahrivar Z, Alaghband-Rad J, Sharifi V, Davoodi E, Ansari S, Emari F, Wynchank D, Kooij JJS, Asherson P. Reliability, Criterion and Concurrent Validity of the Farsi Translation of DIVA-5: A Semi-Structured Diagnostic Interview for Adults With ADHD. J Atten Disord 2021; 25:1666-1675. [PMID: 32486881 DOI: 10.1177/1087054720930816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: This study evaluated the psychometrics of the Farsi translation of diagnostic interview for attention-deficit hyperactivity disorder (ADHD) in adults (DIVA-5) based on DSM-5 criteria. Methods: Referrals to a psychiatric outpatient clinic (N = 120, 61.7% males, mean age 34.35 ± 9.84 years) presenting for an adult ADHD (AADHD) diagnosis, were evaluated using the structured clinical interviews for DSM-5 (SCID-5 & SCID-5-PD) and the DIVA-5. The participants completed Conner's Adult ADHD Rating Scale-Self Report-Screening Version (CAARS-S-SV). Results: According to the SCID-5 and DIVA-5 diagnoses, 55% and 38% of the participants had ADHD, respectively. Diagnostic agreement was 81.66% between DIVA-5/SCID-5 diagnoses, 80% between SCID-5/CAARS-S-SV, and 71.66% between DIVA-5/CAARS-S-SV. Test-retest and inter-rater reliability results for the DIVA-5 were good to excellent. Conclusion: Findings support the validity and reliability of the Farsi translation of DIVA-5 among the Farsi-speaking adult outpatient population.
Collapse
Affiliation(s)
- Lida Zamani
- Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Shadi Ansari
- Tehran University of Medical Sciences, Tehran, Iran
| | | | - Dora Wynchank
- Expertise Centre Adult ADHD, PsyQ, The Hague, The Netherlands
| | - J J Sandra Kooij
- Expertise Centre Adult ADHD, PsyQ, The Hague, The Netherlands.,Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Asherson
- MRC Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College London, UK
| |
Collapse
|
15
|
Weiss MD, Childress AC, Donnelly GA. Efficacy and Safety of PRC-063, Extended-Release Multilayer Methylphenidate in Adults with ADHD Including 6-Month Open-Label Extension. J Atten Disord 2021; 25:1417-1428. [PMID: 31916473 PMCID: PMC8273537 DOI: 10.1177/1087054719896853] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To evaluate the efficacy and safety of a 16-hr multilayer-release methylphenidate (PRC-063) in a community-based adult ADHD population. Method: In a double-blind study, 375 participants were randomized to one of four fixed doses of PRC-063 or placebo. The primary outcome was the ADHD-Rating Scale-5 (RS). The first 50% of double-blind completers were invited to participate in a 6-month dose-optimized open-label study to assess response and safety. Results: In total, 333 participants completed the double-blind trial; 184 entered the open-label study. PRC-063 produced greater symptom reduction in ADHD-RS-5 total score from baseline compared with placebo in the double-blind study (least-square [LS] mean = -4.7 [-7.7, -1.6], p = .003). The most frequent adverse events were headache, insomnia, and decreased appetite. No significant sleep quality impact was observed (p = .123). Significant improvements in ADHD-RS-5 scores from baseline continued through the open-label study (p < .0001), coincident with dose optimization. Conclusion: PRC-063 was well tolerated and significantly improved ADHD symptomatology in adults.
Collapse
Affiliation(s)
- Margaret D. Weiss
- Cambridge Health Alliance, Cambridge, MA, USA,Margaret D. Weiss, Child and Adolescent Psychiatry, Cambridge Health Alliance, 1493 Cambridge St, Cambridge, MA, USA, 02139-1047.
| | - Ann C. Childress
- Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, NV, USA
| | | |
Collapse
|
16
|
Martínez-Luna N, Daigre C, Palma-Álvarez F, Perea-Ortueta M, Grau-López L, Roncero C, Castell-Panisello E, Ramos-Quiroga JA. Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders. J Atten Disord 2021; 25:978-988. [PMID: 31550967 DOI: 10.1177/1087054719875787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: The objective of this study was to compare psychiatric comorbidity and consumption-related variables in ADHD patients seeking treatment for cocaine, cannabis, or both. Method: Assessment was conducted using European Addiction Severity Index (EuropASI), Conners' Adult ADHD Diagnostic Interview (CAADID), Structured Clinical Interview for DSM Disorders (SCID), Adult Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Barratt Impulsiveness Scale-11 (BIS-11), and FIDI, with statistical analyses of analysis of variance (ANOVA), Student's t test, chi-square test, and multinomial regression model. Results: In total, 1,538 patients with substance use disorder (SUD) were evaluated for ADHD; 239 (15.5%) had ADHD, with cannabis 41, cannabis/cocaine 36, and cocaine 74. Men represented 80%, with mean age of 32.9 ± 10 years. Significant variables were-in bivariate analysis-more years of cannabis use in cannabis group and younger age for cocaine use disorder in cannabis/cocaine group, and-in multivariate analysis-lifetime anxiety disorder and younger age at onset of any SUD in cannabis group and working affected scale in cannabis and polysubstance use in cannabis/cocaine group. Conclusion: Groups with cannabis use had higher severity. ADHD features were similar in all groups. The assessment of ADHD and comorbid disorders is important.
Collapse
Affiliation(s)
- Nieves Martínez-Luna
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Institute of Biomedicine of Salamanca , University of Salamanca, Spain
| | - Eudald Castell-Panisello
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| |
Collapse
|
17
|
Lunsford-Avery JR, Kollins SH, Mitchell JT. Sluggish Cognitive Tempo in Adults Referred for an ADHD Evaluation: A Psychometric Analysis of Self- and Collateral Report. J Atten Disord 2021; 25:322-331. [PMID: 30024295 PMCID: PMC6458092 DOI: 10.1177/1087054718787894] [Citation(s) in RCA: 9] [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] [Indexed: 11/15/2022]
Abstract
Objective: Sluggish cognitive tempo (SCT) symptoms uniquely contribute to psychiatric and functional outcomes in child samples; however, the psychometric properties of SCT measures among adult outpatients are unknown. Method: Adults (n = 124) presenting for an ADHD evaluation provided self- and collateral report of SCT symptoms. Results: The SCT scale had good internal consistency and yielded three factors across raters: Slow/Daydreamy, Sleepy/Sluggish, and Low Initiation/Persistence. SCT scores exhibited convergent validity with ADHD symptoms across raters. Individuals with ADHD received higher SCT ratings than those without ADHD via collateral report, a pattern that was similar when comorbidity was considered. SCT was associated with poorer functioning after accounting for ADHD symptoms with some differential effects based on reporting source. Conclusion: Findings support the internal consistency and validity of a three-factor SCT scale among adult outpatients. Differential results between self- and collateral report demonstrate the importance of multiple reporters of SCT in clinical settings.
Collapse
|
18
|
Prakash J, Chatterjee K, Guha S, Srivastava K, Chauhan VS. Adult attention-deficit Hyperactivity disorder: From clinical reality toward conceptual clarity. Ind Psychiatry J 2021; 30:23-28. [PMID: 34483520 PMCID: PMC8395556 DOI: 10.4103/ipj.ipj_7_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 11/07/2022] Open
Abstract
There is ambiguity about the clinical picture and concept of attention-deficit hyperactivity disorder (ADHD) in adults. Relevant literature was extracted from various search engines, analyzed, and interpreted. Available literature suggests a significant prevalence of ADHD in the adult population affecting the quality of socio-occupational functioning. Inattentiveness was more commonly present than hyperactivity-impulsivity. Frequent comorbidities with other psychiatric disorders like anxiety disorders and substance use disorders were noted. Pharmacological management and psychotherapy have been found effective in its management. ADHD is a disorder across the lifespan and fairly prevalent among adults. Greater awareness and more research are required for a better understanding of Adult ADHD and its effective management.
