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Jakobsson Støre S, Van Zalk N, Granander Schwartz W, Nilsson V, Tillfors M. The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review. J Atten Disord 2024; 28:1299-1319. [PMID: 38651640 PMCID: PMC11168018 DOI: 10.1177/10870547241247448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This review aimed to systematically gather empirical data on the link between social anxiety disorder and ADHD in both clinical and non-clinical populations among adolescents and adults. METHOD Literature searches were conducted in PsycInfo, PubMed, Scopus, and Web of Science, resulting in 1,739 articles. After screening, 41 articles were included. Results were summarized using a narrative approach. RESULTS The prevalence of ADHD in adolescents and adults with SAD ranged from 1.1% to 72.3%, while the prevalence of SAD in those with ADHD ranged from 0.04% to 49.5%. Studies indicate that individuals with both SAD and ADHD exhibit greater impairments. All studies were judged to be of weak quality, except for two studies which were rated moderate quality. DISCUSSION Individuals with SAD should be screened for ADHD and vice versa, to identify this common comorbidity earlier. Further research is needed to better understand the prevalence of comorbid ADHD and SAD in adolescents.
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Affiliation(s)
- Siri Jakobsson Støre
- Karlstad University, Sweden
- Child and Adolescent Psychiatry, Region Värmland, Karlstad, Sweden
| | | | | | - Victoria Nilsson
- Pediatric and Adolescent Medicine, Region Värmland, Karlstad, Sweden
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2
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Mattos P, Moraes CEFD, Sichieri R, Hay P, Faraone SV, Appolinario JC. Adult ADHD Symptoms in a Large Metropolitan Area From Brazil: Prevalence and Associations with Psychiatric Comorbidity, Bullying, Sexual Abuse, and Quality of Life. J Atten Disord 2024; 28:1082-1091. [PMID: 38380531 DOI: 10.1177/10870547241229097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence and psychiatric correlates of symptomatic ADHD in a large metropolitan area of a middle-income country. METHODS An in-person household survey with randomly selected 2,297 adults aged 19 to 60 from Rio de Janeiro, Brazil, assessed by trained lay interviewers. The Adult Self-Rating Scale Screener (ASRS-6) was used. Chi-square and logistic regression were conducted. RESULTS ADHD prevalence was 4.59 (95% CI [3.56, 5.44]). Those with ADHD were younger and more often unemployed; they displayed more psychiatric symptoms (depression, anxiety, and alcohol abuse) and a history of bullying and sexual abuse. They also had worse physical health indicators. Findings remained significant when controlling for socioeconomic variables. CONCLUSION Adults with symptomatic ADHD from a large metropolitan area in Brazil show a pattern of findings consistent with what has been observed in higher-income countries.
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Affiliation(s)
- Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Carlos Eduardo Ferreira de Moraes
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
| | - Rosely Sichieri
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
- Mental Health Services, SWSLHD, Campbelltown, Sydney, Australia
| | - Stephen V Faraone
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jose Carlos Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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3
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González-Martínez Á, Muñiz de Miguel S, Graña N, Costas X, Diéguez FJ. Serotonin and Dopamine Blood Levels in ADHD-Like Dogs. Animals (Basel) 2023; 13:ani13061037. [PMID: 36978578 PMCID: PMC10044280 DOI: 10.3390/ani13061037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
As with humans, dogs can suffer from attention deficit hyperactivity disorder-like (ADHD-like) behaviors naturally and exhibit high levels of hyperactivity/impulsivity and attention deficit problems, making the domestic dog a potential animal model for ADHD. ADHD has a very complex pathophysiology in which many neurotransmitters are involved, such as serotonin and dopamine. The aim of the study was to evaluate serum serotonin and dopamine levels in dogs with ADHD-like symptomatology. Fifty-eight dogs were studied, of which, thirty-six were classified as ADHD-like after physical and behavioral assessments. Additionally, the dogs’ owners performed a series of scientifically validated questionnaires which included C-BARQ, the Dog Impulsivity Assessment Scale, and the Dog-ADHD rating scale. Serum from every animal was collected after the behavioral assessments and analyzed with commercial ELISA tests for serotonin and dopamine determination. Kruskal–Wallis tests and Lasso regressions were applied to assess the relationships between both neurotransmitters and the ADHD-like behaviors (as assessed by clinical evaluation and through the different questionnaires). The dogs clinically classified as ADHD-like showed lower serotonin and dopamine concentrations. Further, serotonin and dopamine levels were also linked to aggression, hyperactivity, and impulsivity. Decreased serotonin concentrations were also related to fear, attachment, and touch sensitivity. Finally, it must be noted that our data suggested a strong relationship between serotonin and dopamine and ADHD-like behaviors.
