scholarly journals Methylphenidate treatment of adult ADHD patients improves the degree of ADHD severity under routine conditions

2020 ◽  
Vol 127 (10) ◽  
pp. 1427-1434
Author(s):  
Wolfgang Retz ◽  
Michael Rösler ◽  
Roland Fischer ◽  
Claudia Ose ◽  
Richard Ammer

Abstract Attention-deficit hyperactivity disorder (ADHD) is associated with substantial personal and social impairments. Besides psychosocial interventions, current guidelines recommend a therapy with methylphenidate (MPH). This prospective, non-interventional study aims to investigate the efficacy and tolerability of MPH treatment of adult ADHD patients in a real-world setting. 468 adult patients with newly diagnosed ADHD were observed for 12–14 weeks. Primary efficacy endpoint was the clinical global impression (CGI) by the physician. Secondary endpoints comprise patient evaluation (Wender–Reimherr self-report, WR-SR), safety, tolerability, and dosage of MPH. With a mean daily dose of 35.8 (±17.0) mg MPH, the population of patients being severely/most extremely ill or markedly ill decreased by 64% and 61%, respectively. According to physicians’ assessment (CGI), 74.5% of patients were identified as treatment responders. The total score of patient-based assessment (WR-SR) improved by 23.5% (50.1 ± 40.3 points) with the most profound improvement in attention deficit (−30.0%), disorganization (−26.6%), and hyperactivity / unrest (−23.3%). Self-evaluation revealed a responder rate of 35.4%. In summary, MPH treatment improves the degree of ADHD severity under routine conditions. In addition, activities of daily living were facilitated when taking MPH. The rather poor responder rates determined by patient assessment as well as the comparatively low applied mean daily dose of 35.8 mg (median 40 mg) indicate sub-optimal dosing under routine conditions, not exploiting the full beneficial therapeutic potential of MPH.

CNS Spectrums ◽  
2004 ◽  
Vol 9 (9) ◽  
pp. 649-659 ◽  
Author(s):  
Mary V. Solanto ◽  
Kenneth Etefia ◽  
David J. Marks

ABSTRACTBackground: Attention-deficit/hyperactivity disorder (ADHD) occurs in as many as 4% of adults yet it is often not recognized in clinical settings because the presenting symptoms may resemble those seen in other disorders or because symptoms may be masked by commonly comorbid conditions such as anxiety and depression.Objective: The purpose of this study was to examine the diagnostic utility of instruments commonly used in the assessment of adults presenting with symptoms of ADHD.Methods: We reviewed several widely used self-report and laboratory measures and empirically examined the utility of the Brown Attention-Deficit Disorder Scale for Adults (Brown ADD Scale) and the Conners Continuous Performance Test (CPT) in differentially identifying adults with ADHD and those with other Axis I disorders.Results:Ninety-three adults who self-referred to the ADHD program for adults at a university medical center participated in the study. Of these, 44 had ADHD combined subtype (ADHD-CB), and 26 had ADHD, predominantly inattentive subtype (ADHD-IA). Thirty-three non-ADHD adults diagnosed with Axis I mood or anxiety disorders comprised an “Other Psychiatric” group. Rates of comorbid disorders, including substance abuse, in the ADHD groups were typical of those reported in the adult ADHD literature. Data on the Brown ADD Scale and on the CPT were available for subsets of 61 and 46 participants, respectively. Analyses showed that the ADHD-CB, ADHD-IA, and Other Psychiatric groups all received mean scores in the clinical range on the Brown ADD Scale, with a trend toward even higher elevations in the two ADHD groups. Among 12 CPT variables assessed for the three groups, the mean scores on only two variables for the ADHD-IA group were clinically elevated. Neither the Brown ADD Scale nor CPT scores evinced sufficient sensitivity and specificity to qualify them to assist in differential diagnosis of ADHD vis-a-vis other, predominantly internalizing, psychiatric disorders.Conclusion: The results indicate a need for closer examination of executive and adaptive functioning in adults with ADHD compared with those with internalizing disorders in order to identify features that could assist in differential diagnosis.


