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Alonzo-Castillo T, Lugo-Marín J, Robles M, Rossich R, Gallego L, González M, Setién-Ramos I, Martínez-Ramírez M, Ramos-Quiroga JA, Gisbert-Gustemps L. [Autism spectrum disorder: the impact of an online training strategy on the knowledge of the healthcare staff of a tertiary care hospital]. Rev Neurol 2024; 78:1-7. [PMID: 38112651 DOI: 10.33588/rn.7801.2023244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Autism spectrum disorder (ASD) often presents related medical disorders that require specialised healthcare. Professionals in the health sector therefore face difficulties that require specific training in the healthcare needs of this population. AIM The aim of this study is to quantify paediatric healthcare professionals' knowledge about ASD and to assess the impact of online training. SUBJECTS AND METHODS It is a quasi-experimental, longitudinal, prospective before-and-after study; study subjects: health professionals; independent variable: online training in ASD; dependent variable: knowledge about ASD. An online training course was held for paediatric professionals to address the core characteristics of diagnosis, as well as the needs they present in the hospital context and the adaptations it is recommended that should be carried out. Fifty-eight healthcare professionals took part. RESULTS An increase in knowledge about ASD was observed at the end of the intervention (from 73.9% to 85% according to the ASD background knowledge questionnaire), which showed that more than 90% of the participants had the highest level of knowledge about ASD. CONCLUSIONS Online training courses are a useful and effective way to increase knowledge about ASD and the adaptations that are recommended in the hospital setting. More training in ASD should be made available in these settings.
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Affiliation(s)
| | - J Lugo-Marín
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | - M Robles
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | - R Rossich
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | - L Gallego
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | - M González
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | - I Setién-Ramos
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
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Corrales M, García-González S, Richarte V, Fadeuilhe C, Daigre C, García-Gea E, Ramos-Quiroga JA. Long-term efficacy of a new 6-session cognitive behavioral therapy for adults with attention-deficit/hyperactivity disorder: A randomized, controlled clinical trial. Psychiatry Res 2024; 331:115642. [PMID: 38103281 DOI: 10.1016/j.psychres.2023.115642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects about 2.8 % of the adult population. Cognitive behavioral therapy (CBT) has been demonstrated to be the most effective psychological intervention for ADHD. The aim of this study was to explore the efficacy of a new 6-session CBT program in comparison with a 12-session CBT program for adults with ADHD at short- and long-term. METHODS 81 adults with ADHD (58 % males; mean age = 41.27±9.26 years old) were randomly assigned to each treatment condition (6- or 12-session CBT). Validated instruments were used to assess ADHD symptoms, comorbidities (anxiety and depression), and functional impairments at post treatment, and at 3- and 6-month follow-up. RESULTS A significant improvement in ADHD severity, comorbidities (anxiety and depression) and functional impairments were found in both CBT programs after treatment. Furthermore, this improvement was also reported at 3- and 6-month follow-up. CONCLUSION The current study highlights that a 6-session CBT program is as effective as a 12-session CBT program for ADHD improvement at post treatment and follow-up. The newly developed 6-session CBT program can be used to treat a larger number of patients, reducing the financial cost.
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Affiliation(s)
- 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.
| | - S García-González
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, 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
| | - 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
| | - E García-Gea
- 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
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Ribasés M, Mitjans M, Hartman CA, Soler Artigas M, Demontis D, Larsson H, Ramos-Quiroga JA, Kuntsi J, Faraone SV, Børglum AD, Reif A, Franke B, Cormand B. Genetic architecture of ADHD and overlap with other psychiatric disorders and cognition-related phenotypes. Neurosci Biobehav Rev 2023; 153:105313. [PMID: 37451654 PMCID: PMC10789879 DOI: 10.1016/j.neubiorev.2023.105313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) co-occurs with many other psychiatric disorders and traits. In this review, we summarize and interpret the existing literature on the genetic architecture of these comorbidities based on hypothesis-generating approaches. Quantitative genetic studies indicate that genetic factors play a substantial role in the observed co-occurrence of ADHD with many different disorders and traits. Molecular genetic correlations derived from genome-wide association studies and results of studies based on polygenic risk scores confirm the general pattern but provide effect estimates that are smaller than those from twin studies. The identification of the specific genetic variants and biological pathways underlying co-occurrence using genome-wide approaches is still in its infancy. The first analyses of causal inference using genetic data support causal relationships between ADHD and comorbid disorders, although bidirectional effects identified in some instances point to complex relationships. While several issues in the methodology and inferences from the results are still to be overcome, this review shows that the co-occurrence of ADHD with many psychiatric disorders and traits is genetically interpretable.
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Affiliation(s)
- M Ribasés
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - M Mitjans
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain
| | - C A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M Soler Artigas
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - D Demontis
- Department of Biomedicine/Human Genetics, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark; The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - H Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - J A Ramos-Quiroga
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Kuntsi
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - S V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - A D Børglum
- Department of Biomedicine/Human Genetics, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - B Franke
- Departments of Cognitive Neuroscience and Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - B Cormand
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain.
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Ramos-Quiroga JA, Richarte V, Soto I, Targhetta M, Ward J, Perulero N. The Prevalence and Treatment of ADHD in Spain: A Retrospective Cohort Analysis. J Atten Disord 2023; 27:273-282. [PMID: 36373564 DOI: 10.1177/10870547221136226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Estimate the prevalence and incidence of Attention Deficit Hyperactivity Disorder (ADHD) and analyze variations in its treatment across Spain. METHOD Analyses were performed using IQVIA's clinical practice RealWorld Database, the electronic medical records of some 1 million patients from 2013 to 2018. MPH treatment was assessed using the Defined Daily Dose (DDD), MPH sales were extracted from IQVIA's Sell-Out database and the number of active psychiatrists from IQVIA's OneKey Database. RESULTS Significantly higher ADHD prevalence and incidence (1) in children than in adults and (2) in males compared to females. 91% of patients take MPH. Regional variations in MPH consumption range from 247 Daily Dose per Inhabitant (DDI) per 100,000 inhabitants to 414. CONCLUSION ADHD continues to be underdiagnosed and undertreated, particularly in adults, and more so in females. The lack of diagnostic tools for adults and the variations in treatment across the country need to be addressed.
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Affiliation(s)
- Jose Antonio Ramos-Quiroga
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Vanesa Richarte
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Isabel Soto
- IQVIA Information S.A., Madrid, Comunidad de Madrid, Spain
| | | | - John Ward
- IQVIA RDS S.L, Madrid, Comunidad de Madrid, Spain
| | - Núria Perulero
- IQVIA Information S.A., Madrid, Comunidad de Madrid, Spain
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Anastasiadou D, Slater M, Spanlang B, Cano Porras D, Comas M, Ciudin A, Puig GP, Vázquez-De Sebastián J, Ramos-Quiroga JA, Lusilla-Palacios P. Clinical efficacy of a virtual reality tool for the treatment of obesity: study protocol of a randomised controlled trial. BMJ Open 2022; 12:e060822. [PMID: 35732390 PMCID: PMC9226992 DOI: 10.1136/bmjopen-2022-060822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Previous research has shown that it is feasible to integrate motivational interviewing techniques with behavioural and psychological interventions for the treatment of obesity. Moreover, these combined interventions have the potential to improve health-related outcomes of people living with obesity (PLWO) and to afford maintenance of behavioural changes over time. In addition, the use of virtual reality (VR) embodiment techniques in the treatment of eating disorders and obesity has promising preliminary effectiveness. The objective of this study is to assess the clinical efficacy of a VR intervention that uses embodiment and body-swapping techniques and has been specifically developed to cover the needs of PLWO. METHODS AND ANALYSIS A randomised control trial will be carried out with an estimated sample of 96 participants with body mass index (BMI)>30. The whole duration of the trial will be 12 months. Participants will be recruited from the external consultations of the Vall d'Hebron University Hospital and be randomly assigned to three groups. The experimental group 1 will engage in a virtual self-conversation using the ConVRself platform, the experimental group 2 will participate in a 'pre-established discourse' provided by the virtual counsellor, who will give psychoeducation advice, and the control group will continue with treatment as usual. Readiness to change, BMI, eating habits and physical activity, psychological well-being, body image satisfaction, quality of life in relation to body image, and weight bias internalisation will be assessed at baseline, post intervention, 1-week and 4-week follow-up. Finally, variables related to adherence and satisfaction with the VR tool will be evaluated for the experimental groups. ETHICS AND DISSEMINATION This study was approved by the Research Projects Committee of the Vall d'Hebron University Hospital. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences and other events for the scientific and clinical community, and the general public. TRIAL REGISTRATION NUMBER NCT05094557.