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Affiliation(s)
| | | | - Noemi Graña
- Lar do Belelle, Canine Center, 15509 Fene, Spain
| | - Xiana Costas
- Etoloxía, Behavior Medicine Service, 36312 Pontevedra, Spain
| | - Francisco Javier Diéguez
- Anatomy, Animal Production and Clinical Veterinary Sciences Department, Santiago de Compostela University, 27002 Lugo, Spain
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Rodríguez C, García T, Areces D, Rodríguez J, Arteaga-Henriquez G, Ramos-Quiroga A. Retrospective symptoms and learning difficulties predicting ADHD in adults: Differences between prison inmates and the clinical population. Scand J Psychol 2021; 62:301-311. [PMID: 33709422 DOI: 10.1111/sjop.12716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 12/15/2020] [Accepted: 01/17/2021] [Indexed: 11/30/2022]
Abstract
People who suffer from ADHD in their childhood are more likely to be involved in criminal acts in late adolescence and adulthood. This study analyses the association between retrospective ADHD symptoms and associated problems (somatic and learning difficulties), and current symptoms in a sample of adults from imprisoned and clinical populations. Four hundred and fifty-seven participants, aged between 17 and 69 years, were divided into four groups: ADHD prison group without clinical history of symptoms (n = 61), prison group (n = 162), ADHD clinical group (n = 176) and clinical group (n = 58). The ADHD-IV scale and Wender Utah Rating Scale (WURS) were administered to the four groups and demonstrated high rates of persistence of ADHD symptoms into adulthood. ADHD groups reported significantly higher impairment both during childhood (symptoms, somatic and learning difficulties) and at present, with the ADHD clinical group being the most severely impaired. Finally, current symptoms of ADHD, along with childhood ADHD symptoms and learning difficulties, significantly predicted current impairments, but only in the clinical group. These findings represent some initial steps into the identification of predictors of ADHD symptomatology in adulthood in order to elucidate its etiopathogenesis and better identify high-risk groups for targeted prevention.
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Affiliation(s)
| | - Trinidad García
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Débora Areces
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Gara Arteaga-Henriquez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, 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), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, 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), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Şahan E, Zengin Eroğlu M, Sertçelik S. Eating behaviors, depression, and anxiety levels of pre bariatric surgery patients with obesity comorbid with or without Attention deficit and hyperactivity disorder: ADHD or Major Depression? Which is more related with eating behaviors? Brain Behav 2021; 11:e01915. [PMID: 33118314 PMCID: PMC7821566 DOI: 10.1002/brb3.1915] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/02/2020] [Accepted: 10/09/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE A high rate of attention deficit and hyperactivity disorder (ADHD) has been reported in patients undergoing obesity treatment. It is controversial whether ADHD solely or its comorbid disorders account for eating behaviors associated with obesity. METHODS After presurgery psychiatric assessment, 100 severely obese patients (50 with ADHD and 50 without ADHD) were administered Adult Attention Deficit Hyperactivity Disorder Self-Report Scale(ASRS), Wender Utah Rating Scale(WURS), Three-Factor Eating Questionnaire(TFEQ), and Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). RESULTS Patients with obesity and ADHD had significantly greater emotional eating, susceptibility to hunger, depression, and anxiety but less restraint of eating scores than those without ADHD. Disinhibition of eating scores and presence of Binge Eating Disorder(BED) did not differ significantly between ADHD and non-ADHD groups. Obese patients with major depression had significantly higher ASRS, WURS, TFEQ, BAI scores, disinhibition of eating control, emotional eating, susceptibility to hunger, and diagnosis of BED than nondepressed ones. CONCLUSIONS Major depression and anxiety disorder have associations with disinhibition of eating control, emotional eating, susceptibility to hunger and BED, ADHD. Disinhibition of eating and BED did not differ according to the presence of ADHD; thus, depression was associated with eating control on more constructs than ADHD in our study.