Collapse
Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - K. Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - S. Guha
- Private Consultant Psychiatrist, Sr Lecturer UQ School of Medicine and Griffith University School of Medicine, Australia
| | - K. Srivastava
- Department of Clinical Psychologist, Armed Forces Medical College, Pune, Maharashtra, India
| | - V. S. Chauhan
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| |
Collapse
|
19
|
Notzon DP, Pavlicova M, Glass A, Mariani JJ, Mahony AL, Brooks DJ, Levin FR. ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders. J Atten Disord 2020; 24:1487-1492. [PMID: 27033880 PMCID: PMC5568505 DOI: 10.1177/1087054716640109] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To estimate the prevalence of ADHD and determine an effective screening test for ADHD in a population-seeking treatment for cannabis use disorders. Method: The Conners Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; CAADID) was used to generate sensitivity and specificity data for ADHD screening tests, which were then administered to 99 participants seeking treatment for cannabis use disorders to estimate ADHD prevalence. Results: The prevalence estimated from the Wender Utah Rating Scale (WURS) was 45% (sensitivity = 0.88, sensitivity of 0.75), from the Conners Adult ADHD Rating Scale (CAARS) 34% (sensitivity = 0.80, specificity = 0.91), from the WURS + CAARS 36% (sensitivity = 0.71, specificity = 0.95), and from the Adult ADHD Self-Report Scale (ASRS) 46% (sensitivity = 0.61, specificity = 0.86). Conclusion: The prevalence of ADHD in adults seeking treatment for cannabis use disorders is estimated to be between 34% and 46%. The WURS paired with the CAARS provides excellent sensitivity and specificity for the diagnosis of ADHD in this population.
Collapse
Affiliation(s)
- Daniel P. Notzon
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| | | | | | - John J. Mariani
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| | | | | | - Frances R. Levin
- New York State Psychiatric Institute, NY, USA
- Columbia University, New York, NY, USA
| |
Collapse
|
20
|
Bakare B, Jordanova V. Psychometric Properties of a Brief Screening Measure for ADHD in Adults. Int J Psychol Res (Medellin) 2020; 13:78-88. [PMID: 33329880 PMCID: PMC7735513 DOI: 10.21500/20112084.4511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/26/2020] [Accepted: 06/13/2020] [Indexed: 11/06/2022] Open
Abstract
The use of screening tools is an effective and practical approach within the clinical diagnostic assessment of attention deficit hyperactivity disorder (ADHD) in adults. Existing screening measures for adult ADHD have focused on a younger population. Subsequently, the current study aimed to evaluate the utility and general usability of an adapted four-item screening tool for adult ADHD: a brief version of the Wender Utah Rating Scale (WURS-brief), within a middle-aged population. The sample consisted of 69 adults, aged between 30 and 63 (age M= 45, SD=6.95), who had been referred to a specialist adult ADHD outpatients clinic. Using factor analysis, the WURS-brief screening measure was compared to existing ADHD diagnostic tools that were used as reference measures within the analysis. The WURS-brief had respectable sensitivity when compared with existing diagnostic tools. This study highlights the importance of validating brief screening measures for middle-aged adults with ADHD within clinical settings and offers suggestions for future research.
Collapse
Affiliation(s)
- Blessing Bakare
- Institute of Psychiatry, Neurology and Neurosciences, Kings College London, London, United KingdomKing's College LondonKings College LondonLondonUnited Kingdom
| | - Vesna Jordanova
- Institute of Psychiatry, Neurology and Neurosciences, Kings College London, London, United KingdomKing's College LondonKings College LondonLondonUnited Kingdom
| |
Collapse
|
21
|
Shapiro ZR, Huang-Pollock C, Graham JW, Neely K. Making the Most of It: Application of Planned Missingness Design to Increase the Efficiency of Diagnostic Assessment. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020; 42:314-327. [PMID: 32523240 DOI: 10.1007/s10862-019-09780-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Multimethod assessment is recommended as "best practice" in clinical assessment and is often implemented through the combined use of symptom rating scales and structured interviews. While this approach increases confidence in the validity of assessment, it also increases burden, expense, and leads to the accumulation of redundant information. To address this problem, we evaluate the use a planned missingness design within the framework of adult Attention Deficit/Hyperactivity Disorder (ADHD) assessment. In a sample of 169 young adults, we fit a two-method measurement (TMM) model using ADHD symptoms obtained from rating scales and a structured diagnostic interview. Based on an estimated 8:1 differential between the cost of conducting an in-person diagnostic interview vs. completing questionnaires online, we conducted a series of Monte Carlo simulations to determine the utility of combining TMM with a planned missingness design. We find that even when costs are kept constant, statistical power of the TMM/planned missingness design was equal to the power that would have been obtained had nearly twice the number of participants with complete data been recruited. Conversely, costs could be decreased by 20-25%, while maintaining statistical power equivalent to a design with complete data. Our results suggest the TMM design is a promising technique for reducing the cost and burden of diagnostic assessment within research settings.
Collapse
Affiliation(s)
- Zvi R Shapiro
- The Pennsylvania State University, University Park, PA 16802, USA
| | | | - John W Graham
- The Pennsylvania State University, University Park, PA 16802, USA
| | - Kristina Neely
- School of Kinesiology, Auburn University, Auburn, AL, USA
| |
Collapse
|
22
|
Kuwano M, Nakao T, Yonemoto K, Yamada S, Murayama K, Okada K, Honda S, Ikari K, Tomiyama H, Hasuzawa S, Kanba S. Clinical characteristics of hoarding disorder in Japanese patients. Heliyon 2020; 6:e03527. [PMID: 32181397 PMCID: PMC7063155 DOI: 10.1016/j.heliyon.2020.e03527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/19/2019] [Accepted: 02/28/2020] [Indexed: 11/30/2022] Open
Abstract
Previous studies have reported clinical characteristics of hoarding disorder (HD), such as early onset, a chronic course, familiality, high unmarried rate, and high rates of comorbidities. However, clinical research targeting Japanese HD patients has been very limited. As a result, there is a low recognition of HD in Japan, leading to insufficient evaluation and treatment of Japanese HD patients. The aim of the current study was to delineate the clinical characteristics of Japanese HD patients. Thirty HD patients, 20 obsessive-compulsive disorder (OCD) patients, and 21 normal controls (NC) were targeted in this study. The HD group had a tendency toward higher familiality, earlier onset, and longer disease duration compared to the OCD group. In addition, the HD group showed a significantly higher unmarried rate than the NC group. The top two comorbidities in the HD group were major depressive disorder (56.7%) and attention-deficit/hyperactivity disorder (26.7%). The HD group had significantly higher scores on hoarding rating scales and lower scores on the Global Assessment of Functioning Scale than the other two groups. The current study showed a clinical trend in Japanese HD patients similar to previous studies in various countries, suggesting that HD may be a universal disease with consistent clinical symptoms.