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Affiliation(s)
- Dimitra Anastasiadou
- Psychiatry Department, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mel Slater
- Virtual Bodyworks SL, Barcelona, Spain
- Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | | | - Desiderio Cano Porras
- Department of Cognitive Science and Artificial Intelligence, School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
| | - Marta Comas
- Endocrinology and Nutrition Department - Diabetes and Metabolism Research Unit - Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Vall d'Hebron University Hospital - Vall d'Hebron Research Institute (VHIR) - Universitat Autònoma de Barcelona - Instituto de Salud Carlos III (Madrid, Spain), Barcelona, Spain
| | - Andreea Ciudin
- Endocrinology and Nutrition Department - Diabetes and Metabolism Research Unit - Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Vall d'Hebron University Hospital - Vall d'Hebron Research Institute (VHIR) - Universitat Autònoma de Barcelona - Instituto de Salud Carlos III (Madrid, Spain), Barcelona, Spain
| | - Gemma Parramon Puig
- Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Psychiatry Department - Department of Psychiatry and Legal Medicine - Biomedical Network Research Centre on Mental Health (CIBERSAM), Vall d'Hebron University Hospital - Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julia Vázquez-De Sebastián
- Psychiatry Department, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- RE-FiT Barcelona Research Group, Vall d'Hebron Research Institute - Parc Sanitari Pere Virgili, Barcelona, Spain
| | - Jose Antonio Ramos-Quiroga
- Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Psychiatry Department - Department of Psychiatry and Legal Medicine - Biomedical Network Research Centre on Mental Health (CIBERSAM), Vall d'Hebron University Hospital - Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Lusilla-Palacios
- Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Psychiatry Department - Department of Psychiatry and Legal Medicine - Biomedical Network Research Centre on Mental Health (CIBERSAM), Vall d'Hebron University Hospital - Universitat Autònoma de Barcelona, Barcelona, Spain
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6
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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7
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Serra-Navarro M, Amoretti S, Verdolini N, Forte MF, Sánchez-Torres AM, Vieta E, Clougher D, Lobo A, González-Pinto A, Panadero R, Roldán A, Carvalho AF, de la Serna E, Toll A, Ramos-Quiroga JA, Torrent C, Cuesta MJ, Bernardo M. Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: Differences between males and females. Front Psychiatry 2022; 13:982583. [PMID: 36339856 PMCID: PMC9632657 DOI: 10.3389/fpsyt.2022.982583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset. MATERIALS AND METHODS The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up. RESULTS FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = -0.307, p = 0.012) were significantly associated with functioning. CONCLUSION Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.
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Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - María Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain.,Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
| | - Rocío Panadero
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Institute of Psychiatry and Mental Health, Universidad Complutense, IiSGM, Madrid, Spain
| | - Alexandra Roldán
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - André F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), School of Medicine, Barwon Health, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clínic de Neurociències, Hospital Clínic Universitari, CIBERSAM, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J A Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
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8
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Braquehais MD, Vargas-Cáceres S, Nieva G, Mantilla MF, Ortega G, Valero S, Ramos-Quiroga JA, Bruguera E. Characteristics of resident physicians accessing a specialised mental health service: a retrospective study. BMJ Open 2021; 11:e055184. [PMID: 34857580 PMCID: PMC8640645 DOI: 10.1136/bmjopen-2021-055184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Little is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians. DESIGN Retrospective observational study. SETTING Medical records of the Galatea Care Programme for Sick Physicians. PARTICIPANTS 1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018. PRIMARY AND SECONDARY OUTCOME MEASURES Number of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation. RESULTS Residents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001). CONCLUSIONS Residents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.
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Affiliation(s)
- María Dolores Braquehais
- Integral Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Catalonia, Spain
- Psychiatry, Mental Health and Addiction Research Group, VHIR, CIBERSAM, Barcelona, Catalonia, Spain
| | - Sebastián Vargas-Cáceres
- Mental Health, Benito Menni, Adult Mental Health Service, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Gemma Nieva
- Integral Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Catalonia, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
| | | | - Germán Ortega
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
| | - Sergi Valero
- Integral Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Catalonia, Spain
- ACE Alzheimer Center, Fundacio ACE, Barcelona, Catalonia, Spain
| | - Jose Antonio Ramos-Quiroga
- Psychiatry, Mental Health and Addiction Research Group, VHIR, CIBERSAM, Barcelona, Catalonia, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
| | - Eugeni Bruguera
- Integral Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Catalonia, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
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9
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Perapoch J, Vidal R, Gómez-Lumbreras A, Hermosilla E, Riera L, Cortés J, Céspedes MC, Ramos-Quiroga JA, Morros R. Prematurity and ADHD in Childhood: An Observational Register-Based Study in Catalonia. J Atten Disord 2021; 25:933-941. [PMID: 31409171 DOI: 10.1177/1087054719864631] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To evaluate the association between prematurity (by the gestational week [gw]) and ADHD during childhood. Method: Observational, matched cohort study using data from children born in a tertiary-level hospital (Hospital Universitari Vall d'Hebron, Catalonia, Spain) during 1995-2007 and data from the Information System for the Development of Research in Primary Health Care (SIDIAP database, Catalonia, Spain). Results: Prevalence of ADHD increases as gestational age decreases, 12.7% for those born ≤28 gw, compared to 3.2% for those born after the 37 gw. The risk of developing ADHD in the non-premature children tends to increase as the gw decreases (35-36 gw, hazard ratio [HR] = 1.70, 95% confidence interval [CI] [1.19, 2.44]; 33-34 gw, HR = 3.38, 95% CI [2.08, 5.50]; 29-32 gw, HR = 2.37, 95% CI [1.54, 3.63]; and ≤28 gw, HR = 5.57, 95% CI [2.49, 12.46]) Conclusion: Being born preterm is associated with a risk of developing ADHD, also in late preterm children (35-36 gw). Attention when taking care of these infants regarding their mental health must be made.
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Affiliation(s)
- J Perapoch
- Pediatric Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - R Vidal
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia. Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR).,Biomedical Network Research Centre on Mental Health (CIBERSAM)
| | - A Gómez-Lumbreras
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - E Hermosilla
- Sistema d'Informació per al desenvolupament de la investigació en Atenció Primària, Barcelona, Spain
| | - L Riera
- Institut Català de la Salut, Barcelona, Spain
| | - J Cortés
- Universitat Politècnica de Catalunya, Barcelona, Spain
| | - M C Céspedes
- Pediatric Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia. Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR).,Biomedical Network Research Centre on Mental Health (CIBERSAM)
| | - R Morros
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain.,Deparment of Pharmacology and Therapeutics, Universitat Autònoma de Barcelona, Bellaterra, Spain
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10
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Nieto-Fernández Z, Vidal R, Gómez-Barros N, Ramos-Quiroga JA. [Psychological interventions on fetal alcohol spectrum disorder across the life span]. Rev Neurol 2021; 72:168-176. [PMID: 33616199 DOI: 10.33588/rn.7205.2020639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Fetal alcohol spectrum disorder (FASD) is the leading known and preventable cause of intellectual disability in the western world, affecting up to 1-5% of the population. It is considered an underdiagnosed and undertreated disorder, with few psychological interventions with empirical evidence. AIM To review all the studies published to date on the psychological treatment of FASD throughout life. A bibliographic search was carried out using the MEDLINE, PsychINFO, PubMed and Cochrane Library databases using the terms 'fetal alcohol syndrome disorder' AND 'cognitive behavioral intervention' OR 'psychological intervention' OR 'psychological treatment' OR 'therapy' OR 'psychotherapy'. The review included published works which evaluate the efficacy of psychological treatments for these patients. DEVELOPMENT Twenty published studies met the inclusion criteria. The treatments were classified according to the type of intervention: emotional and behavioral regulation, social skills training and family interventions for patients with FASD. CONCLUSIONS The results indicate that psychological treatments focused on emotional and behavioral regulation, social skills training and family interventions are the most evidenced treatments for these patients. These treatments are based on cognitive-behavioral principles and include school-age children. However, more research is needed on psychological interventions for adults with FASD. Despite the progress in psychological interventions for FASD, the research still reflects highlighted limitations.
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Affiliation(s)
| | - R Vidal
- Hospital Universitario Vall d'Hebron, Barcelona, España
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11
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Pereira-Pinto A, Palma-Álvarez RF, Ortega-Hernández G, Grau-López L, Ramos-Quiroga JA. [Drug-induced mania and hypomania: analysis of a case of lamotrigine-induced mania]. Rev Neurol 2021; 72:368-370. [PMID: 33978231 DOI: 10.33588/rn.7210.2021082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Lamotrigine is an antiepileptic medication approved as a mood stabilizer for the prevention of depressive episodes in bipolar disorder. Among its adverse reactions, it may present maniac symptoms, despite being an idiosyncratic adverse effect and low incidence. CASE REPORT We present the case of a 58-year-old patient, diagnosed with bipolar disorder since her youth and who has required multiple therapeutic schemes. After a pharmacological change from lithium to lamotrigine in progressive ascending doses, she presented a mania decompensation, temporally consistent with the initiation of lamotrigine, and that was accentuated with increasing dose. The symptoms disappear when lamotrigine is withdrawn and a pharmacological approach is carried out. When evaluating the case according to the causality criteria of Naranjo et al, we found a possible result. CONCLUSION Although lamotrigine-induced manifest symptoms have been previously documented, it is important to take this adverse effect into account, given the affective and behavioral repercussions. Further studies are needed to understand the bilateral relationship of this effect from a clinical and neurobiological point of view.