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Affiliation(s)
- Ebru Şahan
- Department of PsychiatryMarmara UniversityİstanbulTurkey
| | - Meliha Zengin Eroğlu
- Department of PsychiatryHaydarpaşa Numune Training and Research HospitalİstanbulTurkey
| | - Sencan Sertçelik
- Department of PsychiatryHaydarpaşa Numune Training and Research HospitalİstanbulTurkey
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Pehlivanidis A, Papanikolaou K, Mantas V, Kalantzi E, Korobili K, Xenaki LA, Vassiliou G, Papageorgiou C. Lifetime co-occurring psychiatric disorders in newly diagnosed adults with attention deficit hyperactivity disorder (ADHD) or/and autism spectrum disorder (ASD). BMC Psychiatry 2020; 20:423. [PMID: 32847520 PMCID: PMC7449076 DOI: 10.1186/s12888-020-02828-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. METHODS The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. RESULTS At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). CONCLUSIONS Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
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Affiliation(s)
- Artemios Pehlivanidis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital, 72-74 Vas. Sofias Ave, 11528, Athens, Greece.
| | - Katerina Papanikolaou
- Department of Child Psychiatry, National and Kapodistrian University of Athens, Medical School, “Agia Sophia” Children’s Hospital, 11527 Athens, Greece
| | - Vasilios Mantas
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Eva Kalantzi
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Kalliopi Korobili
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Lida-Alkisti Xenaki
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Georgia Vassiliou
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Charalambos Papageorgiou
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
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Fruchter E, Marom-Harel H, Fenchel D, Kapra O, Ginat K, Portuguese S, Weiser M. Functioning of Young Adults With ADHD in the Military. J Atten Disord 2019; 23:1470-1474. [PMID: 27269006 DOI: 10.1177/1087054716652478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To assess the functioning of young adults with ADHD in a military setting. Method: In all, 14,655 young adults with ADHD (mean age at first examination 17.8 ± 0.7) attending mandatory service in the Israeli military were compared with matched controls on several functioning domains. Results: Young adults with ADHD had more sessions with mental health care professionals, physician appointments, sick days, and disqualifications of professions than controls (p < .001). Young adults with ADHD were also less medically fit for combat service (odds ratio [OR] = 0.75, 95% confidence interval [CI] = [0.72, 0.79]), more medically unfit for military service in general (OR = 1.26, 95% CI = [1.13, 1.40]), and had higher rates of overweight and obesity (p < .001). In addition, they were more likely to be diagnosed with a personality disorder (OR = 1.29, 95% CI = [1.07, 1.53]) or with minor affective and anxiety disorders (OR = 1.33, 95% CI = [1.06, 1.67]) than matched controls. Conclusion: These results support a negative effect of ADHD on the functioning of young adults in a military setting.
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Affiliation(s)
- Eyal Fruchter
- 1 IDF Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | | | | | - Ori Kapra
- 2 Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Keren Ginat
- 1 IDF Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | | | - Mark Weiser
- 2 Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.,3 Tel Aviv University, Tel Aviv-Yafo, Israel
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8
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Pond E, Fowler K, Hesson J. The Influence of Socioeconomic Status on Psychological Distress in Canadian Adults With ADD/ADHD. J Atten Disord 2019; 23:940-948. [PMID: 27288904 DOI: 10.1177/1087054716653214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The primary purpose of this study was to examine the relationship between socioeconomic status (SES) and psychological distress in individuals self-reporting a diagnosis of attention deficit disorder (ADD)/ADHD. METHOD This correlational study encompasses cross-sectional data from 488 male and female adults (20-64 years) who reported that they have been diagnosed with ADD/ADHD. Psychological distress was measured with the Kessler Psychological Distress Scale (K10). RESULTS Adults with ADD/ADHD and high incomes have significantly lower K10 scores than Canadians with ADD/ADHD and low incomes. Income, but not education, was significant in predicting psychological distress among the sample. Canadian adults with ADD/ADHD have an increased risk for developing psychological distress and comorbid psychiatric disorders. CONCLUSION The findings suggest that negative outcomes associated with ADD/ADHD are not necessarily pervasive. High income may serve as a protective factor for psychological distress among adults with ADD/ADHD.