Collapse
Affiliation(s)
- Masumi Kuwano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Nagasaki Support Center for Children, Women and People with Disabilities, Nagasaki, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.,Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Satoshi Yamada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Fukuoka Prefectural Psychiatric Center Dazaifu Hospital, Fukuoka, Japan
| | - Keitaro Murayama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kayo Okada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Okehazama Hospital Fujita Mental Care Center, Aichi, Japan
| | - Shinichi Honda
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Keisuke Ikari
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Suguru Hasuzawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
23
|
Polaprezinc (Zinc-L-Carnosine Complex) as an Add-on Therapy for Binge Eating Disorder and Bulimia Nervosa, and the Possible Involvement of Zinc Deficiency in These Conditions: A Pilot Study. J Clin Psychopharmacol 2020; 40:599-606. [PMID: 33044355 PMCID: PMC7643788 DOI: 10.1097/jcp.0000000000001284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Zinc plays an important role in appetite regulation. L-Carnosine, an endogenous dipeptide, may also regulate eating behavior via its histaminergic and antiglutamatergic properties. Polaprezinc (zinc-L-carnosine complex) is a medication for gastric ulcers. A small case series reported successful treatment of binge eating with add-on polaprezinc. METHODS This was an open trial of add-on polaprezinc in patients with binge eating disorder (BED; n = 22) or bulimia nervosa (BN; n = 7) receiving antidepressants. A 4-week baseline period was followed by a 16-week polaprezinc treatment at 150 mg/d (containing 34 mg zinc and 116 mg L-carnosine) in addition to ongoing psychotropic medications. We also assessed their zinc status via a laboratory index and zinc deficiency-related symptoms. RESULTS At the study end, both conditions showed a significant reduction in the 4-week frequency of combined objective and subjective binge eating episodes, the 4-week frequency of days when at least 1 such episode occurred (only in BED), several aspects of eating disorder psychopathology (rated by the Eating Disorder Examination-Questionnaire), and comorbid depressive symptoms (rated by the 16-item Quick Inventory of Depressive Symptomatology [Self-Report]). Serum copper/zinc ratio decreased from 1.4 to 1.1 on average in both conditions. All patients had multiple zinc deficiency-related symptoms at baseline that substantially improved after polaprezinc treatment. Overall, the effectiveness of polaprezinc was greater in BED patients than in BN patients, with minor adverse effects. CONCLUSIONS These findings offer preliminary evidence for the effectiveness of polaprezinc in treating BED and BN and suggest the involvement of zinc deficiency in these conditions.
Collapse
|
24
|
González RA, Vélez-Pastrana MC, Blankers M, Bäcker A, Konstenius M, Holtmann M, Levin FR, Noack M, Kaye S, Demetrovics Z, van de Glind G, van den Brink W, Schellekens A. Onset and Severity of Early Disruptive Behavioral Disorders in Treatment-Seeking Substance Use Disorder Patients with and without Attention-Deficit/Hyperactivity Disorder. Eur Addict Res 2020; 26:211-222. [PMID: 32594079 DOI: 10.1159/000508653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Abstract
AIMS This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
Collapse
Affiliation(s)
- Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom, .,Centre for Psychiatry, Imperial College London, London, United Kingdom,
| | - María C Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, USA
| | - Matthijs Blankers
- Arkin Mental Health Care, Department of Research, Amsterdam, The Netherlands.,Trimbos institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Amanda Bäcker
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maija Konstenius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Frances R Levin
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Moritz Noack
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnt Schellekens
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | | |
Collapse
|
25
|
Slobodin O. The Utility of the CPT in the Diagnosis of ADHD in Individuals with Substance Abuse: A Systematic Review. Eur Addict Res 2020; 26:283-294. [PMID: 32535592 DOI: 10.1159/000508041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early identification of attention-deficit/hyperactivity disorder (ADHD) in individuals with substance use disorders (SUD) is important because ADHD has an adverse effect on the development and course of SUD. Given the limited validity of self-report measures of ADHD in individuals with SUD, it is important to investigate the utility of the continuous performance test (CPT) in classifying ADHD in adults with SUD. OBJECTIVE This review aims to examine the quantitative similarities and differences in CPT performance of adults with ADHD, SUD, and their comorbidity to determine if a distinct neurocognitive profile exists for each. METHOD A systematic review of CPT studies that included patients with the comorbidity of ADHD and SUD and a comparison group of one of the disorders alone was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. RESULTS Eight studies were identified with sample sizes ranging from n = 17 to n = 386. The comorbidity of ADHD and SUD was, mostly, not associated with higher rates of commission and omission errors than either disorder alone. However, the comorbidity of ADHD and SUD was more likely to be associated with increased deficits in response time variability compared with individuals with ADHD alone. CONCLUSIONS This review highlights the shortage of large-scale CPT research involving patients with ADHD and SUD. The CPT might be sensitive to attentional deficits, but it lacks specificity for the classification of adult ADHD, SUD, or their comorbidity, and the CPT is thus not useful in discriminating comorbid ADHD and SUD from either disorder alone. Future CPT research should explore whether specific attentional deficits account for the development and persistence of SUD. Such research should also reach beyond traditional CPT measures and include other cognitive and behavioral deficits that were associated with ADHD, such as distractibility and hyperactivity.
Collapse
Affiliation(s)
- Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Israel,
| |
Collapse
|
26
|
Sánchez-García NC, González RA, Ramos-Quiroga JA, van den Brink W, Luderer M, Blankers M, Grau-Lopez L, Levin FR, Kaye S, Demetrovics Z, van de Glind G, Schellekens A, Vélez-Pastrana MC. Attention Deficit Hyperactivity Disorder Increases Nicotine Addiction Severity in Adults Seeking Treatment for Substance Use Disorders: The Role of Personality Disorders. Eur Addict Res 2020; 26:191-200. [PMID: 32564016 DOI: 10.1159/000508545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
AIMS To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients. METHODS In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD. RESULTS Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity. CONCLUSIONS SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.
Collapse
Affiliation(s)
| | - Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lara Grau-Lopez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Frances R Levin
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,CUMC/Herbert Pardes Building, New York State Psychiatric Institute, New York, New York, USA
| | - Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addictions, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | | | | |
Collapse
|
27
|
Icick R, Moggi F, Slobodin O, Dom G, Mathys F, van den Brink W, Levin FR, Blankers M, Kaye S, Demetrovics Z, van de Glind G, Velez-Pastrana MC, Schellekens ASA. Attention Deficit/Hyperactivity Disorder and Global Severity Profiles in Treatment-Seeking Patients with Substance Use Disorders. Eur Addict Res 2020; 26:201-210. [PMID: 32570249 DOI: 10.1159/000508546] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Comorbid attention deficit/hyperactivity disorder (ADHD) is present in 15-25% of all patients seeking treatment for substance use disorders (SUDs). Some studies suggest that comorbid ADHD increases clinical severity related to SUDs, other psychiatric comorbidities, and social impairment, but could not disentangle their respective influences. OBJECTIVES To investigate whether comorbid adult ADHD in treatment-seeking SUD patients is associated with more severe clinical profiles in these domains assessed altogether. METHODS Treatment-seeking SUD patients from 8 countries (N = 1,294: 26% females, mean age 40 years [SD = 11 years]) were assessed for their history of DSM-IV ADHD, SUDs, and other psychiatric conditions and sociodemographic data. SUD patients with and without comorbid ADHD were compared on indicators of severity across 3 domains: addiction (number of SUD criteria and diagnoses), psychopathological complexity (mood disorders, borderline personality disorder, lifetime suicidal thoughts, or behavior), and social status (education level, occupational and marital status, and living arrangements). Regression models were built to account for confounders for each severity indicator. RESULTS Adult ADHD was present in 19% of the SUD patients. It was significantly associated with higher SUD severity, more frequent comorbid mood or borderline personality disorder, and less frequent "married" or "divorced" status, as compared with the absence of comorbid ADHD. ADHD comorbidity was independently associated with a higher number of dependence diagnoses (OR = 1.97) and more psychopathology (OR = 1.5), but not marital status. CONCLUSIONS In treatment-seeking SUD patients, comorbid ADHD is associated with polysubstance dependence, psychopathological complexity, and social risks, which substantiates the clinical relevance of screening, diagnosing, and treating ADHD in patients with SUDs.