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Affiliation(s)
- A Pereira-Pinto
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | - R F Palma-Álvarez
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España.,Universitat Autònoma de Barcelona, Bellaterra, España.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | | | - L Grau-López
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España.,Universitat Autònoma de Barcelona, Bellaterra, España.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - J A Ramos-Quiroga
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España.,Universitat Autònoma de Barcelona, Bellaterra, España.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
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12
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Corominas-Roso M, Ibern I, Capdevila M, Ramon R, Roncero C, Ramos-Quiroga JA. Benefits of EEG-Neurofeedback on the Modulation of Impulsivity in a Sample of Cocaine and Heroin Long-Term Abstinent Inmates: A Pilot Study. Int J Offender Ther Comp Criminol 2020; 64:1275-1298. [PMID: 32090660 DOI: 10.1177/0306624x20904704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim of this pilot study was to assess whether neurofeedback (NFB) can be useful in the treatment of impulsive behavior in long-term abstinent cocaine and heroin addicts. A single-blind sham-controlled NFB protocol was carried out to assess the effects of NFB on impulsivity in 20 (10 + 10) cocaine and heroin long-term abstinent addicts (Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR]). Psychotic and neurologic diseases were excluded. Participants underwent 40 NFB sessions based on the very slow cortical potential range. Inhibitory deficits were specifically addressed through right and left prefrontal training. Clinical improvement was measured with Likert-type scales, the Hamilton Depression Rating Scale, and the State-Trait Anxiety Inventory, and impulsivity was assessed using the Barratt Impulsiveness Scale and the Continuous Performance Test. Although the results are preliminary due to the small sample size, the NFB-treated group showed a significant clinical improvement, including symptoms of anxiety and depression, with two differentiated time periods. No significant clinical improvement was found in the control group. A significant decrease in the post- versus pre-treatment measures of global impulsivity, nonplanning impulsivity, and error commission measures was found in the NFB-treated group; effect size (dKorr) in the pre-post control design was moderate. No significant change was found in the control group. Despite the limitations of this study, the results suggest that NFB is better than placebo in improving impulsivity and clinical symptoms of anxiety and depression in long-term abstinent cocaine- and heroin-dependent individuals.
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Affiliation(s)
- M Corominas-Roso
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
- Biomedical Network Research Center on Mental Health, Madrid, Spain
| | - I Ibern
- Generalitat de Catalunya, Barcelona, Spain
| | | | - R Ramon
- Generalitat de Catalunya, Barcelona, Spain
| | - C Roncero
- Biomedical Network Research Center on Mental Health, Madrid, Spain
- Universidad de Salamanca, Spain
| | - J A Ramos-Quiroga
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
- Biomedical Network Research Center on Mental Health, Madrid, Spain
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13
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Castellano-Tejedor C, Moreno J, Knittle K, Nurmi J, Ginchev T, Parramón G, Ciudin A, Ramos-Quiroga JA, Lusilla-Palacios P. Assessing the user experience and usability of the PRECIOUS system: a randomized controlled trial in obese patients. Inform Health Soc Care 2020; 45:410-427. [PMID: 32713290 DOI: 10.1080/17538157.2020.1776292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective To assess users' usability, satisfaction, acceptance and effectiveness of the PRECIOUS system to promote behavior change toward healthier lifestyles. Design: Thirty-one adult patients with BMI>30 (M = 44.23, SD = 5.91) were recruited and randomized into three conditions for a longitudinal study (3 months length): 1) Control group (TAU + biofeedback + follow-ups); 2) PRECIOUS only (app + biofeedback + follow-ups); 3) PRECIOUS + MI (app + biofeedback + motivational interviewing follow-ups). Main Outcome Measures: Usability, satisfaction, acceptance and effectiveness of PRECIOUS, and stages of change (S-Weight questionnaire). Results: The system was described as easy to use, flexible, fairly satisfying and good as a preventive health system. Participants rated biofeedback and the Physical Activity module as the most satisfying features. However, participants were unsatisfied with the Diet module. All additional features received acceptable scores in terms of satisfaction. Despite this, the PRECIOUS only group reported that they would probably recommend the system to others because it meets its purposes quite well. Conclusion: PRECIOUS was found a usable and acceptable solution, although improving several features in the Diet module in successive versions of the app would promote sustained use and satisfaction among users, possibly increasing its effectiveness in promoting healthier lifestyles. Abbreviations: ADA American Diabetes Association; BG2: BodyGuard2; BMI: Body Mass Index; CBT: Cognitive-behavioral therapy; EMA: Ecological Momentary Assessment; eHealth: Electronic health; mHealth: Mobile health; MI: Motivational interviewing; NCD: Non-communicable diseases; PA: Physical activity; PRECIOUS: PREventive Care Infrastructure based On Ubiquitous Sensing.
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Affiliation(s)
- Carmina Castellano-Tejedor
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona , Barcelona, Spain.,Vall d'Hebron Research Institute , Barcelona, Spain
| | - Jordi Moreno
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona , Barcelona, Spain.,Vall d'Hebron Research Institute , Barcelona, Spain
| | - Keegan Knittle
- Department of Social Research, University of Helsinki , Helsinki, Finland, Europe
| | - Johanna Nurmi
- Department of Social Research, University of Helsinki , Helsinki, Finland, Europe.,Behavioural Science Group, University of Cambridge, Institute of Public Health , Cambridge, England, UK
| | - Todor Ginchev
- Department of Communications and Networking, Aalto University School of Electrical Engineering , Aalto, Espoo, Finland, Europe
| | - Gemma Parramón
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona , Barcelona, Spain.,Vall d'Hebron Research Institute , Barcelona, Spain
| | - Andreea Ciudin
- Department of Endocrinology, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona , Barcelona, Spain
| | - Jose Antonio Ramos-Quiroga
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona , Barcelona, Spain.,Vall d'Hebron Research Institute , Barcelona, Spain
| | - Pilar Lusilla-Palacios
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona , Barcelona, Spain.,Vall d'Hebron Research Institute , Barcelona, Spain
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14
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Siegl A, Matura S, Reif A, Arteaga-Henríquez G, Rosales-Ortiz K, Arias-Vásquez A, Bitter I, Ginsberg Y, Kilencz T, Rethelyi J, Ramos-Quiroga JA. Treating impulsivity with synbiotics in adults: a multicentre, double-blind, randomized, placebo-controlled trial. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0039-3403041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A Siegl
- Universitätsklinikum Frankfurt, Germany
| | - S Matura
- Universitätsklinikum Frankfurt, Germany
| | - A Reif
- Universitätsklinikum Frankfurt, Germany
| | | | | | | | - I Bitter
- Universitätsklinikum Frankfurt, Germany
| | | | - T Kilencz
- Universitätsklinikum Frankfurt, Germany
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15
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Grau-López L, Grau-López L, Daigre C, Palma-Álvarez RF, Martínez-Luna N, Ros-Cucurull E, Ramos-Quiroga JA, Roncero C. Insomnia Symptoms in Patients With Substance Use Disorders During Detoxification and Associated Clinical Features. Front Psychiatry 2020; 11:540022. [PMID: 33312131 PMCID: PMC7704430 DOI: 10.3389/fpsyt.2020.540022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Insomnia is highly prevalent in patients with substance use disorders (SUD), and it has been related to a worse course of addiction. Insomnia during detoxification in a hospital has not been adequately studied. This study aims to compare sociodemographic, clinical, and psychopathological characteristics of SUD patients undergoing a detoxification program, by comorbidity and insomnia symptoms. Methodology: We recruited 481 patients who received pharmacological and psychotherapeutic treatment for detoxification. They were evaluated through semi-structured interviews, standardized questionnaires, and a specific sleep log. A bivariate and multivariate analysis of the data was performed. Results: Insomnia was reported by 66.5% patients, with sleep-maintenance insomnia the most frequent issue, followed by early morning awakening and sleep-onset insomnia. Patients with alcohol use disorder and cannabis use disorder had higher prevalence of sleep-onset insomnia. Patients with cocaine and heroin use disorder had higher prevalence of sleep-maintenance insomnia. Independent factors that allowed the identification of insomnia symptoms included being female (OR: 3.43), polysubstance use (OR: 2.85), comorbid anxiety disorder (OR: 2.02), and prior admission for detoxification (OR: 1.22). Conclusions: Insomnia symptoms are very prevalent in patients admitted for detoxification. The diagnosis and therapeutic strategies for the insomnia symptoms should be improved, especially in women and in patients with greater addiction severity and with anxiety disorders.
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Affiliation(s)
- Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Laia Grau-López
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Constanza Daigre
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Nieves Martínez-Luna
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Jose Antonio Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain.,Psychiatric Unit, School of Medicine University of Salamanca, Salamanca, Spain
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16
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Arias-Vásquez A, Groffen AJ, Spijker S, Ouwens KG, Klein M, Vojinovic D, Galesloot TE, Bralten J, Hottenga JJ, van der Most PJ, Kattenberg VM, Pool R, Nolte IM, Penninx BWJH, Fedko IO, Dolan CV, Nivard MG, den Braber A, van Duijn CM, Hoekstra PJ, Buitelaar JK, Kiemeney LA, Hoogman M, Middeldorp CM, Draisma HHM, Vermeulen SH, Sánchez-Mora C, Ramos-Quiroga JA, Ribasés M, Hartman CA, Kooij JJS, Amin N, Smit AB, Franke B, Boomsma DI. A Potential Role for the STXBP5-AS1 Gene in Adult ADHD Symptoms. Behav Genet 2019; 49:270-285. [PMID: 30659475 DOI: 10.1007/s10519-018-09947-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 12/26/2018] [Indexed: 12/15/2022]
Abstract
We aimed to detect Attention-deficit/hyperactivity (ADHD) risk-conferring genes in adults. In children, ADHD is characterized by age-inappropriate levels of inattention and/or hyperactivity-impulsivity and may persists into adulthood. Childhood and adulthood ADHD are heritable, and are thought to represent the clinical extreme of a continuous distribution of ADHD symptoms in the general population. We aimed to leverage the power of studies of quantitative ADHD symptoms in adults who were genotyped. Within the SAGA (Study of ADHD trait genetics in adults) consortium, we estimated the single nucleotide polymorphism (SNP)-based heritability of quantitative self-reported ADHD symptoms and carried out a genome-wide association meta-analysis in nine adult population-based and case-only cohorts of adults. A total of n = 14,689 individuals were included. In two of the SAGA cohorts we found a significant SNP-based heritability for self-rated ADHD symptom scores of respectively 15% (n = 3656) and 30% (n = 1841). The top hit of the genome-wide meta-analysis (SNP rs12661753; p-value = 3.02 × 10-7) was present in the long non-coding RNA gene STXBP5-AS1. This association was also observed in a meta-analysis of childhood ADHD symptom scores in eight population-based pediatric cohorts from the Early Genetics and Lifecourse Epidemiology (EAGLE) ADHD consortium (n = 14,776). Genome-wide meta-analysis of the SAGA and EAGLE data (n = 29,465) increased the strength of the association with the SNP rs12661753. In human HEK293 cells, expression of STXBP5-AS1 enhanced the expression of a reporter construct of STXBP5, a gene known to be involved in "SNAP" (Soluble NSF attachment protein) Receptor" (SNARE) complex formation. In mouse strains featuring different levels of impulsivity, transcript levels in the prefrontal cortex of the mouse ortholog Gm28905 strongly correlated negatively with motor impulsivity as measured in the five choice serial reaction time task (r2 = - 0.61; p = 0.004). Our results are consistent with an effect of the STXBP5-AS1 gene on ADHD symptom scores distribution and point to a possible biological mechanism, other than antisense RNA inhibition, involved in ADHD-related impulsivity levels.