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Affiliation(s)
- Emily Pond
- 1 Memorial University of Newfoundland, St. John's, Canada
| | - Ken Fowler
- 1 Memorial University of Newfoundland, St. John's, Canada
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Yoshimasu K, Barbaresi WJ, Colligan RC, Voigt RG, Killian JM, Weaver AL, Katusic SK. Psychiatric Comorbidities Modify the Association Between Childhood ADHD and Risk for Suicidality: A Population-Based Longitudinal Study. J Atten Disord 2019; 23:777-786. [PMID: 28689473 DOI: 10.1177/1087054717718264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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 evaluate the effect of psychiatric comorbidities on the association between childhood ADHD and suicidality among adults. METHOD Subjects were recruited from a population-based birth cohort. Participating adult subjects with childhood ADHD and non-ADHD controls were administered a structured psychiatric interview to assess suicidality and psychiatric comorbidities. Associations were assessed using logistic regression. RESULTS Compared with controls, ADHD cases were significantly more likely to meet criteria for suicidality. Subjects with childhood ADHD who met criteria for generalized anxiety disorder had a higher than expected risk of suicidality with an observed odds ratio of 10.94 (95% confidence interval [4.97, 24.08]) compared with an expected odds ratio of 4.86, consistent with a synergistic interaction effect. Significant synergistic interactions were also observed for hypomanic episode and substance-related disorders. CONCLUSION Childhood ADHD is significantly associated with adult suicidal risk. Comorbidity between ADHD and some psychiatric disorders is associated with a higher suicidal risk than expected.
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Affiliation(s)
- Kouichi Yoshimasu
- 1 Mayo Clinic, Rochester, MN, USA.,2 Wakayama Medical University, Japan
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10
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Tsai FJ, Tseng WL, Yang LK, Gau SSF. Psychiatric comorbid patterns in adults with attention-deficit hyperactivity disorder: Treatment effect and subtypes. PLoS One 2019; 14:e0211873. [PMID: 30730956 PMCID: PMC6366698 DOI: 10.1371/journal.pone.0211873] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022] Open
Abstract
Psychiatric comorbidities are common in individuals with attention-deficit/hyperactivity disorder (ADHD). In this study, we sought to evaluate the effects of medication and childhood ADHD subtypes on psychiatric comorbidities among adults with ADHD as compared to healthy adult controls. We assessed 121 drug-naïve adults with ADHD, 93 treated adults with ADHD, and 145 healthy controls (age 18–36 years) using semi-structured psychiatric interviews, intelligence tests, and medical records. Drug-naïve adults with ADHD had more comorbidities than treated adults with ADHD and controls. Childhood ADHD-combined subtype, relative to ADHD-inattentive subtype, was associated with higher risks of comorbidities. Current medication treatment was associate with a higher risk for anxiety disorders, and longer treatment duration was associated with lower risks of mood disorders and sleep disorders. Our results indicate that no medication treatment, short treatment duration, and childhood ADHD-combined subtype are associated with increased risks for psychiatric comorbidities among adults with ADHD.