Collapse
Affiliation(s)
- Romain Icick
- Integrative Neurobiology of Cholinergic Systems, CNRS UMR 3571, Institut Pasteur, Paris, France, .,Assistance Publique - Hôpitaux de Paris, University Hospital Saint-Louis - Lariboisière - Fernand Widal, Paris, France, .,INSERM UMR-S1144, Paris, France, .,Paris University, Paris, France,
| | - Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Israel
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
| | - Frieda Mathys
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Institute for Addiction Research - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Frances R Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute - Columbia University Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - Matthijs Blankers
- Trimbos, Netherlands Institute of Mental Health and Addiction, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Psychiater Radboudumc, Donders Centre for Neuroscience, Afdeling Psychiatrie Wetenschappelijk, Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | | | - Arnt S A Schellekens
- Psychiater Radboudumc, Donders Centre for Neuroscience, Afdeling Psychiatrie Wetenschappelijk, Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | | |
Collapse
|
28
|
Dvorsky MR, Langberg JM. Predicting Impairment in College Students With ADHD: The Role of Executive Functions. J Atten Disord 2019; 23:1624-1636. [PMID: 25234039 DOI: 10.1177/1087054714548037] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study longitudinally evaluated whether parent-ratings and self-ratings of executive function (EF) predicted the academic and overall functioning of college students with ADHD and whether EF deficits mediated the relationship between ADHD symptoms and functioning. METHOD A prospective longitudinal study of 59 college students comprehensively diagnosed with ADHD and their parents who completed ratings at the beginning and end of the school year. RESULTS Student-rated motivation and parent-rated emotion regulation significantly predicted overall impairment above and beyond symptoms of ADHD. Student-rated EF motivation mediated the relationship between ADHD symptoms and overall impairment. Student-rated EF organization mediated the relationship between ADHD symptoms and end of the year grades. CONCLUSION Motivation and organization aspects of EF appear particularly important for functioning. However, given the study's modest sample size, additional longitudinal research is needed to confirm these findings and to develop best-practice assessment and treatment recommendations for college students with ADHD.
Collapse
|
29
|
A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with attention-deficit/hyperactivity disorder (ADHD). Psychiatry Res 2019; 279:23-33. [PMID: 31280035 DOI: 10.1016/j.psychres.2019.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/11/2022]
Abstract
The study aimed to explore whether cognitive behavioral therapy (CBT) combined with medication is superior to CBT alone in core symptoms, emotional symptoms, self-esteem as well as social and cognitive functions of adult attention-deficit/hyperactivity disorder (ADHD) patients. Samples from a previous RCT study and outpatient participants were all included. A total of 124 patients received 12 weeks of manualized CBT sessions, either with (n = 57) or without (n = 67) medication. Efficacy variables were evaluated at baseline and each week. Mixed linear models (MLM) were used to compare differences between the two groups in all of the above domains. Within-group comparisons showed that both groups had robust improvements in core ADHD symptoms, emotional symptoms and social functional outcomes. The CBT + M group presented more domains of improvement in executive functions than the CBT group. However, comparisons between groups didn't indicate the superiority of CBT + M in core symptoms, emotional symptoms and self-esteem. Instead, the CBT group showed a greater improvement in the physical domain of the WHOQOL-BREF than the CBT + M group. This study further indicated that CBT is an effective treatment for adults with ADHD. A combination of CBT and medication presented broader improvements in executive functions, but not in clinical symptoms, than CBT alone.
Collapse
|
30
|
Psychiatric factors affecting recovery after a long term treatment program for substance use disorder. Psychiatry Res 2019; 276:283-289. [PMID: 31128488 DOI: 10.1016/j.psychres.2019.05.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 12/11/2022]
Abstract
Psychiatric comorbidity can negatively impact the course of addictions. Psychiatric features of patients who continued treatment after the first stage of an addiction program have not been sufficiently analysed. Therefore, only these patients were included in order to compare psychiatric comorbidity and clinical factors between patients who were able or not to complete a long term substance-free program. Treatment-completion status of 245 patients was systematically recorded. Addiction severity, psychiatry comorbidity, and psychological symptoms were evaluated. No significant differences were found regarding comorbid psychiatric diagnoses and the completion of the treatment. Longer treatment duration (OR: 1.22; p < 0.01), higher educational level (OR: 2.37; p = 0.02), and cocaine dependence as main substance (OR: 3.68; p < 0.01) were found to be related to increased likelihood in completing the treatment. Patients with higher severity of alcohol consumption (OR: 0.06; p = 0.02) and more depressive symptoms (OR: 0.95; p = 0.01) completed the treatment less frequently. Moreover, differences regarding employment problems, treatment facilities, anxiety symptoms, dysfunctional impulsivity, and mental HRQoL were found. It is concluded that comorbid psychiatric diagnoses do not determine treatment outcomes. However, therapeutic and psychological factors have a major influence on the likelihood to complete a long-term treatment program.
Collapse
|
31
|
Do EK, Haberstick BC, Williams RB, Lessem JM, Smolen A, Siegler IC, Fuemmeler BF. The role of genetic and environmental influences on the association between childhood ADHD symptoms and BMI. Int J Obes (Lond) 2019; 43:33-42. [PMID: 30349010 PMCID: PMC7065598 DOI: 10.1038/s41366-018-0236-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 08/02/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND/OBJECTIVES Although childhood attention deficit hyperactivity disorder (ADHD) has been previously associated with concurrent and later obesity in adulthood, the etiology of this association remains unclear. The objective of this study is to determine the shared genetic effects of ADHD symptoms and BMI in a large sample of sibling pairs, consider how these shared effects may vary over time, and examine potential sex differences. SUBJECT/METHODS Sibling pair data were obtained from the National Longitudinal Study of Adolescent to Adult Health (Add Health); childhood ADHD symptoms were reported retrospectively during young adulthood, while three prospective measurements of BMI were available from young adulthood to later adulthood. Cholesky decomposition models were fit to this data using Mx and maximum-likelihood estimation. The twin and sibling sample for these analyses included: 221 monozygotic (MZ) pairs (92 male-male, 139 female-female), 228 dizygotic (DZ) pairs (123 male-male, 105 female-female), 471 full-sibling (FS) pairs (289 male-male, 182 female-female), 106 male-female DZ twin pairs, and 234 male-female FS pairs. RESULTS The magnitude of the association between childhood ADHD symptoms and BMI changed over time and by sex. The etiological relationship between childhood ADHD symptoms and the three prospective measurements of BMI differed for males and females, such that unique or non-shared environmental influences contributed to the relationship within males and genetic factors contributed to the relationship within females. Specifically, among females, genetic influences on childhood ADHD symptoms were partially shared with those effecting BMI and increased from adolescence to later adulthood (genetic correlation = 0.20 (95% CI: 0.07-0.36) in adolescence and 0.24 (95% CI: 0.10, 0.41) in adulthood). CONCLUSION Genetic influences on ADHD symptoms in childhood are partially shared with those effecting obesity. However, future research is needed to determine why this association is limited to females.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Brett C Haberstick
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Redford B Williams
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jeffrey M Lessem
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Andrew Smolen
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Ilene C Siegler
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
| |
Collapse
|
32
|
Fabiano GA, Hulme KF, Sodano SM, Caserta A, Hulme K, Stephan G, Smyth AC. An Evaluation of Occupational Behavior in Individuals with and without Attention Deficit/Hyperactivity Disorder. HUMAN PERFORMANCE 2018. [DOI: 10.1080/08959285.2018.1489809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
33
|
Barbaresi WJ, Weaver AL, Voigt RG, Killian JM, Katusic SK. Comparing Methods to Determine Persistence of Childhood ADHD Into Adulthood: A Prospective, Population-Based Study. J Atten Disord 2018; 22:571-580. [PMID: 26700793 PMCID: PMC6203296 DOI: 10.1177/1087054715618791] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the rate of persistence of ADHD into adulthood as determined by a norm-referenced versus non-norm-referenced diagnostic interview, and by standardized questionnaires. METHOD Adults from a birth cohort, including research-identified childhood ADHD cases ( N = 232; Mage = 27.0 years; 167 males, 65 females) and controls ( N = 335; Mage = 28.6 years; 210 males, 125 females), were administered the M.I.N.I. International Neuropsychiatric Interview, the Murphy-Barkley Symptoms Checklist (MB), and the Wender Utah Rating Scale (WURS) Results: Among the childhood ADHD cases, 29.3% fulfilled criteria for adult ADHD using a norm-referenced approach to M.I.N.I. scoring, versus 13.8% using published M.I.N.I. criteria. Among participants meeting norm-referenced diagnostic criteria, 41.8% and 69.1% were classified as adult ADHD using the MB and WURS, respectively. CONCLUSION A non-norm-referenced approach resulted in a significant underestimate of the rate of adult ADHD. Reliance on either of two adult ADHD questionnaires would have further reduced this estimate.