2019 ◽  
Vol 50 (2) ◽  
pp. 262-273
Author(s):  
Charles H Van Wijk

In the South African context, resource constraints often preclude the comprehensive assessment of large numbers of people for the likelihood of Adult Attention-Deficit/Hyperactivity Disorder (ADHD). Primary screening through a self-report measure may be useful to stream at-risk individuals towards diagnostic assessment services, as well as being useful in population and workplace based research. The present study set out, first, to investigate the usefulness of a self-report ADHD scale to identify at-risk individuals, and, second, to provide preliminary prevalence estimates for Adult ADHD, guided by Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria, in a South African workplace sample. Workers in full-time skilled employment ( N = 1,917), aged 18–44, completed a self-report Adult ADHD scale, and participated in an interview with a psychologist. Their scale data, using three different scoring and interpretation systems, were subjected to statistical analysis. Favourable internal reliability and positive predictive validity were found. Different interpretation systems provided different prevalence estimations: using DSM-5 criteria, a total prevalence estimate of 3.3 % was calculated (attention deficit subtype = 0.9%, hyperactivity-impulsivity subtype = 1.0%, and combined subtype = 1.4%). The positive predictive validity found with this sample suggests that this scale can be used constructively in research or screening contexts to identify at-risk individuals. Furthermore, preliminary prevalence estimates for Adult ADHD, guided by DSM-5 criteria, are now available for a South African workplace sample.


2017 ◽  
Vol 41 (S1) ◽  
pp. S396-S397
Author(s):  
B. Tuzun Mutluer ◽  
T.G. Yener Orum ◽  
S. Sertcelik

ObjectiveIn this study, it was aimed to determine the internet use properties of Adult Attention Deficit Hyperactivity Disorder (ADHD) patients who were followed-up at Haydarpasa Numune Research and Training Hospital, Psychiatry Department; ADHD Outpatient Clinic.MethodThirty participants who were diagnosed with adult ADHD aged between 18–31 years rated their ADHD symptoms in childhood retrospectively, using Wender Utah Rating Scale. Patients rated current adult ADHD symptoms with the Adult ADHD DSM-IV-Based Diagnostic Screening and Rating Scale (DSRS) and severity of symptoms measured by Adult ADHD Self-Report Scale (ASRS). Internet addiction (IA) was assessed with Young's Internet Addiction Scale (IAS). It was determined that, none of 30 Adult ADHD patients have been diagnosed with IA.29 of patient have moderate internet use although 1 of patients have risky internet use. The results revealed that total ASRS score (P = 0.020), total Adult ADHD DSM-IV-Based DSRS score (P = 0.036) and the Attention Deficit related properties subscale total score (P = 0.042) were significantly correlated with the IAS total score. Subscale of the self-report scales including; failing to finish schoolworks, chores, or duties at workplace, difficulty of following through on instructions (P = 0.017), restiveness; impaired inhibitory performance (P = 0.017), feeling not confident (P = 0.017), difficulty of managing time (P = 0.047), failing to give close attention to details or making careless mistakes (P = 0.037) are closely relevant to IAS total score.ResultIn conclusion, clinical features, which are characteristic of Adult ADHD could have same shared etiology with IA. Furthermore, ADHD patients are more likely to have an IA diagnosis. However, it was thought that this result had to be supported with studies including larger samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 11 (2) ◽  
pp. 238
Author(s):  
Shaimaa Ezzat Basha ◽  
Futiem Nasha Alsubie

The present paper aims at determining the contribution of the Sluggish Cognitive Tempo (SCT) and self-esteem to predicting Attention-Deficit Hyperactivity Disorder (ADHD) among female university students in Saudi Arabia. It examines the differences in the research variables according to academic achievement. It also identifies the correlations of these variables. The authors applied the research instruments, i.e., the Adult ADHD Self-Report Scale (ASRS-v1.1), Adult Concentration Inventory (ACI), and Rosenberg’s Self-Esteem Scale (RSES) to a sample of 203 female university students aged 19-31 years (M = 23.29 years; SD= 3.74 years). The results showed no differences in the mean scores of ASRS, ACI, and negative self-esteem in the achievement levels among university students. In contrast, there was a positive direct relationship between ADHD, SCT, and negative self-esteem. SCT contributed significantly (by 40%), whereas self-esteem contributed by 6% in predicting ADHD among university students. The study highlighted the contribution of both negative self-esteem and SCT to predicting ADHD among Saudi university students to understand the nature of the disorder and its predictors. The findings of this study can be utilized to develop preventive programs for enhancing self-esteem and increasing attention among university students.   Received: 17 December 2020 / Accepted: 31 January 2021 / Published: 5 March 2021