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Affiliation(s)
- Fang-Ju Tsai
- Department of Psychiatry, National Taiwan University and College of Medicine, Taipei, Taiwan
- Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Wan-Ling Tseng
- Emotion and Development Branch, National Institute of Mental Heath, National Institutes of Health, Department of Health and Human Sevices, Bethesda, MD, United States of America
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University and College of Medicine, Taipei, Taiwan
- Beitou Branch, Tri-Service General Hospital, National Medical Defense Center, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Yoshimasu K, Barbaresi WJ, Colligan RC, Voigt RG, Killian JM, Weaver AL, Katusic SK. Adults With Persistent ADHD: Gender and Psychiatric Comorbidities-A Population-Based Longitudinal Study. J Atten Disord 2018; 22:535-546. [PMID: 27864428 PMCID: PMC5600693 DOI: 10.1177/1087054716676342] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate associations between ADHD and comorbid psychiatric disorders among adults from a population-based birth cohort. METHOD Participants were recruited from all children born between 1976 and 1982 remaining in Rochester, Minnesota, after age 5. Participants with childhood ADHD ( n = 232; M age = 27.0 years; 72% men) and non-ADHD controls ( n = 335; M age = 28.6 years; 63% men) completed a structured interview (M.I.N.I. International Neuropsychiatric Interview) assessing current ADHD status and comorbid psychiatric disorders. RESULTS Among 232 with childhood ADHD, 68 (49 men, 19 women) had persistent adult ADHD. Compared with non-ADHD controls and non-persistent ADHD participants, adults with persistent ADHD were significantly more likely to have any or each of 12 psychiatric comorbidities. The associations retained significant or marginally significant when stratified by gender. Externalizing psychiatric disorders were more common in men (74%) and internalizing disorders in women (58%). CONCLUSION Persistent ADHD is associated with an increased risk of comorbid psychiatric disorders in adult men and women.
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Affiliation(s)
- Kouichi Yoshimasu
- Mayo Clinic, Rochester, MN, USA,Wakayama Medical University, Wakayama, Japan
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12
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Moulin F, Chollet A, Ramos-Quiroga JA, Bouvard M, Melchior M, Galéra C. Prevalence and Psychosocial Correlates of ADHD Symptoms in Young Adulthood: A French Population-Based Study. J Atten Disord 2018; 22:167-181. [PMID: 28490216 DOI: 10.1177/1087054717706758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The scientific literature suggests that ADHD in adulthood is associated with a considerable psychosocial burden. However, most knowledge in this area relies on studies conducted in the United States or in North European nations, thereby limiting generalization to other countries. METHOD We assessed the psychosocial correlates of ADHD symptoms in a French community-based sample. Data came from 1,214 community-based young adults (18-35 years) and their parents (Trajectoires Epidémiologiques en Population and GAZEL studies). ADHD symptoms and socioeconomic and psychosocial correlates were assessed in a telephone interview. Logistic regression analyses were conducted to assess associations. RESULTS A total of 7.1% of the sample presented high levels of ADHD symptoms. Parental history of anxiety, dissatisfaction with love life, and consumption of tobacco were associated with the highest odds ratios. CONCLUSION This study confirms the high functional impairment associated with adult ADHD symptoms in a French community sample. It extends the existing literature to family risk correlates and individual well-being correlates.
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Affiliation(s)
| | - Aude Chollet
- 2 Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonnes Université, Paris, France.,3 Institut National de la Santé et de la Recherche Médicale (INSERM), UMR_S_1136, Paris, France
| | | | - Manuel Bouvard
- 1 Bordeaux University Hospital, France.,5 Child Psychiatry Department, Charles Perrens Hospital, Bordeaux, France
| | - Maria Melchior
- 2 Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonnes Université, Paris, France.,3 Institut National de la Santé et de la Recherche Médicale (INSERM), UMR_S_1136, Paris, France
| | - Cédric Galéra
- 1 Bordeaux University Hospital, France.,5 Child Psychiatry Department, Charles Perrens Hospital, Bordeaux, France
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Hesson J, Fowler K. Prevalence and Correlates of Self-Reported ADD/ADHD in a Large National Sample of Canadian Adults. J Atten Disord 2018; 22:191-200. [PMID: 25749874 DOI: 10.1177/1087054715573992] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to examine the prevalence and correlates of self-reported attention deficit disorder (ADD)/ADHD in Canadian adults. METHOD Prevalence of self-reported ADD/ADHD was examined in a large national sample of Canadians ( n = 16,957). Demographic variables, lifetime, and current psychiatric comorbidities were then compared in a group of adults with self-reported ADD/ADHD ( n = 488) and an age- and gender-matched control group ( n = 488). RESULTS The prevalence of self-reported ADD/ADHD was 2.9%. Significantly higher lifetime and current prevalence rates of major depressive disorder, bipolar I and II disorders, generalized anxiety disorder, and substance use disorders were observed in the ADD/ADHD group compared with the control group. Within the ADD/ADHD group, lifetime and 12-month prevalence rates of major depressive disorder and generalized anxiety disorder were significantly higher in women, whereas lifetime and current rates of some substance use disorders were significantly higher in men. CONCLUSION In a national sample of Canadian adults, self-reported ADD/ADHD was associated with significant psychiatric comorbidity. Gender differences were also noted.