Collapse
Affiliation(s)
- William J. Barbaresi
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amy L. Weaver
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Robert G. Voigt
- Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas
| | - Jill M. Killian
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Slavica K. Katusic
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
34
|
Eddy LD, Dvorsky MR, Molitor SJ, Bourchtein E, Smith Z, Oddo LE, Eadeh HM, Langberg JM. Longitudinal Evaluation of the Cognitive-Behavioral Model of ADHD in a Sample of College Students With ADHD. J Atten Disord 2018; 22:323-333. [PMID: 26637840 DOI: 10.1177/1087054715616184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The primary aim of this study was to evaluate longitudinal pathways to impairment as outlined in the cognitive-behavioral model of ADHD in a sample of 59 college students diagnosed with ADHD. METHOD Serial mediation models were used to test whether underachievement, defined as prior year GPA, would longitudinally predict self-reported impairment at the end of the next school year, through negative self-concept and associated changes in symptoms of anxiety and depression, while controlling for baseline impairment and changes in ADHD symptoms. RESULTS Findings supported the cognitive-behavioral model of ADHD. The association between prior year GPA and overall impairment at the end of the year was fully mediated through self-concept and symptoms of depression. CONCLUSION These results help explain why impairment often persists even when ADHD symptoms remit and suggests that internalizing symptoms may be an important target for intervention in college students with ADHD.
Collapse
Affiliation(s)
- Laura D Eddy
- 1 Virginia Commonwealth University, Richmond, USA
| | | | | | | | - Zoe Smith
- 1 Virginia Commonwealth University, Richmond, USA
| | | | | | | |
Collapse
|
35
|
van Emmerik-van Oortmerssen K, Vedel E, Kramer FJ, Koeter MW, Schoevers RA, van den Brink W. Diagnosing ADHD during active substance use: Feasible or flawed? Drug Alcohol Depend 2017; 180:371-375. [PMID: 28957778 DOI: 10.1016/j.drugalcdep.2017.07.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent in patients with a substance use disorder (SUD). Because of possible problems with validity, diagnostic assessment of ADHD is usually postponed until after a period of abstinence, which may jeopardize adequate and timely treatment. The aim of this study is to investigate how a diagnostic assessment of ADHD in patients who are actively using substances compares to the results of a second assessment after a period of full or partial abstinence. METHODS Prospective test-retest study in a SUD treatment center among 127 treatment seeking adult SUD patients with a comorbid diagnosis of adult ADHD. Conners' Adult ADHD Diagnostic Interview for DSM-IV was administered at intake and after four SUD treatment sessions. RESULTS The mean time interval between intake and retest assessment was 78days (SD=32; range 31-248). At the second ADHD assessment, substance use had decreased to about 50% of baseline consumption. Of the 127 patients with an initial diagnosis of ADHD, 121 patients (95.3%) still fulfilled DSM-IV adult ADHD criteria at re-diagnosis. Subtyping of ADHD was less stable (Cohen's Kappa=0.53). Agreement on the number of childhood and adult ADHD symptoms between both assessments was good (intraclass correlation coefficient of 0.69 and 0.65, respectively). Sensitivity analyses in subgroups of patients who were fully abstinent during the second assessment yielded very similar results. CONCLUSIONS These findings strongly suggest that a pragmatic approach, in which patients are evaluated for ADHD even when they are not (yet) abstinent, is feasible and justifiable.
Collapse
Affiliation(s)
- Katelijne van Emmerik-van Oortmerssen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands; Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands; Jellinek Substance Abuse Treatment Center, Amsterdam, The Netherlands.
| | - Ellen Vedel
- Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands; Jellinek Substance Abuse Treatment Center, Amsterdam, The Netherlands
| | - Floor J Kramer
- Arkin Mental Health and Addiction Treatment Center, Amsterdam, The Netherlands; Jellinek Substance Abuse Treatment Center, Amsterdam, The Netherlands
| | - Maarten W Koeter
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Wim van den Brink
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
36
|
Ferrer M, Andión Ó, Calvo N, Ramos-Quiroga JA, Prat M, Corrales M, Casas M. Differences in the association between childhood trauma history and borderline personality disorder or attention deficit/hyperactivity disorder diagnoses in adulthood. Eur Arch Psychiatry Clin Neurosci 2017; 267:541-549. [PMID: 27658669 DOI: 10.1007/s00406-016-0733-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 09/09/2016] [Indexed: 12/01/2022]
Abstract
Common environmental etiological factors between borderline personality disorder (BPD) and attention deficit/hyperactivity disorder (ADHD) have not been fully studied. The main aim of this study was to investigate the relationship between childhood trauma histories, assessed by the Childhood Trauma Questionnaire-Short Form (CTQ-SF), with adult BPD, ADHD or BPD-ADHD diagnoses. Comorbid BPD-ADHD patients exhibited significantly higher clinical severity and higher scores in the Total Neglect Scale, compared to BPD and ADHD patients, and only a marginal difference was observed for Sexual Abuse when BPD and ADHD patients were compared. Physical Trauma Scales were associated with ADHD diagnosis, whereas Emotional Abuse and Sexual Abuse Scales were associated with BPD or BPD-ADHD diagnoses. The study findings support the association between experiencing traumatic events in childhood and a higher clinical severity of BPD in adulthood. Furthermore, physical trauma history in childhood could be associated with the persistence of ADHD in adulthood and emotional or sexual abuse with later development of BPD or comorbid BPD-ADHD. Whereas experiencing childhood traumas is associated with later development of more general psychopathology, our study supports that a specific type of traumatic event could increase the risk for the consolidation of a concrete psychiatric disorder in the trajectory from childhood to adulthood of vulnerable subjects.