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Affiliation(s)
- A Arias-Vásquez
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands. .,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - A J Groffen
- Department of Functional Genomics and Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam and VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - S Spijker
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - K G Ouwens
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - M Klein
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - D Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - T E Galesloot
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J Bralten
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - J J Hottenga
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - P J van der Most
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - V M Kattenberg
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - R Pool
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - I M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - I O Fedko
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - C V Dolan
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - M G Nivard
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - A den Braber
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - C M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - P J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Karakter, Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - L A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M Hoogman
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - C M Middeldorp
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Child Health Research Centre, University of Queensland, Brisbane, Australia.,Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia
| | - H H M Draisma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - S H Vermeulen
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C Sánchez-Mora
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - J A Ramos-Quiroga
- 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
| | - M Ribasés
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | | | - C A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J J S Kooij
- Psycho-Medical Programs, PsyQ, Program Adult ADHD, The Hague, The Netherlands
| | - N Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A B Smit
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - B Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - D I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
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17
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Valero S, Bosch R, Corominas M, Barrau V, Ramos-Quiroga JA, Casas M. Remittance or persistence of attention deficit-hyperactivity disorder (ADHD) and its impact on recidivism in risky driving behaviors. Traffic Inj Prev 2018; 19:701-707. [PMID: 30485128 DOI: 10.1080/15389588.2018.1505043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/22/2018] [Accepted: 07/22/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Recent data regarding the persistence or remittance of attention deficit-hyperactivity disorder (ADHD) diagnosis into adulthood raise the question of its possible role in crucial public health issues, including road safety, especially when neurocognitive capacities are challenged. METHODS The study included 611 participants with serious traffic violations. The Spanish version of the Mini International Neuropsychiatric Interview (M.I.N.I.) was used to assess psychopathology. They were grouped into 3 diagnostic conditions: non-ADHD, persistent ADHD (ADHD-P), and remittent ADHD (ADHD-R). Several risky driving behaviors were analyzed. RESULTS Although participants with ADHD have more driving violations relative to non-ADHD, ADHD-R, and ADHD-P drivers have similar profiles. ADHD-R and ADHD-P drivers are more prone to perform risky and recidivistic behaviors relative to non-ADHD counterparts (P = .044 and P = .047, respectively); ADHD-R and ADHD-P participants are statistically comparable in this proneness (P = .772). CONCLUSION These results suggest that the underlying core deficits of ADHD-attention and other executive disabilities-persist despite the fact that some people no longer reach the threshold for clinical diagnosis.
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Affiliation(s)
- S Valero
- a Group of Psychiatry, Mental Health and Addiction , Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
| | - R Bosch
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - M Corominas
- a Group of Psychiatry, Mental Health and Addiction , Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
| | - V Barrau
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - J A Ramos-Quiroga
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - M Casas
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
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18
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Valero S, Bosch R, Corominas M, Giannoni A, Barrau V, Ramos-Quiroga JA, Casas M. Psychopathology and traffic violations in subjects who have lost their driving license. Compr Psychiatry 2017; 76:45-55. [PMID: 28411408 DOI: 10.1016/j.comppsych.2017.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 03/05/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The persistence of risky behaviors while driving and traffic accidents despite campaigns to increase awareness suggest that there may be underlying causes that maintain proneness to traffic violations. The aim of the current study was to assess: a) the prevalence of psychopathology in a sample of people who have lost their driving license due to former traffic violations and b) the discriminatory capacity of each psychopathological disorder to differentiate among people with high and low proneness to perform risky behaviors while driving. METHODS 383 participants in a course to recover their driving license after its loss due to previous traffic violations were included. The International Neuropsychiatric Interview (M.I.N.I.) according to DSM-IV was used to assess psychopathology. RESULTS Between 67% and 76.2% of the participants had been affected by a lifetime psychopathological disorder until the moment of assessment. The most prevalent diagnoses were substance abuse including alcohol (52.5-62.7%), ADHD (19.7-28.5%), depression (7.9-14.4%) and anxiety (3.6-12.4%). Substance abuse and ADHD also showed the strongest set of associations with specific risk behaviors, but ADHD emerged as the most discriminant disorder to distinguish between those people at high and low risk of while driving. CONCLUSIONS The results of the current study suggest that addressing psychopathology explicitly to prevent risky behaviors and recidivism while driving would provide benefits in this area.
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Affiliation(s)
- S Valero
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain.
| | - R Bosch
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain
| | - M Corominas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain
| | - A Giannoni
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - V Barrau
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
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19
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Corominas-Roso M, Armario A, Palomar G, Corrales M, Carrasco J, Richarte V, Ferrer R, Casas M, Ramos-Quiroga JA. IL-6 and TNF-α in unmedicated adults with ADHD: Relationship to cortisol awakening response. Psychoneuroendocrinology 2017; 79:67-73. [PMID: 28262601 DOI: 10.1016/j.psyneuen.2017.02.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/10/2017] [Accepted: 02/16/2017] [Indexed: 01/23/2023]
Abstract
There is preliminary evidence that the immune system's cytokines may have impact on ADHD in children. Nevertheless, studies exploring the possible role of pro-inflammatory cytokines in adults with ADHD are lacking. This study aimed to assess differences in serum IL-6 and TNF-α between patients and controls and their possible relationship to resting cortisol. 108 adults with ADHD (DSM-IV), 44 inattentive and 64 combined, age ranging between 18 and 55 years, and 27 healthy controls were included. Major psychiatric disorders and organic comorbidities were excluded. Serum samples for IL-6 and TNF-α and salivary samples to assess cortisol awakening response were collected on the same day. Analysis of variance was applied to study differences in IL-6 and TNF-α between groups. Pearson correlations were used to study associations between IL-6, TNF-α, and CAR. There were no significant differences in serum IL-6 or TNF-α levels between patients and controls or between combined and inattentive patients. Negative associations between IL-6 (r=-0.386, p=0.020), TNF-α (r=-0.372, p=0.023) and cortisol awakening response were found in the inattentive subtype, whereas no association was seen in the combined subtype. A negative correlation between IL-6 and cortisol was also present in the control group (r=-0.44, 0.030). The peripheral pro-inflammatory markers, IL-6 and TNF-α, do not appear to be primarily involved in ADHD in adults, although the role of other inflammatory markers cannot be ruled out. The differences regarding the association between IL-6 and TNF-α and morning cortisol response suggest possible underlying neurobiological differences between the inattentive or combined patients that merit further studies.
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Affiliation(s)
- M Corominas-Roso
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain.
| | - A Armario
- Institut de Neurociéncies, Red de Trastornos Adictivos (RTA) and CIBERSAM, Unitat de Fisiologia Animal, Department de Biologia Cel·lular, Fisiologia I Immunologia, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - G Palomar
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - J Carrasco
- Institut de Neurociéncies, Red de Trastornos Adictivos (RTA) and CIBERSAM, Unitat de Fisiologia Animal, Department de Biologia Cel·lular, Fisiologia I Immunologia, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - R Ferrer
- Department of Biochemistry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - M Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
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20
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Serra-Pla JF, Pozuelo M, Richarte V, Corrales M, Ibanez P, Bellina M, Vidal R, Calvo E, Casas M, Ramos-Quiroga JA. [Treatment of attention deficit hyperactivity disorder in adults using virtual reality through a mindfulness programme]. Rev Neurol 2017; 64:S117-S122. [PMID: 28256698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder, which presents a high comorbidity with anxiety and affective signs and symptoms. It has repercussions on the functioning of those suffering from it, who also have low therapy compliance and generate a significant cost both at a personal level and for society. Mindfulness is a psychological treatment that has proved to be effective for ADHD. Virtual reality is widely used as treatment in cases of phobias and other pathologies, with positive results. AIMS To develop the first treatment for ADHD in adults based on virtual reality and mindfulness, while also resulting in increased treatment adherence and reduced costs. PATIENTS AND METHODS We conducted a pilot study with 25 patients treated by means of virtual reality, in four 30-minute sessions, and 25 treated with psychostimulants. Measures will be taken pre-treatment, post-treatment and at 3 and 12 months post-treatment, to evaluate both ADHD and also depression, anxiety, functionality and quality of life. Data will be later analysed with the SPSS v. 20 statistical program. An ANOVA of independent groups will be performed to see the differences between treatments and also a test-retest to detect whether the changes will be maintained. RESULTS AND CONCLUSIONS It is necessary to use treatments that are effective, reduce costs and increase therapy adherence. Treatment with virtual reality is an interesting alternative to the classical treatments, and is shorter and more attractive for patients.