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Affiliation(s)
| | - Ken Fowler
- 1 Memorial University of Newfoundland, St. John's, Canada
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Geffen J, Forster K. Treatment of adult ADHD: a clinical perspective. Ther Adv Psychopharmacol 2018; 8:25-32. [PMID: 29344341 PMCID: PMC5761907 DOI: 10.1177/2045125317734977] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/21/2017] [Indexed: 12/22/2022] Open
Abstract
Adult attention deficit/hyperactivity disorder (ADHD) has moved from the blurred edge of clinical focus to clear recognition as a prevalent and significant disorder in its own right. It is a relatively common comorbidity which if identified and treated may open the door to better outcomes for hard-to-treat patients. Conversely, failure to identify and treat adult ADHD is linked to negative outcomes. The recognition of the importance of adult ADHD in a subset of our patients challenges us to overcome our anxiety about this diagnosis and prevent the societal marginalization of vulnerable patients. Adult ADHD responds well to integrated pharmacological and psychotherapeutic intervention. Its treatment responsiveness reduces disability and allows the comorbidity which is typically present to be addressed. Mastering this challenge can make the diagnosis and treatment of adult ADHD a rewarding experience.
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Affiliation(s)
- Josh Geffen
- Toowong Specialist Clinic, 2/54 Jephson St, Toowong, Brisbane, Queensland, 4066, Australia
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The generalizability of the structure of substance abuse and antisocial behavioral syndromes: A systematic review. Psychiatry Res 2018; 259:412-421. [PMID: 29120851 DOI: 10.1016/j.psychres.2017.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/29/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although several authors have suggested that a single externalizing spectrum encompassing both antisocial behavioral syndromes and substance use disorder is to be preferred, this assumption has not been evaluated systematically throughout studies. PURPOSE The objective was to establish the generalizability of transdiagnostic models of externalizing disorders across different types of disorders and populations, in regard to the strength of the evidence. METHOD We conducted a systematic literature review using combinations of two sets of keywords: 1) "antisocial", "externalizing", "conduct disorder", "disruptive behavior disorder", "substance abuse", "substance-related disorder", "cannabis", "cocaine", "hallucinogen", "alcoholism", "opioid"; 2) "latent structure", "factor analysis", "multivariate analysis". RESULTS Models supporting a superordinate factor appeared dominant in a limited set of different populations, on which the majority of the research sample was focused. CONCLUSIONS Although the externalizing spectrum model is a promising angle for future research and treatment, extending research on this model in a higher diversity of populations is recommended to enhance the understanding and applicability of the externalizing spectrum model.