2021 ◽  
Vol 6 (3) ◽  
pp. 225-229
Author(s):  
Aparna Patel ◽  
Jalpa Parikh

Background: Attention deficit hyperactivity disorder-ADHD is a developmental nervous behavioural disorder mostly diagnosed in childhood and rarely in adults. Characteristic clinical features in adults are mainly, hyperactivity, attention deficit and impulsiveness instability in interpersonal relations and alcohol abuse which can cause poor occupational, academic and social performance in future. As ADHD is usually undiagnosed in adults because of its poor knowledge of the symptoms. Need of study is to see the prevalence of ADHD among individuals, as ADHD youth are at high risk of a wide range of adverse psychiatric outcomes. Methodology: This observational study was performed in 307 young female & male of all the fields aged between 18-24, according to Newman’s classification. The subjects were screened for ADHD by Adult ADHD Self-Report Scale (ASRS) which has two parts- inattentive and hyperactive/impulsive. This questionnaire was sent through Google Form. Results: Statistical analysis was done using Microsoft Excel 10th version. According to ASR Scale among 307, 5.53% were highly likely to have inattentiveness and 6.64% were highly likely to have hyper activeness and impulsiveness. In 207 females 6.28%, 5.79% were highly likely to be inattentive, hyperactive/impulsive and in 100 males 9%,4% were highly likely to be hyperactive/impulsive, inattentive. Conclusion: Total prevalence of Adult ADHD is 11.40%. Among all the participants, prevalence of ADHD for Part-A (Inattentive) is 5.53% and Part-B (Hyperactive/Impulsive) is 6.64%. Out of total, 0.977% got mixed symptoms of ADHD. Keywords: Young individuals, ASRS, Adult ADHD, Inattentive, Hyperactive, Impulsive.


2004 ◽  
Vol 19 (2) ◽  
pp. 72-78 ◽  
Author(s):  
J.H. Dowson ◽  
A. McLean ◽  
E. Bazanis ◽  
B. Toone ◽  
S. Young ◽  
...  

AbstractCharacteristics of DSM-IV attention-deficit/hyperactivity disorder (ADHD) in adults can also be found as part of other psychiatric disorders. This study investigated the specificity of adult ADHD features in relation to patients with borderline personality disorder (BPD), a syndrome which shares some of its intrinsic features with ADHD and often co-occurs with ADHD. A group of 20 adult patients selected on the basis of a diagnosis of ADHD and 20 patients selected on the basis of a diagnosis of BPD were assessed by the self-report Attention Deficit Scales for Adults (ADSA). The two groups were matched for age, verbal IQ and gender. Of the nine ADSA scales, seven showed significant inter-group differences, in particular involving attention, organisation and persistence. The ‘Consistency/Long-Term’ scale, which mainly reflects impaired task and goal persistence, was the best discriminator between the groups. Furthermore, ratings on this scale correlated significantly with the error score of a computer-administered task of spatial working memory, the performance of which has been reported to be impaired in patients with ADHD. The results provide further validation for the ADSA scales and support a previous claim that ‘long-term consistencies’, i.e., related to task and goal persistence, is ‘the centrepiece behavioural issue’ for adults with ADHD.


2017 ◽  
Vol 45 ◽  
pp. 227-234 ◽  
Author(s):  
A. Stickley ◽  
A. Koyanagi ◽  
H. Takahashi ◽  
V. Ruchkin ◽  
Y. Inoue ◽  
...  