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Affiliation(s)
| | - M Pozuelo
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - V Richarte
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - M Corrales
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - P Ibanez
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - M Bellina
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - R Vidal
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - E Calvo
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - M Casas
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
- Universitat Autonoma de Barcelona. Facultat de Medicina. Unitat docent de l'Hospital Vall d'Heb, 08035 Barcelona, Espana
- CIBERSAM, Madrid, Espana
| | - J A Ramos-Quiroga
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
- Universitat Autonoma de Barcelona. Facultat de Medicina. Unitat docent de l'Hospital Vall d'Heb, 08035 Barcelona, Espana
- CIBERSAM, Madrid, Espana
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21
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Garcia-Martínez I, Sánchez-Mora C, Pagerols M, Richarte V, Corrales M, Fadeuilhe C, Cormand B, Casas M, Ramos-Quiroga JA, Ribasés M. Preliminary evidence for association of genetic variants in pri-miR-34b/c and abnormal miR-34c expression with attention deficit and hyperactivity disorder. Transl Psychiatry 2016; 6:e879. [PMID: 27576168 PMCID: PMC5022091 DOI: 10.1038/tp.2016.151] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/16/2016] [Accepted: 06/19/2016] [Indexed: 12/31/2022] Open
Abstract
Attention deficit and hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by impairment to sustain attention and inability to control impulses and activity level. The etiology of ADHD is complex, with an estimated heritability of 70-80%. Under the hypothesis that alterations in the processing or target binding of microRNAs (miRNAs) may result in functional alterations predisposing to ADHD, we explored whether common polymorphisms potentially affecting miRNA-mediated regulation are involved in this psychiatric disorder. We performed a comprehensive association study focused on 134 miRNAs in 754 ADHD subjects and 766 controls and found association between the miR-34b/c locus and ADHD. Subsequently, we provided preliminary evidence for overexpression of the miR-34c-3p mature form in peripheral blood mononuclear cells of ADHD subjects. Next, we tested the effect on gene expression of single-nucleotide polymorphisms within the ADHD-associated region and found that rs4938923 in the promoter of the pri-miR-34b/c tags cis expression quantitative trait loci for both miR-34b and miR-34c and has an impact on the expression levels of 681 transcripts in trans, including genes previously associated with ADHD. This gene set was enriched for miR-34b/c binding sites, functional categories related to the central nervous system, such as axon guidance or neuron differentiation, and serotonin biosynthesis and signaling canonical pathways. Our results provide preliminary evidence for the contribution to ADHD of a functional variant in the pri-miR-34b/c promoter, possibly through dysregulation of the expression of mature forms of miR-34b and miR-34c and some target genes. These data highlight the importance of abnormal miRNA function as a potential epigenetic mechanism contributing to ADHD.
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Affiliation(s)
- I Garcia-Martínez
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - C Sánchez-Mora
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - M Pagerols
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Corrales
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - B Cormand
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain
- Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Esplugues, Barcelona, Spain
| | - M Casas
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J A Ramos-Quiroga
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Ribasés
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
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Ramos-Quiroga JA, Corominas-Roso M, Palomar G, Ferrer R, Valero S, Corrales M, Richarte V, Casas M. Cortisol awakening response in adults with attention deficit hyperactivity disorder: Subtype differences and association with the emotional lability. Eur Neuropsychopharmacol 2016; 26:1140-9. [PMID: 27084305 DOI: 10.1016/j.euroneuro.2016.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 02/12/2016] [Accepted: 03/24/2016] [Indexed: 01/08/2023]
Abstract
Cortisol awakening response (CAR) has been studied in children with ADHD, and some authors have reported morning cortisol differences among ADHD subtypes. Despite, only half of the children with ADHD continue to exhibit the disorder into adulthood, CAR has not been studied in adults so far. One hundred and nine adults with ADHD according to the DSM-IV criteria (46 inattentive and 63 combined) ranging in age from 18 to 55 years, and 27 healthy controls were included. Psychiatric and organic comorbidities were excluded. Salivary cortisol samples were obtained at 0, 30, 45 and 60 minutes after awakening. CAR was present in 84% of the healthy controls but in only 64% of the adults with ADHD (68% of the inattentive and 61% of the combined were CAR-positive). There were no significant differences in any of the morning cortisol measures between patients and controls or between the combined and inattentive subtypes of ADHD. Among the inattentive subtype but not in the combined patients, significant positive correlations were observed between the CAR and emotional lability (p=0.05), or self-concept (p=0.014) CAARS subscales, as well as with the cognitive impulsivity subscale of the Barratt impulsiveness scale (p=0.028). These results suggest that adults with ADHD exhibit normal cortisol responses upon awakening and thus cannot be defined in terms of hypo-arousal. Neurobiological differences between the combined and inattentive subtypes involving cortisol, are discussed.
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Affiliation(s)
- J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - M Corominas-Roso
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain.
| | - G Palomar
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - R Ferrer
- Department of Biochemistry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - S Valero
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
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23
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Stringer S, Minică CC, Verweij KJH, Mbarek H, Bernard M, Derringer J, van Eijk KR, Isen JD, Loukola A, Maciejewski DF, Mihailov E, van der Most PJ, Sánchez-Mora C, Roos L, Sherva R, Walters R, Ware JJ, Abdellaoui A, Bigdeli TB, Branje SJT, Brown SA, Bruinenberg M, Casas M, Esko T, Garcia-Martinez I, Gordon SD, Harris JM, Hartman CA, Henders AK, Heath AC, Hickie IB, Hickman M, Hopfer CJ, Hottenga JJ, Huizink AC, Irons DE, Kahn RS, Korhonen T, Kranzler HR, Krauter K, van Lier PAC, Lubke GH, Madden PAF, Mägi R, McGue MK, Medland SE, Meeus WHJ, Miller MB, Montgomery GW, Nivard MG, Nolte IM, Oldehinkel AJ, Pausova Z, Qaiser B, Quaye L, Ramos-Quiroga JA, Richarte V, Rose RJ, Shin J, Stallings MC, Stiby AI, Wall TL, Wright MJ, Koot HM, Paus T, Hewitt JK, Ribasés M, Kaprio J, Boks MP, Snieder H, Spector T, Munafò MR, Metspalu A, Gelernter J, Boomsma DI, Iacono WG, Martin NG, Gillespie NA, Derks EM, Vink JM. Genome-wide association study of lifetime cannabis use based on a large meta-analytic sample of 32 330 subjects from the International Cannabis Consortium. Transl Psychiatry 2016; 6:e769. [PMID: 27023175 PMCID: PMC4872459 DOI: 10.1038/tp.2016.36] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 12/21/2015] [Indexed: 01/15/2023] Open
Abstract
Cannabis is the most widely produced and consumed illicit psychoactive substance worldwide. Occasional cannabis use can progress to frequent use, abuse and dependence with all known adverse physical, psychological and social consequences. Individual differences in cannabis initiation are heritable (40-48%). The International Cannabis Consortium was established with the aim to identify genetic risk variants of cannabis use. We conducted a meta-analysis of genome-wide association data of 13 cohorts (N=32 330) and four replication samples (N=5627). In addition, we performed a gene-based test of association, estimated single-nucleotide polymorphism (SNP)-based heritability and explored the genetic correlation between lifetime cannabis use and cigarette use using LD score regression. No individual SNPs reached genome-wide significance. Nonetheless, gene-based tests identified four genes significantly associated with lifetime cannabis use: NCAM1, CADM2, SCOC and KCNT2. Previous studies reported associations of NCAM1 with cigarette smoking and other substance use, and those of CADM2 with body mass index, processing speed and autism disorders, which are phenotypes previously reported to be associated with cannabis use. Furthermore, we showed that, combined across the genome, all common SNPs explained 13-20% (P<0.001) of the liability of lifetime cannabis use. Finally, there was a strong genetic correlation (rg=0.83; P=1.85 × 10(-8)) between lifetime cannabis use and lifetime cigarette smoking implying that the SNP effect sizes of the two traits are highly correlated. This is the largest meta-analysis of cannabis GWA studies to date, revealing important new insights into the genetic pathways of lifetime cannabis use. Future functional studies should explore the impact of the identified genes on the biological mechanisms of cannabis use.