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Kaisari P, Dourish CT, Rotshtein P, Higgs S. Associations Between Core Symptoms of Attention Deficit Hyperactivity Disorder and Both Binge and Restrictive Eating. Front Psychiatry 2018; 9:103. [PMID: 29651258 PMCID: PMC5884932 DOI: 10.3389/fpsyt.2018.00103] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 03/14/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION It is unclear whether core symptoms of attention deficit hyperactivity disorder (ADHD) relate to specific types of disordered eating and little is known about the mediating mechanisms. We investigated associations between core symptoms of ADHD and binge/disinhibited eating and restrictive eating behavior and assessed whether negative mood and/or deficits in awareness and reliance on internal hunger/satiety cues mediate these relationships. METHODS In two independent studies, we used a dimensional approach to study ADHD and disordered eating. In Study 1, a community-based sample of 237 adults (72.6% female, 18-60 years [M = 26.8, SE = 0.6]) completed an online questionnaire, assessing eating attitudes/behaviors, negative mood, awareness, and reliance on internal hunger/satiety cues and ADHD symptomatology. In Study 2, 142 students (80.3% female, 18-32 years [M = 19.3, SE = 0.1]) were recruited to complete the same questionnaires and complete tasks assessing interoceptive sensitivity and impulsivity in the laboratory. RESULTS In each study, core symptoms of ADHD correlated positively with both binge/disinhibited and restrictive eating and negative mood mediated the relationships. Deficits in awareness and reliance on internal hunger/satiety signals also mediated the association between inattentive symptoms of ADHD and disordered eating, especially binge/disinhibited eating. The results from both studies demonstrated that inattentive symptoms of ADHD were also directly related to binge/disinhibited eating behavior, while accounting for the indirect pathways of association via negative mood and awareness and reliance on internal hunger/satiety signals. CONCLUSION This research provides evidence that core symptoms of ADHD are associated with both binge/disinhibited eating and restrictive eating behavior. Further investigation of the role of inattentive symptoms of ADHD in disordered eating may be helpful in developing novel treatments for both ADHD and binge eating.
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Affiliation(s)
- Panagiota Kaisari
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | | | - Pia Rotshtein
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Müller D, Grevet EH, Panzenhagen AC, Cupertino RB, da Silva BS, Kappel DB, Mota NR, Blaya-Rocha P, Teche SP, Vitola ES, Rohde LA, Contini V, Rovaris DL, Schuch JB, Bau CHD. Evidence of sexual dimorphism of HTR1B gene on major adult ADHD comorbidities. J Psychiatr Res 2017; 95:269-275. [PMID: 28923721 DOI: 10.1016/j.jpsychires.2017.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/07/2017] [Accepted: 09/07/2017] [Indexed: 12/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a very common psychiatric disorder across the life cycle and frequently presents comorbidities. Since ADHD is highly heritable, several studies have focused in the underlying genetic factors involved in its etiology. One of the major challenges in this search is the phenotypic heterogeneity, which could be partly attributable to the sexual dimorphism frequently seen in psychiatric disorders. Taking into account the well-known sexual dimorphic effect observed in serotonergic system characteristics, we differentially tested the influence of HTR1B SNPs (rs11568817, rs130058, rs6296 and rs13212041) on ADHD susceptibility and on its major comorbidities according to sex. The sample comprised 564 adults with ADHD diagnosed according to DSM-IV criteria and 635 controls. There was no association of any HTR1B SNPs tested in relation to ADHD susceptibility. As for the comorbidities evaluated, after correction for multiple tests, significant associations were observed for both rs11568817 and rs130058 with substance use disorders (Pcorr = 0.009 and Pcorr = 0.018, respectively) and for rs11568817 with nicotine dependence (Pcorr = 0.025) in men with ADHD. In women with ADHD, the same rs11568817 was associated with generalized anxiety disorder (Pcorr = 0.031). The observed effects of rs11568817 G allele presence conferring risk to either substance use disorders or generalized anxiety disorder according to sex, suggest an overall scenario where a higher transcriptional activity of HTR1B, resulting from the presence of this allele, is related to externalizing behaviors in men and internalizing behaviors in women. These results are consistent with and expand previous evidence of sexual dimorphism of the serotoninergic system.