AbstractBackground:There has been little research on the association of attention-deficit/hyperactivity disorder (ADHD) with co-occurring physical diseases. The aim of this study was to examine the association between possible ADHD and physical multimorbidity (i.e. = 2 physical diseases) among adults in the English general population.Methods:Data were analyzed from 7274 individuals aged = 18 years that came from the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed with the Adult Self-Report Scale (ASRS) Screener. Information was also obtained on 20 self-reported doctor/other health professional diagnosed physical health conditions present in the past 12 months. Multivariable logistic regression and mediation analyses were conducted to assess the associations.Results:There was a monotonic relation between the number of physical diseases and possible ADHD (ASRS score = 14). Compared to those with no diseases, individuals with = 5 diseases had over 3 times higher odds for possible ADHD (odds ratio [OR]: 3.30, 95% confidence interval [CI]: 2.48–4.37). This association was observed in all age groups. Stressful life events (% mediated 10.3–24.3%), disordered eating (6.8%), depression (12.8%), and anxiety (24.8%) were significant mediators in the association between possible ADHD and physical multimorbidity.Conclusion:Adults that screen positive for ADHD are at an increased risk for multimorbidity and several factors are important in this association. As many adults with ADHD remain undiagnosed, the results of this study highlight the importance of detecting adult ADHD as it may confer an increased risk for poorer health outcomes, including physical multimorbidity.


Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 976
Author(s):  
Sunhae Kim ◽  
Hyekyung Lee ◽  
Kounseok Lee

(1) Background: Adult attention-deficit/hyperactivity disorder (ADHD) symptoms cause various social difficulties due to attention deficit and impulsivity. In addition, in contrast to ADHD in childhood, ADHD in adulthood is difficult to diagnose due to mixed psychopathologies. This study aimed to determine whether it is possible to predict ADHD symptoms in adults using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) with machine learning (ML) techniques; (2) Methods: Data collected from 5726 college students were analyzed. The MMPI-2-Restructured Form (MMPI-2-RF) was used, and ADHD symptoms in adults were evaluated using the Attention-Deficit/Hyperactivity Disorder Self-Report Scale (ASRS). For statistical analysis, three ML algorithms were used, i.e., K-nearest neighbors (KNN), linear discriminant analysis (LDA), and random forest, with the ASRS evaluation result as the dependent variable and the 50 MMPI-2-RF scales as predictors; (3) Results: When the KNN, LDA, and random forest techniques were applied, the accuracy was 93.1%, 91.2%, and 93.6%, respectively, and the area under the curve (AUC) was 0.722, 0.806, and 0.790, respectively. The AUC of the LDA method was the largest, with an excellent level of diagnostic accuracy; (4) Conclusions: ML using the MMPI-2 in a large group could provide reliable accuracy in screening for adult ADHD.


2021 ◽  
Author(s):  
Maayan Ben Dor Cohen ◽  
Eran Eldar ◽  
Adina Maeir ◽  
Mor Nahun

Abstract Objective: Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional dysregulation (ED) and impaired quality of life (QoL). However, the role of ED in explaining the relationship between ADHD and QoL is unclear. The purpose of the present study was to do so in a sample of non-referred young adults with and without ADHD.Method: The study design was cross-sectional. A non-clinical sample of 62 young adults with ADHD (mean age = 24.86 years, SD = 3.25) and 69 controls (mean age = 23.84 years, SD = 2.59) were recruited. The Adult ADHD Quality-of-Life scale was used to measure QoL; The Adult ADHD Self-Report Scale was used to measure ADHD symptoms. The Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale and the Difficulties in Emotion Regulation Scale were used to measure ED. Group differences on all measures were tested using univariate and multivariate analyses of covariance, while controlling for age. Univariate analyses of variance were conducted to investigate the possible effect of medication on all outcome measures in the ADHD group. Finally, a moderation analysis was used in order to examine the impact of ED on QoL beyond that accounted for by ADHD symptoms.Results: Both QoL and ED were significantly worse for the ADHD group compared to the control group. The medication status of the ADHD group participants had no significant effect on the level of ADHD symptoms, ED or QoL. ED moderated the effect of ADHD symptoms on QoL for the ADHD group.Conclusion: The findings support the centrality of ED in ADHD and its crucial influence on QoL. Young adults with ADHD and high levels of ED are at risk for aversive impact on their well-being regardless of their ADHD symptoms level.


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