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Affiliation(s)
- S Stringer
- Department of Complex Trait Genetics, VU Amsterdam, Center for Neurogenomics and Cognitive Research, Amsterdam, The Netherlands
- Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
| | - C C Minică
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - K J H Verweij
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - H Mbarek
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - M Bernard
- The Hospital for Sick Children Research Institute, Toronto, Canada
| | - J Derringer
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - K R van Eijk
- Department of Human Neurogenetics, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J D Isen
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - A Loukola
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - D F Maciejewski
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - E Mihailov
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - P J van der Most
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C Sánchez-Mora
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - L Roos
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - R Sherva
- Biomedical Genetics Department, Boston University School of Medicine, Boston, MA, USA
| | - R Walters
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - J J Ware
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - A Abdellaoui
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - T B Bigdeli
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - S J T Branje
- Research Centre Adolescent Development, Utrecht University, Utrecht, The Netherlands
| | - S A Brown
- Department of Psychology and Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - M Bruinenberg
- The LifeLines Cohort Study, University of Groningen, Groningen, The Netherlands
| | - M Casas
- 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
| | - T Esko
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - I Garcia-Martinez
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S D Gordon
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - J M Harris
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - C A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A K Henders
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - A C Heath
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - I B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - M Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - C J Hopfer
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - J J Hottenga
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - A C Huizink
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - D E Irons
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - R S Kahn
- Department of Human Neurogenetics, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T Korhonen
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - H R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - K Krauter
- Department of Molecular, Cellular and Developmental Biology, University of Colorado Boulder, Boulder, CO, USA
| | - P A C van Lier
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - G H Lubke
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - P A F Madden
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - R Mägi
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - M K McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - S E Medland
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - W H J Meeus
- Research Centre Adolescent Development, Utrecht University, Utrecht, The Netherlands
- Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - M B Miller
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - G W Montgomery
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - M G Nivard
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - I M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A J Oldehinkel
- Interdisciplinary Center for Pathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Z Pausova
- The Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - B Qaiser
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - L Quaye
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - J A Ramos-Quiroga
- 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
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - R J Rose
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - J Shin
- The Hospital for Sick Children Research Institute, Toronto, Canada
| | - M C Stallings
- Department of Psychology and Neuroscience, Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - A I Stiby
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - T L Wall
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - M J Wright
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - H M Koot
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - T Paus
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
- Department of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - J K Hewitt
- Department of Psychology and Neuroscience, Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - M Ribasés
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - J Kaprio
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - M P Boks
- Department of Human Neurogenetics, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - T Spector
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - M R Munafò
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies and School of Experimental Psychology, University of Bristol, Bristol, UK
| | - A Metspalu
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - J Gelernter
- Department of Psychiatry, Genetics, and Neurobiology, Yale University School of Medicine and VA CT, West Haven, CT, USA
| | - D I Boomsma
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - W G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - N G Martin
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - N A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - E M Derks
- Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
| | - J M Vink
- Department of Biological Psychology/Netherlands Twin Register, VU University, Amsterdam, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Pagerols M, Richarte V, Sánchez-Mora C, Garcia-Martínez I, Corrales M, Corominas M, Cormand B, Casas M, Ribasés M, Ramos-Quiroga JA. Pharmacogenetics of methylphenidate response and tolerability in attention-deficit/hyperactivity disorder. Pharmacogenomics J 2016; 17:98-104. [DOI: 10.1038/tpj.2015.89] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/15/2015] [Accepted: 11/02/2015] [Indexed: 01/06/2023]
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Torres I, Gómez N, Colom F, Jiménez E, Bosch R, Bonnín CM, Martínez-Aran A, Casas M, Vieta E, Ramos-Quiroga JA, Goikolea JM. Bipolar disorder with comorbid attention-deficit and hyperactivity disorder. Main clinical features and clues for an accurate diagnosis. Acta Psychiatr Scand 2015; 132:389-99. [PMID: 25900393 DOI: 10.1111/acps.12426] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the prevalence of attention-deficit and hyperactivity disorder (ADHD) in adult patients with bipolar disorder (BD) and identify differential clinical features for a better diagnosis. METHOD A total of 163 euthymic bipolar out-patients were screened for ADHD with the ASRS.V1 and the WURS at a BD Unit. Patients with a positive screening were assessed with the CAADID, at an ADHD unit. Sociodemographic and clinical features of the groups with and without ADHD were compared. RESULTS Lifetime prevalence of comorbid ADHD was 17.9% (10.5% for adult ADHD and 7.4% for childhood ADHD). The BD + ADHD group showed more suicidal behaviour although less severe. Comorbidity was also more common, especially regarding substance use disorders. Nevertheless, these patients did not show more affective episodes or hospitalizations and suffered more atypical but less melancholic depression. However, they required more treatment with psychotherapy and valproate. One-third of positive screenings at the ASRS were false; a severe course of BD was the hallmark of this subgroup. CONCLUSION Adult patients with BD and ADHD show differential clinical features, but not a more severe course of BD. Comorbidity with substance abuse is a big issue, deserving special clinical attention. Better screening tools are necessary to avoid overdiagnosis of comorbid ADHD in BD.
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Affiliation(s)
- I Torres
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - N Gómez
- ADHD Unit, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Catalonia, Spain
| | - F Colom
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jiménez
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - R Bosch
- ADHD Unit, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Catalonia, Spain
| | - C M Bonnín
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Martínez-Aran
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Casas
- ADHD Unit, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - J A Ramos-Quiroga
- ADHD Unit, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Catalonia, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma of Barcelona, Barcelona, Spain
| | - J M Goikolea
- Bipolar Disorder Unit, Hospital Clínic i Universitari, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Nogueira M, Bosch R, Valero S, Gómez-Barros N, Palomar G, Richarte V, Corrales M, Nasillo V, Vidal R, Casas M, Ramos-Quiroga JA. Early-age clinical and developmental features associated to Substance Use Disorders in Attention-Deficit/Hyperactivity Disorder in Adults. Compr Psychiatry 2014; 55:639-49. [PMID: 24411652 DOI: 10.1016/j.comppsych.2013.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 12/01/2013] [Accepted: 12/04/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The main objective was to explore early-age conditions associated to Substance Use Disorders (SUD) in adults with Attention Deficit/Hyperactivity Disorder (ADHD); secondly, to determine which of those conditions are specific to ADHD subjects; and finally, to compare ADHD and non-ADHD subjects in terms of SUD lifetime prevalence and professional, social and personal adjustment. METHOD Comparison between ADHD adults with (n=236) and without lifetime SUD (n=309) regarding clinical characteristics of ADHD, externalization disorders, temperamental traits, environmental factors, academic history and family psychiatric history; secondly, ADHD subjects were compared to a non-ADHD group (n=177) concerning those variables. RESULTS The following variables were found to be positively associated to SUD in ADHD subjects: ADHD severity, CD and ODD comorbidities, temperamental characteristics ("fearful", "accident prone" and "frequent temper tantrums"), "sexual abuse", "be suspended from school", family history of SUD and ADHD, and male gender; ADHD inattentive subtype and "fearful" were inversely associated to SUD. From those variables, "frequent temper tantrums" was also associated to SUD in non-ADHD subjects. ADHD subjects had higher prevalence of lifetime SUD and greater professional, social and personal impairment than non-ADHD subjects. CONCLUSION Findings suggest a significant association between ADHD, SUD and early-age conditions, such as CD and ODD comorbidity; other variables from childhood, namely, ADHD subtype, temper characteristics ("fearful", "accident prone"), "sexual abuse", "be suspended from school" and family history of ADHD are associated to SUD in ADHD subjects, but not in non-ADHD subjects. Moreover, this study confirms both the higher prevalence of lifetime SUD and greater professional, social and personal impairment in ADHD subjects than in non-ADHD subjects.
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Affiliation(s)
- M Nogueira
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - R Bosch
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - S Valero
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - N Gómez-Barros
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - G Palomar
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, 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
| | - M Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - V Nasillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - R Vidal
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - M Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, 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; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain.
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Valdizán-Usón JR, Cánovas-Martínez A, De Lucas-Taracena MT, Díaz-Atienza F, Eddy-Ives LS, Fernández-Jaén A, Fernández-Pérez M, García-Giral M, García-Magán P, Garraus-Oneca M, Idiazábal-Alecha MA, López-Benito M, Lorenzo-Sanz G, Martínez-Antón J, Martínez-Granero MA, Montañés-Rada F, Mulas-Delgado F, Ochando-Perales G, Ortega-García E, Pelaz-Antolín A, Ramos-Quiroga JA, Ruiz-Sanz FC, Vaquerizo-Madrid J, Yusta-Izquierdo A. Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study. Neuropsychiatr Dis Treat 2013; 9:211-8. [PMID: 23430373 PMCID: PMC3573811 DOI: 10.2147/ndt.s35836] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics. METHODS This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4-65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002-2006 in sequential order. RESULTS The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as "very satisfied" or "satisfied" by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy. CONCLUSION Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD.
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Sanchez-Mora C, Ribases M, Mulas F, Soutullo C, Sans A, Pamias M, Casas M, Ramos-Quiroga JA. [Genetic bases of attention deficit hyperactivity disorder]. Rev Neurol 2012; 55:609-618. [PMID: 23143962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIMS The purpose of this study is to update the information available on the main group of genes that have been related with a susceptibility to attention deficit hyperactivity disorder (ADHD) or with the pharmacological response to different drugs used in the treatment of ADHD, in a number of different association and meta-analysis studies. DEVELOPMENT Different studies have provided evidence of the importance of the genetic load in the susceptibility to ADHD. The work carried out to date point to genes in the dopaminergic system, such as the gene that codes for the dopamine transporter (DAT1 or SLC6A3) and for the dopamine receptor D4 (DRD4); in the noradrenergic system, like the gene coding for the adrenergic alpha-2A receptor (ADRA2A), the COMT gene, which codes for the enzyme catechol-O-methyltransferase and the gene that codes for latrophilin 3 (LPHN3), as genes that are candidates for playing a part in the susceptibility to ADHD, and being involved in the pharmacological response as well as in the risk of presenting associated behavioural disorders. On the other hand, the genes involved in regulating the metabolism of the drugs used in the treatment of ADHD, such as the gene CYP2D6 and gene CES1, play a role in the efficiency and tolerance of these psycho-pharmaceuticals. CONCLUSIONS Although in recent years there has been an increase in the number of pharmacogenetic studies conducted on ADHD, findings differ significantly from one study to another. Integrating and meta-analytical studies are needed to be able to develop a more personalised treatment for ADHD.