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Affiliation(s)
- Diana Müller
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Eugenio H Grevet
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alana C Panzenhagen
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Renata B Cupertino
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Bruna S da Silva
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Djenifer B Kappel
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Nina R Mota
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paula Blaya-Rocha
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Stefania P Teche
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Eduardo S Vitola
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luis A Rohde
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Verônica Contini
- PPGBIOTEC - Postgraduate Program in Biotechnology, Centro Universitário Univates, Lajeado, Brazil
| | - Diego L Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jaqueline B Schuch
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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Mehl-Madrona L, Mainguy B. Adjunctive Treatment of Psychotic Disorders with Micronutrients. J Altern Complement Med 2017; 23:526-533. [PMID: 28103052 DOI: 10.1089/acm.2016.0215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the effect of micronutrients (minerals and vitamins) on adult psychosis when added to conventional medications by using a placebo-controlled randomized design with a 1-month open-label run-in. DESIGN Longitudinal comparison study following a randomized, controlled trial that had failed because participants declined to undergo randomization. Setting/Locations: Rural primary care and psychiatry clinic in northern New England (town of 16,000 people). PARTICIPANTS People older than age 18 years diagnosed with a psychotic disorder who were receiving medications. INTERVENTION Fifty consecutive clients seen in 1 month's time were invited to participate; 19 completed a 1-month open-label phase of the addition of a micronutrient to their medication regimen; all 19 then withdrew rather than risk randomization to a placebo. This finding itself was important, so the study was restructured to compare the response of those 19 patients during 24 months of micronutrients + medication to the response of the 31 people who declined participation, enriched by an additional 28 consecutive patients recruited over the second month of the study. This yielded a total of 59 patients who received medication without micronutrients. OUTCOME MEASURES All clients were evaluated with the Positive and Negative Symptom Scale and the Clinical Global Impression scale at study baseline and after 3, 6, 9, 12, 15, 18, and 24 months. Psychosis was confirmed with clinical interview by using Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision, criteria. All participants had normal physical examinations and laboratory studies. RESULTS Outcomes were similar for both groups until 15 months, although the micronutrient group used significantly less antipsychotic medication throughout that time (p < 0.001). At 15 months, the micronutrients + medication group exhibited significantly fewer symptoms than the medication-only group, a difference that was even stronger at 24 months. CONCLUSIONS Micronutrients may appear to be a beneficial long-term, adjunctive strategy for people with psychotic disorders, allowing for smaller doses of medication to achieve the same effectiveness with fewer side effects.
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Affiliation(s)
- Lewis Mehl-Madrona
- 1 Family Medicine Residency, Eastern Maine Medical Center , Bangor, ME.,2 University of New England College of Osteopathic Medicine , Biddeford, ME.,3 Coyote Institute , Orono, ME.,4 University of Maine , Orono, ME
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Berger NAA, Müller A, Brähler E, Philipsen A, de Zwaan M. Association of symptoms of attention-deficit/hyperactivity disorder with symptoms of excessive exercising in an adult general population sample. BMC Psychiatry 2014; 14:250. [PMID: 25214027 PMCID: PMC4172949 DOI: 10.1186/s12888-014-0250-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 08/26/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND An increasing number of studies suggest that physical activity can alleviate symptoms of ADHD in children. In adults there are currently insufficient data available on this subject. Interestingly, ADHD and forms of excessive exercising have both been shown to occur more frequently in adult athletes. The aim of the present study was to empirically investigate the association of ADHD and excessive exercising in the adult general population. METHODS For diagnosis of adult and childhood ADHD a large representative sample of the German general population (n = 1,615) completed a retrospective assessment of childhood ADHD and a self-report assessment of adult ADHD. Excessive exercising as well as putative mediating variables such as eating related psychopathology, depression, and anxiety were assessed using standardized self-rating instruments. RESULTS Individuals with childhood only ADHD had a significantly higher frequency of excessive exercising (9.0%) than individuals without ADHD (2.7%). Excessive exercising was significantly associated with childhood only ADHD compared to no ADHD with an odds ratio of 3.239 even after controlling for socio-demographic variables, BMI, eating related and general psychopathology. CONCLUSIONS Our data show that excessive exercising is significantly overrepresented in individuals in which ADHD symptoms in childhood have not persisted into adulthood. We thus hypothesize that a subgroup of individuals might suppress ADHD symptoms by excessive sporting activities. Although in healthy adults physical activity has been associated with immediate and long term improvements in cognitive functioning, studies empirically investigating associations between the effects of physical activity and adult ADHD are rare. Further studies are warranted to explore the potential role of physical activity in the treatment of ADHD in adults.
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Affiliation(s)
- Nikolas AA Berger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany ,Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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