Collapse
Affiliation(s)
- Marc Ferrer
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain. .,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Grup TLP Barcelona (BPD Barcelona Group), Barcelona, Spain.
| | - Óscar Andión
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natalia Calvo
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup TLP Barcelona (BPD Barcelona Group), Barcelona, Spain
| | - Josep A Ramos-Quiroga
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mònica Prat
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup TLP Barcelona (BPD Barcelona Group), Barcelona, Spain
| | - Montserrat Corrales
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miguel Casas
- BPD Program, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Psychiatry Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup TLP Barcelona (BPD Barcelona Group), Barcelona, Spain
| |
Collapse
|
37
|
Daigre C, Grau-López L, Rodríguez-Cintas L, Ros-Cucurull E, Sorribes-Puertas M, Esculies O, Bones-Rocha K, Roncero C. The role of dual diagnosis in health-related quality of life among treatment-seeking patients in Spain. Qual Life Res 2017; 26:3201-3209. [PMID: 28786018 DOI: 10.1007/s11136-017-1668-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE The comorbidity of any substance use disorder and another mental disorder is defined as dual diagnosis. Dual diagnosis is very common and clinical and therapeutic consequences have been described. This cross-sectional study aimed to analyse health-related quality of life (HRQoL) according to clinical characteristics and psychiatric comorbidities in patients with substance dependence. METHODS A total of 1276 substance-dependent patients seeking treatment were recruited. HRQoL was evaluated by the Short-Form 36 (SF-36) questionnaire. The SCID-I, SCID-II and Conners' adult ADHD diagnostic interview were used to evaluate dual diagnosis. A visual analogue scale was used to measure craving. Bivariate and multivariate analyses were performed, and correction for multiple tests was conducted. RESULTS Substance-dependent patients had impaired quality of life, especially in the mental component. SF-36 physical and mental component scores were 47.7 ± 10.9 and 36.1 ± 14.1, respectively. Furthermore, 65% of the patients had dual diagnosis, 51% had an Axis I DSM-IV-TR mental disorder and 35% had some personality disorder. Impaired physical quality of life was independently associated with medical condition, age, being female, depressive disorder and anxiety disorder. Depression disorder, any personality disorder, active consumption last month, Attention deficit hyperactivity disorder, anxiety disorder, suicide attempt were independently associated with worse mental quality of life. CONCLUSION These findings emphasize the significance of dual diagnosis in the impairment of HRQoL in substance-dependent patients, particularly with regard to mental component. In addicted patients with low scores on SF-36, psychiatric comorbidity should be evaluated and treated in an integrated approach.
Collapse
Affiliation(s)
- Constanza Daigre
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain.
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | | | - Katia Bones-Rocha
- Faculty of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| |
Collapse
|
38
|
Childhood trauma exposure in substance use disorder patients with and without ADHD. Addict Behav 2017; 65:118-124. [PMID: 27816036 DOI: 10.1016/j.addbeh.2016.10.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 10/09/2016] [Accepted: 10/21/2016] [Indexed: 11/24/2022]
|
39
|
Addiction severity pattern associated with adult and childhood Attention Deficit Hyperactivity Disorder (ADHD) in patients with addictions. Psychiatry Res 2016; 246:656-662. [PMID: 27842945 DOI: 10.1016/j.psychres.2016.10.071] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 09/12/2016] [Accepted: 10/30/2016] [Indexed: 12/14/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent among adults with addictive disorders, but little is known about addiction patterns associated with ADHD diagnosis. This study examined addiction severity in patients with co-occurring addictive disorders and ADHD controlling for the potential influence of associated psychiatric comorbidity. Data were collected in French outpatient addiction treatment centers. A total of 217 patients seeking treatment for substance or gambling addiction were included. At treatment entry, participants were interviewed with the Addiction Severity Index, the Conners Adult ADHD Diagnosis Interview for the DSM-IV (CAADID), the Mini International Neuropsychiatric Interview (MINI) and the Structured Clinical Interview for DSM-IV Axis II for borderline personality disorder (SCID II). History of ADHD was associated with an earlier onset of addiction, poly-dependence (defined by presence of at least two current substance dependence diagnoses in addition to tobacco dependence if present) and borderline personality disorder. Persistence of ADHD during adulthood was associated with a higher prevalence of poly-dependence. This study highlights the need for early implementation of preventive interventions for substance use or behavioral addiction in children/adolescents with ADHD and the need to consider ADHD in the treatment of addictive disorders.
Collapse
|
40
|
Kysow K, Park J, Johnston C. The use of compensatory strategies in adults with ADHD symptoms. ACTA ACUST UNITED AC 2016; 9:73-88. [PMID: 27614892 DOI: 10.1007/s12402-016-0205-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/27/2016] [Indexed: 11/28/2022]
Abstract
This study examined the use of compensatory strategies reported by adults with ADHD symptoms and their relation to measures of functioning. Forty-nine adults (55.1 % female) completed a structured diagnostic interview to assess ADHD, and responses were coded for compensatory strategies: Adaptation, Paying Attention, Organization, External Support, and Avoidance. The majority of adults with ADHD symptoms reported using compensatory strategies, and their reported strategy use in childhood was related to their use in adulthood. No gender differences were found in the use of strategies, although Organization and External Support were used more often for inattention than for hyperactive/impulsive symptoms. Use of the compensatory strategy, Adaptation, was significantly related to measures of functioning, and the use of strategies reduced the negative relationship between ADHD symptoms and parenting difficulties. Results encourage the development of compensatory strategies among adults with ADHD symptoms, as well as provide recommendations for treatment programs.
Collapse
Affiliation(s)
- Kate Kysow
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Joanne Park
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Charlotte Johnston
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| |
Collapse
|
41
|
Langberg JM, Dvorsky MR, Becker SP, Molitor SJ. School Maladjustment and External Locus of Control Predict the Daytime Sleepiness of College Students With ADHD. J Atten Disord 2016; 20:792-801. [PMID: 24756174 DOI: 10.1177/1087054714529818] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The primary aim of this study was to evaluate whether school maladjustment longitudinally predicts the daytime sleepiness of college students with ADHD above and beyond symptoms of ADHD and to determine whether internalizing dimensions mediate the relationship between maladjustment and sleepiness. METHOD A prospective longitudinal study of 59 college students comprehensively diagnosed with ADHD who completed ratings at the beginning, middle, and end of the school year. RESULTS School maladjustment at the beginning of the year significantly predicted daytime sleepiness at the end of the year above and beyond symptoms of ADHD. Locus of control mediated the relationship between maladjustment and daytime sleepiness. CONCLUSION The significant school maladjustment difficulties that students with ADHD experience following the transition to college may lead to the development of problems with daytime sleepiness, particularly for those students with high external locus of control. This pattern is likely reciprocal, whereby sleep problems in turn result in greater school impairment, reinforcing the idea that life events are outside of one's control.
Collapse
|
42
|
Reliability and validity of a semi-structured DSM-based diagnostic interview module for the assessment of Attention Deficit Hyperactivity Disorder in adult psychiatric outpatients. Psychiatry Res 2016; 242:46-53. [PMID: 27259136 DOI: 10.1016/j.psychres.2016.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/10/2016] [Accepted: 05/16/2016] [Indexed: 11/21/2022]
Abstract
Despite growing recognition that the symptoms and functional impairments of Attention Deficit/Hyperactivity Disorder (ADHD) persist into adulthood, only a few psychometrically sound diagnostic measures have been developed for the assessment of ADHD in adults, and none have been validated for use in a broad treatment-seeking psychiatric sample. The current study presents the reliability and validity of a semi-structured DSM-based diagnostic interview module for ADHD, which was administered to 1194 adults presenting to an outpatient psychiatric practice. The module showed excellent internal consistency and interrater reliability, good convergent and discriminant validity (as indexed by relatively high correlations with self-report measures of ADHD and ADHD-related constructs and little or no correlation with other, non-ADHD symptom domains), and good construct validity (as indexed by significantly higher rates of psychosocial impairment and self-reported family history of ADHD in individuals who meet criteria for an ADHD diagnosis). This instrument is thus a reliable and valid diagnostic tool for the detection of ADHD in adults presenting for psychiatric evaluation and treatment.