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Corominas M, Ramos-Quiroga JA, Ferrer M, Sáez-Francàs N, Palomar G, Bosch R, Casas M. Cortisol responses in children and adults with attention deficit hyperactivity disorder (ADHD): a possible marker of inhibition deficits. ACTA ACUST UNITED AC 2012; 4:63-75. [PMID: 22576746 DOI: 10.1007/s12402-012-0075-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 04/24/2012] [Indexed: 11/28/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disease whose neurobiological background is not completely understood. It has been proposed that deficits of the inhibitory function with an underactive behavioral inhibition system (BIS) may be in the core of ADHD. In this regard, this review summarizes all studies that examine the involvement of cortisol in ADHD. Differences in cortisol responses from different ADHD subtypes, hyperactive/impulsive, inattentive, and combined, are analyzed. In addition, we examine the role of comorbidities as confounding factors in the study of cortisol in ADHD, including comorbid disruptive behavioral disorder (DBD), as well as anxiety and depressive disorders. Because ADHD is a neurodevelopmental condition and approximately half of the children enter adulthood with the disorder, we review cortisol studies in adults and children separately. Two diverse patterns of cortisol have been reported both in children and adults with ADHD. Blunted cortisol responses to stress are associated with comorbid DBD, whereas high cortisol responses are associated to comorbid anxiety disorders. Nevertheless, the inhibitory deficits in ADHD do not appear to be related directly to cortisol deficits in either children or adults. This review increases our understanding of the heterogeneity of ADHD and could help in determining new strategies for the treatment of these patients. Future studies including gender and a more systematic methodology to study the cortisol response are needed.
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Affiliation(s)
- M Corominas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron (UAB), Escola d'Infermeria building 5th floor, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain.
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30
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Buitelaar JK, Casas M, Philipsen A, Kooij JJS, Ramos-Quiroga JA, Dejonckheere J, van Oene JC, Schäuble B. Functional improvement and correlations with symptomatic improvement in adults with attention deficit hyperactivity disorder receiving long-acting methylphenidate. Psychol Med 2012; 42:195-204. [PMID: 21733214 PMCID: PMC3226157 DOI: 10.1017/s0033291711000845] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 04/18/2011] [Accepted: 05/03/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND Data on the relationship between core symptoms and daily functioning in adults with attention deficit hyperactivity disorder (ADHD) are limited. Daily functioning was assessed as part of an open-label extension, and associations with symptom scores were evaluated. METHOD After a 5-week double-blind study with adults with ADHD receiving osmotic-controlled release oral delivery system (OROS) methylphenidate (MPH) 18, 36 or 72 mg/day, or placebo, participants were eligible for a 7-week open-label extension in which all patients received OROS MPH. Data for the Conners' Adult ADHD Rating Scale - Observer: Screening Version (CAARS-O:SV) (primary endpoint) have been presented previously. Secondary endpoints included the observer self-reported short version of the CAARS (CAARS-S:S) and the Clinical Global Impressions - Severity Scale (CGI-S). Daily functioning and quality of life were assessed using the Sheehan Disability Scale (SDS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) respectively. In post-hoc analyses, changes in CAARS-O:SV were evaluated in subgroups. Relationships between symptom and functional outcomes were evaluated in a multivariate regression analysis. RESULTS A total of 370 patients entered the open-label extension. Significant improvements from baseline in CAARS-O:SV were similar regardless of sex, ADHD subtype, prior treatment or psychiatric co-morbidity. Significant improvements from double-blind baseline were also seen for the CAARS-S:S, CGI-S, SDS and Q-LES-Q. Improvements in the CAARS-O:SV Hyperactivity/Impulsivity subscale were associated with improvements in SDS total and subscale scores, and in the Q-LES-Q score at open-label endpoint. Improvements in CAARS-O:SV Inattention subscale and CGI-S scores were not significantly associated with functional changes. CONCLUSIONS Improvements in ADHD symptoms relating to hyperactivity and impulsivity in adults receiving OROS MPH are associated with improvements in daily functioning and quality of life.
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Affiliation(s)
- J K Buitelaar
- Department of Cognitive Neuroscience, University Medical Centre, St Radboud and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
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Ribasés M, Ramos-Quiroga JA, Sánchez-Mora C, Bosch R, Richarte V, Palomar G, Gastaminza X, Bielsa A, Arcos-Burgos M, Muenke M, Castellanos FX, Cormand B, Bayés M, Casas M. Contribution of LPHN3 to the genetic susceptibility to ADHD in adulthood: a replication study. Genes Brain Behav 2010; 10:149-57. [PMID: 21040458 DOI: 10.1111/j.1601-183x.2010.00649.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common and highly heritable developmental disorder characterized by a persistent impairing pattern of inattention and/or hyperactivity-impulsivity. Using families from a genetic isolate, the Paisa population from Colombia, and five independent datasets from four different populations (United States, Germany, Norway and Spain), a highly consistent association was recently reported between ADHD and the latrophilin 3 (LPHN3) gene, a brain-specific member of the LPHN subfamily of G-protein-coupled receptors that is expressed in ADHD-related regions, such as amygdala, caudate nucleus, cerebellum and cerebral cortex. To replicate the association between LPHN3 and ADHD in adults, we undertook a case-control association study in 334 adult patients with ADHD and 334 controls with 43 single nucleotide polymorphisms (SNPs) covering the LPNH3 gene. Single- and multiple-marker analyses showed additional evidence of association between LPHN3 and combined type ADHD in adulthood [P = 0.0019; df = 1; odds ratio (OR) = 1.82 (1.25-2.70) and P = 5.1e-05; df = 1; OR = 2.25 (1.52-3.34), respectively]. These results further support the LPHN3 contribution to combined type ADHD, and specifically to the persistent form of the disorder, and point at this new neuronal pathway as a common susceptibility factor for ADHD throughout the lifespan.
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Affiliation(s)
- M Ribasés
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Catalonia, Spain.
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Sánchez-Mora C, Ribasés M, Ramos-Quiroga JA, Casas M, Bosch R, Boreatti-Hümmer A, Heine M, Jacob CP, Lesch KP, Fasmer OB, Knappskog PM, Kooij JJS, Kan C, Buitelaar JK, Mick E, Asherson P, Faraone SV, Franke B, Johansson S, Haavik J, Reif A, Bayés M, Cormand B. Meta-analysis of brain-derived neurotrophic factor p.Val66Met in adult ADHD in four European populations. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:512-523. [PMID: 19603419 DOI: 10.1002/ajmg.b.31008] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a multifactorial, neurodevelopmental disorder that often persists into adolescence and adulthood and is characterized by inattention, hyperactivity and impulsiveness. Before the advent of the first genome-wide association studies in ADHD, genetic research had mainly focused on candidate genes related to the dopaminergic and serotoninergic systems, although several other genes had also been assessed. Pharmacological data, analysis of animal models and association studies suggest that Brain-Derived Neurotrophic Factor (BDNF) is also a strong candidate gene for ADHD. Several polymorphisms in BDNF have been reported and studied in psychiatric disorders but the most frequent is the p.Val66Met (rs6265G > A) single nucleotide polymorphism (SNP), with functional effects on the intracellular trafficking and secretion of the protein. To deal with the inconsistency raised among different case-control and family-based association studies regarding the p.Val66Met contribution to ADHD, we performed a meta-analysis of published as well as unpublished data from four different centers that are part of the International Multicentre Persistent ADHD CollaboraTion (IMpACT). A total of 1,445 adulthood ADHD patients and 2,247 sex-matched controls were available for the study. No association between the p.Val66Met polymorphism and ADHD was found in any of the four populations or in the pooled sample. The meta-analysis also showed that the overall gene effect for ADHD was not statistically significant when gender or comorbidity with mood disorders were considered. Despite the potential role of BDNF in ADHD, our data do not support the involvement of p.Val66Met in the pathogenesis of this neuropsychiatric disorder.
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Affiliation(s)
- C Sánchez-Mora
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Psychiatric Genetics Unit, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - M Ribasés
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Psychiatric Genetics Unit, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - M Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - R Bosch
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - A Boreatti-Hümmer
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - M Heine
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - C P Jacob
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - K-P Lesch
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - O B Fasmer
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Section of Psychiatry, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - P M Knappskog
- Center of Medical Genetics and Molecular Medicine, Haukeland University Hospital, Haukeland, Norway.,Medical Genetics and Molecular Medicine, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - J J Sandra Kooij
- PsyQ, Psycho-Medical Programs, Program Adult ADHD, The Hague, The Netherlands
| | - C Kan
- Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - J K Buitelaar
- Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - E Mick
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - P Asherson
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, London, UK
| | - S V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - B Franke
- Department of Psychiatry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - S Johansson
- Center of Medical Genetics and Molecular Medicine, Haukeland University Hospital, Haukeland, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - J Haavik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - A Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - M Bayés
- Genes and Disease Program, Center for Genomic Regulation (CRG-UPF), Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Catalonia, Spain.,Centro Nacional de Genotipado (CeGen), Barcelona, Catalonia, Spain
| | - B Cormand
- Departament de Genètica, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain.,CIBER Enfermedades Raras, Barcelona, Catalonia, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain
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Landaas ET, Johansson S, Jacobsen KK, Ribasés M, Bosch R, Sánchez-Mora C, Jacob CP, Boreatti-Hümmer A, Kreiker S, Lesch KP, Kiemeney LA, Kooij JJS, Kan C, Buitelaar JK, Faraone SV, Halmøy A, Ramos-Quiroga JA, Cormand B, Reif A, Franke B, Mick E, Knappskog PM, Haavik J. An international multicenter association study of the serotonin transporter gene in persistent ADHD. Genes Brain Behav 2010; 9:449-58. [PMID: 20113357 DOI: 10.1111/j.1601-183x.2010.00567.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common behavioral disorder affecting children and adults. It has been suggested that gene variants related to serotonin neurotransmission are associated with ADHD. We tested the functional promoter polymorphism 5-HTTLPR and seven single nucleotide polymorphisms in SLC6A4 for association with ADHD in 448 adult ADHD patients and 580 controls from Norway. Replication attempts were performed in a sample of 1454 Caucasian adult ADHD patients and 1302 controls from Germany, Spain, the Netherlands and USA, and a meta-analysis was performed also including a previously published adult ADHD study. We found an association between ADHD and rs140700 [odds ratio (OR ) = 0.67; P = 0.01] and the short (S) allele of the 5-HTTLPR (OR = 1.19; P = 0.06) in the Norwegian sample. Analysis of a possible gender effect suggested that the association might be restricted to females (rs140700: OR = 0.45; P = 0.00084). However, the meta-analysis of 1894 cases and 1878 controls could not confirm the association for rs140700 [OR = 0.85, 95% confidence interval (CI) = 0.67-1.09; P = 0.20]. For 5-HTTLPR, five of six samples showed a slight overrepresentation of the S allele in patients, but meta-analysis refuted a strong effect (OR = 1.10, 95% CI = 1.00-1.21; P = 0.06). Neither marker showed any evidence of differential effects for ADHD subtype, gender or symptoms of depression/anxiety. In conclusion, our results do not support a major role for SLC6A4 common variants in persistent ADHD, although a modest effect of the 5-HTTLPR and a role for rare variants cannot be excluded.
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Affiliation(s)
- E T Landaas
- Department of Biomedicine, University of Bergen, Bergen, Norway
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Daigre Blanco C, Ramos-Quiroga JA, Valero S, Bosch R, Roncero C, Gonzalvo B, Nogueira M. Adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist in patients with substance use disorders. Actas Esp Psiquiatr 2009; 37:299-305. [PMID: 20066581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Diagnosing attention deficit/hyperactivity disorder (ADHD) in patients with substance use disorder (SUD) is a complicated process in which a screening tool may be useful. We analyzed the ASRS-v1.1 validity in patients with SUD, considering the addiction severity and co-morbidity with depressive disorders, antisocial and borderline personality. METHODS Eighty outpatients with SUD were evaluated with the following instruments: ASRS-v1.1, CAAD-II, EuropASI, SCID-I, SCID-II. A factor analysis was performed with Varimax rotation to determine the structure of the intercorrelations among the items. Accuracy of ASRS-v1.1 was also analyzed. RESULTS The diagnostic interview CAADID used as a gold standard indicated that 20% (95% confidence interval [CI]: 11-29) meet the criteria for ADHD. The ASRSv1.1 factor structure is marked by two factors related to inattention and hyperactivity / impulsivity that account for 67.7% of the variance. ASRS-v1.1, with a 4 cut-off, showed an 87.5% sensitivity and 68.6% specificity. CONCLUSIONS ASRS-v1.1 is a simple screening tool that is useful and has acceptable validity for the identification of ADHD among addicted patients.
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Affiliation(s)
- Constanza Daigre Blanco
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
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Ramos-Quiroga JA, Daigre C, Valero S, Bosch R, Gómez-Barros N, Nogueira M, Palomar G, Roncero C, Casas M. [Validation of the Spanish version of the attention deficit hyperactivity disorder adult screening scale (ASRS v. 1.1): a novel scoring strategy]. Rev Neurol 2009; 48:449-452. [PMID: 19396760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in the adulthood. It's diagnosis is a complex process in which a screening tool can be useful. AIM To analyze the six-question Adult ADHD Self-Report Scale (ASRS v. 1.1) validity in an outpatient clinical context. SUBJECTS AND METHODS We performed a case-control study, involving 90 patients with ADHD and 90 controls without ADHD. They were outpatient treated in a program for adults ADHD in a hospital. The clinical disorder diagnosis was measured by the Conners Adult ADHD Diagnostic Interview. We analyzed the test accuracy for different ways to score and cut-offs. RESULTS We found the best psychometric characteristics of ASRS v. 1.1 using a quantitative ranking between 0 and 24 points, setting as cut-off 12 points. We observed a sensitivity of 96.7%, specificity 91.1%, positive predictive value 91.6% negative predictive value 96.5%, kappa index 0.88 and area under the curve 0.94 (odds ratio = 297.3; 95% confidence interval = 76.2-1,159). CONCLUSION The ASRS is a valid and useful tool for the adult ADHD screening in the clinical context.
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Affiliation(s)
- J A Ramos-Quiroga
- Departamento de Psiquiatría y Medicina Legal, Universitat Autònoma de Barcelona, España.
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Ribasés M, Ramos-Quiroga JA, Hervás A, Bosch R, Bielsa A, Gastaminza X, Artigas J, Rodriguez-Ben S, Estivill X, Casas M, Cormand B, Bayés M. Exploration of 19 serotoninergic candidate genes in adults and children with attention-deficit/hyperactivity disorder identifies association for 5HT2A, DDC and MAOB. Mol Psychiatry 2009; 14:71-85. [PMID: 17938636 DOI: 10.1038/sj.mp.4002100] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in which different genetic and environmental susceptibility factors are involved. Several lines of evidence support the view that at least 30% of ADHD patients diagnosed in childhood continue to suffer the disorder during adulthood and that genetic risk factors may play an essential role in the persistence of the disorder throughout lifespan. Genetic, biochemical and pharmacological studies support the idea that the serotonin system participates in the etiology of ADHD. Based on these data, we aimed to analyze single nucleotide polymorphisms across 19 genes involved in the serotoninergic neurotransmission in a clinical sample of 451 ADHD patients (188 adults and 263 children) and 400 controls using a population-based association study. Several significant associations were found after correcting for multiple testing: (1) the DDC gene was strongly associated with both adulthood (P=0.00053; odds ratio (OR)=2.17) and childhood ADHD (P=0.0017; OR=1.90); (2) the MAOB gene was found specifically associated in the adult ADHD sample (P=0.0029; OR=1.90) and (3) the 5HT2A gene showed evidence of association only with the combined ADHD subtype both in adults (P=0.0036; OR=1.63) and children (P=0.0084; OR=1.49). Our data support the contribution of the serotoninergic system in the genetic predisposition to ADHD, identifying common childhood and adulthood ADHD susceptibility factors, associations that are specific to ADHD subtypes and one variant potentially involved in the continuity of the disorder throughout lifespan.
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Affiliation(s)
- M Ribasés
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
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Ramos-Quiroga JA, Ribasés-Haro M, Bosch-Munsó R, Cormand-Rifà B, Casas M. [Genetic advances in attention deficit hyperactivity disorder]. Rev Neurol 2007; 44 Suppl 3:S51-2. [PMID: 17523112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
AIM To update the knowledge currently available on the genetic foundations of attention deficit hyperactivity disorder (ADHD). The presentation will focus especially on recent data concerning adults. DEVELOPMENT AND CONCLUSIONS ADHD is one of the most prevalent neuropsychiatric disorders among the general childhood population. In recent years it has been shown that it often progresses into adulthood. The results from studies of families, twins and adopted children display a high degree of familial aggregation. Molecular genetics studies have brought to light positive associations with different genetic polymorphisms in neurotransmitter systems involved in the pathophysiology of ADHD, mainly with the dopaminergic, serotoninergic and noradrenergic, and neurotrophins such as the brain-derived neurotrophic factor (BDNF). The causation of ADHD is still largely unknown but the different studies published to date dealing with the genetic foundations of the disorder suggest that genetics play an important role, its inheritance is complex and it is modulated by environmental factors. ADHD in adults can be a good model for studying the genetic foundations of ADHD.
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Affiliation(s)
- J A Ramos-Quiroga
- Universitat Autonoma de Barcelona. Facultat de Medicina. Unitat docent de l'Hospital Vall d'Heb, 08035 Barcelona, Espana.
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Ramos-Quiroga JA, Bosch-Munsó R, Castells-Cervelló X, Nogueira-Morais M, García-Gimenez E, Casas-Brugué M. [Attention deficit hyperactivity disorder in adults: a clinical and therapeutic characterization]. Rev Neurol 2006; 42:600-6. [PMID: 16703528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
AIM To update the existing knowledge about attention deficit hyperactivity disorder (ADHD) in adults, with special interest given to aspects concerning epidemiology, diagnosis, progression and treatment. DEVELOPMENT Acknowledging the fact that ADHD can persist into adulthood is a relatively recent development. Nevertheless, over the last few years evidence has been put forward to support the validity of its diagnosis in adults. The prevalence of ADHD in the general adult population is estimated to be around 4%. Over 50% of the children with the disorder will continue to have it as adults. The symptoms of ADHD can be different in adults, with less hyperactivity and a slight decrease in impulsiveness, but with the same symptoms of inattention. ADHD in adulthood is linked to serious economic, occupational, academic and familial repercussions, as well as to road accidents and to the presence of other psychiatric pathologies (such as drug addiction, personality disorders and depression). CONCLUSIONS A number of different psychometric instruments are available in Spanish for evaluating ADHD in adults. The use of structured interviews, together with a systemized evaluation of possible comorbid disorders, makes it easier to reach a correct differential diagnostic. Pharmacological treatment in adults is essentially the same as that used with children, but weight-adjusted. Clinical trials have been carried out with psychostimulants and results show methylphenidate to be the most effective and the safest. Atomoxetine is the non-stimulating pharmaceutical that has been most widely studied in adults. Cognitive behavioural psychological treatments have proved to be effective in adults with ADHD.
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Affiliation(s)
- J A Ramos-Quiroga
- Universitat Autonoma de Barcelona, Facultat de Medicina, Servei de Psiquiatria, Unitat docent de l'Hospital Vall d'Hebron, passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain.
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