Collapse
|
43
|
Dvorsky MR, Langberg JM, Molitor SJ, Bourchtein E. Clinical Utility and Predictive Validity of Parent and College Student Symptom Ratings in Predicting an ADHD Diagnosis. J Clin Psychol 2016; 72:401-18. [DOI: 10.1002/jclp.22268] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
44
|
Ramos-Quiroga JA, Díaz-Digon L, Comín M, Bosch R, Palomar G, Chalita JP, Roncero C, Nogueira M, Torrens M, Casas M. Criteria and Concurrent Validity of Adult ADHD Section of the Psychiatry Research Interview for Substance and Mental Disorders. J Atten Disord 2015; 19:999-1006. [PMID: 22915013 DOI: 10.1177/1087054712454191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Prevalence of ADHD in adults is around 2% to 4%. Comorbidity is frequent in ADHD; 75% of patients develop a comorbid disorder across life span, substance use disorder (SUD) being one of the most prevalent. METHOD A case-control study was performed to check the criteria and concurrent validity of psychiatric research interview for substance and mental disorders (PRISM) adult ADHD section. Validation was done comparing PRISM with the Conners' Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). A convenient sample (N = 80) participated, 40 had diagnosis of SUD and ADHD and 40 had diagnosis of SUD without ADHD. The statistics hypothesis was bivariant, and the confidence level was 95%. RESULTS Kappa index concordance was .78, sensitivity of PRISM adult ADHD module was 90%, specificity was 87.5%, positive predictive value was 87.8%, and the negative predictive value was 89.7%. CONCLUSION PRISM has good psychometric properties to detect ADHD associated with SUD.
Collapse
Affiliation(s)
- Josep Antoni Ramos-Quiroga
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain Departament de Psiquiatria i Medicina Legal. Universitat Autònoma de Barcelona, Spain
| | - Laura Díaz-Digon
- Institut de Neuropsiquiatria i Addiccions, Centre Fòrum, Barcelona, Spain IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Marina Comín
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Rosa Bosch
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain Departament de Psiquiatria i Medicina Legal. Universitat Autònoma de Barcelona, Spain
| | - Gloria Palomar
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J Pablo Chalita
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Carlos Roncero
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain Departament de Psiquiatria i Medicina Legal. Universitat Autònoma de Barcelona, Spain
| | - Mariana Nogueira
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain Departament de Psiquiatria i Medicina Legal. Universitat Autònoma de Barcelona, Spain
| | - Marta Torrens
- Departament de Psiquiatria i Medicina Legal. Universitat Autònoma de Barcelona, Spain IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Miguel Casas
- Servei de Psiquiatria. Hospital Universitari Vall d'Hebron, Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain Departament de Psiquiatria i Medicina Legal. Universitat Autònoma de Barcelona, Spain
| |
Collapse
|
45
|
Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, Rohde LA, Sonuga-Barke EJS, Tannock R, Franke B. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 2015; 1:15020. [PMID: 27189265 DOI: 10.1038/nrdp.2015.20] [Citation(s) in RCA: 800] [Impact Index Per Article: 88.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that affects 5% of children and adolescents and 2.5% of adults worldwide. Throughout an individual's lifetime, ADHD can increase the risk of other psychiatric disorders, educational and occupational failure, accidents, criminality, social disability and addictions. No single risk factor is necessary or sufficient to cause ADHD. In most cases ADHD arises from several genetic and environmental risk factors that each have a small individual effect and act together to increase susceptibility. The multifactorial causation of ADHD is consistent with the heterogeneity of the disorder, which is shown by its extensive psychiatric co-morbidity, its multiple domains of neurocognitive impairment and the wide range of structural and functional brain anomalies associated with it. The diagnosis of ADHD is reliable and valid when evaluated with standard criteria for psychiatric disorders. Rating scales and clinical interviews facilitate diagnosis and aid screening. The expression of symptoms varies as a function of patient developmental stage and social and academic contexts. Although there are no curative treatments for ADHD, evidenced-based treatments can markedly reduce its symptoms and associated impairments. For example, medications are efficacious and normally well tolerated, and various non-pharmacological approaches are also valuable. Ongoing clinical and neurobiological research holds the promise of advancing diagnostic and therapeutic approaches to ADHD. For an illustrated summary of this Primer, visit: http://go.nature.com/J6jiwl.
Collapse
Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York (SUNY) Upstate Medical University, Syracuse, New York 13210, USA
- K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, 5020 Bergen, Norway
| | - Philip Asherson
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Joseph Biederman
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Josep Antoni Ramos-Quiroga
- ADHD Program, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Sao Paulo, Brazil
| | - Edmund J S Sonuga-Barke
- Department of Psychology, University of Southampton, Southampton, UK
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Rosemary Tannock
- Neuroscience and Mental Health Research Program, Research Institute of The Hospital for Sick Children, Toronto, Canada
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Barbara Franke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Departments of Human Genetics and Psychiatry, Nijmegen, The Netherlands
| |
Collapse
|
46
|
Takeda T, Tsuji Y, Uwatoko T, Kurita H. Reliability and validity of ADHD diagnostic criteria in the Assessment System for Individuals with ADHD (ASIA): a Japanese semi-structured diagnostic interview. BMC Psychiatry 2015; 15:130. [PMID: 26092179 PMCID: PMC4474425 DOI: 10.1186/s12888-015-0525-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/12/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With reports of a high prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults, publication of ADHD diagnostic criteria in DSM-5, and the urgent need for a relevant diagnostic instrument conforming to DSM-5, we developed the Assessment System for Individuals with ADHD (ASIA), a Japanese semi-structured diagnostic interview. We report here the reliability and validity of ASIA ADHD diagnostic criteria. METHODS ASIA ADHD criterion A corresponds to DSM-5 ADHD criterion A and has 144 original questions assessing nine inattention symptoms and nine hyperactivity-impulsivity symptoms, each having four childhood and four adulthood questions. The 144 questions are evaluated on a 3-point frequency scale. ASIA ADHD criteria B to E correspond to DSM-5 ADHD criteria B to E and are evaluated on a 2-point scale. ASIA was administered to 60 adults (mean age, 29.9 ± 9.0 years; 28 males; 36 ADHD and 24 non-ADHD participants diagnosed by consensus of two experts). RESULTS For ASIA ADHD criterion A, values of Cronbach's α for the adulthood and childhood inattention and hyperactivity-impulsivity symptoms ranged from 0.64 to 0.90. Values of κ for two independent raters ranged from 0.98 to 1.00 for the 144 questions and raw agreement rates ranged from 0.97 to 1.00 for criteria B, C, D, and E. The consensus DSM-5 diagnoses endorsed 59 of the 60 ASIA diagnoses (ADHD and non-ADHD). The ADHD group scored significantly higher on 125 of the 144 questions for criterion A than the non-ADHD group. Correlations between ASIA total and subscale scores in adulthood and corresponding scores on the Japanese version of the Conners' Adult ADHD Scales-Self Report were high. CONCLUSIONS ASIA ADHD criteria showed acceptable psychometric properties, although further investigation is necessary. The use of ASIA ADHD criteria could facilitate clinical practice and research into adult ADHD in Japan.
Collapse
Affiliation(s)
- Toshinobu Takeda
- Department of Clinical Psychology, 125-1 Daiku-cho, Oomiya-higashihairu, Shichijyo-dori, Shimogyo-ku, Kyoto, 600-8268, Japan.
| | - Yui Tsuji
- Ryukoku University Health Care Center, Kyoto, Japan.
| | | | | |
Collapse
|
47
|
Skutle A, Bu ETH, Jellestad FK, van Emmerik-van Oortmerssen K, Dom G, Verspreet S, Carpentier PJ, Ramos-Quiroga JA, Franck J, Konstenius M, Kaye S, Demetrovics Z, Barta C, Fatséas M, Auriacombe M, Johnson B, Faraone SV, Levin FR, Allsop S, Carruthers S, Schoevers RA, Koeter MWJ, van den Brink W, Moggi F, Møller M, van de Glind G. Early developmental, temperamental and educational problems in 'substance use disorder' patients with and without ADHD. Does ADHD make a difference? Addict Behav Rep 2015. [PMID: 29531989 PMCID: PMC5845947 DOI: 10.1016/j.abrep.2015.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Introduction The prevalence of ADHD among patients with substance use disorder (SUD) is substantial. This study addressed the following research questions: Are early developmental, temperamental and educational problems overrepresented among SUD patients with ADHD compared to SUD patients without ADHD? Do this comorbid group receive early help for their ADHD, and are there signs of self-medicating with illicit central stimulants? Method An international, multi-centre cross-sectional study was carried out involving seven European countries, with 1205 patients in treatment for SUD. The mean age was 40 years and 27% of the sample was female. All participants were interviewed with the Mini International Neuropsychiatric Interview Plus and the Conners' Adult ADHD Diagnostic Interview for DSM-IV. Results SUD patients with ADHD (n = 196; 16.3% of the total sample) had a significantly slower infant development than SUD patients without ADHD (n = 1,009; 83.4%), had greater problems controlling their temperament, and had lower educational attainment. Only 24 (12%) of the current ADHD positive patients had been diagnosed and treated during childhood and/or adolescence. Finally, SUD patients with ADHD were more likely to have central stimulants or cannabis as their primary substance of abuse, whereas alcohol use was more likely to be the primary substance of abuse in SUD patients without ADHD. Conclusion The results emphasize the importance of early identification of ADHD and targeted interventions in the health and school system, as well as in the addiction field. SUD patients with ADHD had a significantly slower infant development than SUD patients without ADHD. Furthermore, the former group had greater problems controlling their temperament, and had lower educational attainment. Only 12% of the current SUD and ADHD patients had been diagnosed and treated during childhood and/or adolescence. They were more likely to have stimulants or cannabis as their main substance, suggesting some form of self-medication. Early identification of ADHD is important, as well as adequate treatment of this comorbid patient group.
Collapse
Affiliation(s)
| | | | | | - Katelijne van Emmerik-van Oortmerssen
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,The Netherlands Arkin, Amsterdam, The Netherlands
| | - Geert Dom
- Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout, Belgium
| | - Sofie Verspreet
- Collaborative Antwerp Psychiatry Research Institute (CAPRI, UA), PC Alexian Brothers, Boechout, Belgium
| | | | - Josep Antoni Ramos-Quiroga
- Servei de Psiquiatria, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Johan Franck
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Maija Konstenius
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Melina Fatséas
- Laboratoire de psychiatrie Département d'addictologie, Université de Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- Laboratoire de psychiatrie Département d'addictologie, Université de Bordeaux, Bordeaux, France
| | - Brian Johnson
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.,Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.,Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Frances R Levin
- Columbia University/the New York State Psychiatric Institute, New York, USA
| | - Steve Allsop
- National Drug Research Institute/Curtin University of Technology, Perth, Australia
| | - Susan Carruthers
- National Drug Research Institute/Curtin University of Technology, Perth, Australia
| | - Robert A Schoevers
- Dept of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maarten W J Koeter
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim van den Brink
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Franz Moggi
- Department of Psychology, University of Fribourg, Fribourg, Switzerland.,University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | | | | |
Collapse
|
48
|
Mao AR, Brams M, Babcock T, Madhoo M. A Physician's Guide to Helping Patients with ADHD Find Success in the Workplace. Postgrad Med 2015; 123:60-70. [DOI: 10.3810/pgm.2011.09.2460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
49
|
Konstenius M, Larsson H, Lundholm L, Philips B, van de Glind G, Jayaram-Lindström N, Franck J. An epidemiological study of ADHD, substance use, and comorbid problems in incarcerated women in Sweden. J Atten Disord 2015; 19:44-52. [PMID: 22797213 DOI: 10.1177/1087054712451126] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to examine the prevalence of ADHD and psychiatric comorbidity, including substance use in incarcerated women. METHOD This was a cross-sectional study, consisting of two parts: (a) screening using the ADHD Self-Rating Scale (ASRS) and (b) diagnostic assessment using a structured interview. RESULTS A sample of 96 incarcerated women was screened and 56 underwent the diagnostic assessment. Twenty-nine percent of the women met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnostic criteria for adult ADHD in the diagnostic assessment. Forty-four of the women had misuse of alcohol, and 83% had misuse of narcotics the year prior to the incarceration. The ASRS showed sensitivity of 1.0 and specificity of 0.66. CONCLUSION The prevalence rate of ADHD in incarcerated women was high and comparable to that in male offenders. Illicit stimulant use and antisocial personality disorder were significantly more common in women with ADHD. ASRS is useful as a screener in this population.
Collapse
|
50
|
Takahashi N, Koh T, Tominaga Y, Saito Y, Kashimoto Y, Matsumura T. A randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of osmotic-controlled release oral delivery system methylphenidate HCl in adults with attention-deficit/hyperactivity disorder in Japan. World J Biol Psychiatry 2014; 15:488-98. [PMID: 24456065 DOI: 10.3109/15622975.2013.868925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate the safety and efficacy of osmotic-controlled release oral delivery system (OROS) methylphenidate (MPH) HCl in adults with attention-deficit/hyperactivity disorder (ADHD). METHODS In this study, 284 adults with ADHD were randomized to OROS MPH or placebo. During the 4-week titration period, patients were titrated from a starting dose of 18 mg once daily to an individually-optimized dose of up to 72 mg once daily in weekly 18-mg increments. Patients continued on their individualized dose during the 4-week efficacy assessment period. The primary efficacy endpoint was change in DSM-IV Total ADHD Symptoms subscale score of Conners' Adult ADHD Rating Scale-Observer: Screening Version (CAARS-O:SV) from baseline to endpoint. RESULTS The mean change in DSM-IV Total ADHD Symptoms subscale score of CAARS-O:SV was significantly larger with OROS MPH compared with placebo (P < 0.0001, ANCOVA). Similar results were observed for the majority of secondary endpoints, including CAARS-O:SV total score and other subscale scores. Although treatment-emergent adverse events were reported more frequently in the OROS MPH group (81.8%) versus the placebo group (53.9%), OROS-MPH showed a well-tolerated safety profile overall. CONCLUSIONS OROS MPH in a dose range of 18-72 mg once daily was effective and well-tolerated in adult patients with ADHD.
Collapse
Affiliation(s)
- Nagahide Takahashi
- Clinical Responsible Physician Department, Clinical Science Division , Janssen Pharmaceutical K.K, Tokyo , Japan
| | | | | | | | | | | |
Collapse
|