scholarly journals Attention-deficit hyperactivity disorder in adults

1999 ◽  
Vol 5 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Brian Toone ◽  
Maria Clarke ◽  
Susan Young

Attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder are well-established diagnoses in children, with estimates of prevalence in pre-adolescent children from 3 to 5%. Until recently ADHD was not thought to persist beyond adolescence, but results from long-term prospective outcome studies indicate that 30–70% of children with ADHD exhibit some symptoms as adults. Recognition of this disorder is important as the persistence of ADHD symptoms has been shown to be associated with academic and occupational failure and high rates of psychiatric comorbidity. With the establishment of a UK support group (LADDER) and increasing media attention highlighting this problem it is likely that there will be an increased demand for psychiatric assessment of adult ADHD in the next few years.

2017 ◽  
Vol 68 (2) ◽  
pp. 279-283
Author(s):  
Mihail Silviu Tudosie ◽  
Elena Truta ◽  
Ana Maria Davitoiu ◽  
Luminita Stanciulescu ◽  
George Jinescu ◽  
...  

During one year (september 2013 � september 2014), 50 children from the residential institution for children SOS Satele Copiilor Bucharest, where included in our research. The children were distributed in two groups: Group A which consisted of 25 children (12 girls, 13 boys) who were not diagnosed with attention deficit hyperactivity disorder (ADHD) and Group B which consisted of 25 children (14 boys, 11 girls) who were diagnosed with ADHD. Initially, the two groups were subjected at a psycho-diagnostic battery of tests, one of them being the Evaluating the Health State of children with ADHD questionnaire elaborated by us, particularly for this research, with the purpose of highlighting the direct link between the children health state and their ADHD symptoms. This study sought to determine the concentration of copper in urine samples from a group of children with ADHD and a group of normal children, to highlight the role of copper in the development of ADHD symptoms. Levels of copper concentration in urine samples from the two groups were processed by Student�s t-Test. Statistical analysis showed that the arithmetic averages of copper concentration in urine samples, of the two groups do not differ significantly, so copper may be causing ADHD symptoms occur. The copper content in urine samples has been determined using atomic absorption spectrometry with graphite furnace.


PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 320-325 ◽  
Author(s):  
Jeffrey D. Kent ◽  
Joseph C. Blader ◽  
Harold S. Koplewicz ◽  
Howard Abikoff ◽  
Carmel A. Foley

Objective. This study evaluated the effects on behavior and sleep of methylphenidate (MPH) administered at 4 PM to children with attention-deficit hyperactivity disorder (ADHD). Methodology. Twelve children admitted to a child psychiatric inpatient service with ADHD participated in a double-blind, crossover study in which they received a 4 PM dose of either 15 mg of MPH, 10 mg of MPH, or a placebo in random order for 12 consecutive days. Ratings of behavior, including ADHD symptoms, pertaining to the period from dose administration until sleep onset, were supplied nightly by hospital staff. Sleep latency and sleep adequacy were also assessed for each night. Results. MPH resulted in markedly improved behavioral control compared with placebo; there was no difference between 15-mg and 10-mg MPH doses. MPH did not alter sleep latencies observed with the placebo. Children were more often rated as less tired on awakening after nights that they received 10 mg of MPH compared with 15 mg of MPH and the placebo. Weight loss was apparent among 83% of the patients, but dinner intake did not vary with third-dose condition. Conclusions. Morning and noon administration of stimulants to children with ADHD is a near-universal practice, but many clinicians avoid a third, late-afternoon administration for fear of inducing insomnia. This study's findings show that children with ADHD derive substantial symptom reduction from MPH administered in late afternoon, with no untoward effects on sleep. Therefore, three-times-a-day dosing should be considered for those children exhibiting ADHD symptoms in the evening. Adverse effects on sleep latency were not apparent in the sample overall. Nonetheless, monitoring for possible aggravation of sleep problems and weight loss remains sound treatment practice.


2014 ◽  
Vol 45 (8) ◽  
pp. 1601-1612 ◽  
Author(s):  
S. Park ◽  
J.-M. Lee ◽  
J.-W. Kim ◽  
J. H. Cheong ◽  
H. J. Yun ◽  
...  

Background.Previous studies have implicated the relationship between environmental phthalate exposure and attention deficit hyperactivity disorder (ADHD) symptoms of childhood, but no studies have been conducted in children who have a confirmed diagnosis of ADHD obtained through meticulous diagnostic testing. We aimed to determine whether phthalate metabolites in urine would be higher in children with ADHD than in those without ADHD and would correlate with symptom severity and cortical thickness in ADHD children.Method.A cross-sectional examination of urine phthalate metabolite concentrations was performed; scores for ADHD symptoms, externalizing problems, and continuous performance tests were obtained from 180 children with ADHD, and brain-imaging data were obtained from 115 participants. For the control group, children without ADHD (N = 438) were recruited. Correlations between phthalate metabolite concentrations and clinical measures and brain cortical thickness were investigated.Results.Concentrations of phthalate metabolites, particularly the di(2-ethylhexyl) phthalate (DEHP) metabolite, were significantly higher in boys with ADHD than in boys without ADHD. Concentrations of the di-n-butyl phthalate (DBP) metabolite were significantly higher in the combined or hyperactive-impulsive subtypes compared to the inattentive subtype, and the metabolite was positively correlated with the severity of externalizing symptoms. Concentrations of the DEHP metabolite were negatively correlated with cortical thickness in the right middle and superior temporal gyri.Conclusions.The results of this study suggest an association between phthalate concentrations and both the diagnosis and symptom severity of ADHD. Imaging findings suggest a negative impact of phthalates on regional cortical maturation in children with ADHD.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A245-A245
Author(s):  
Xiao Li ◽  
Ka Sin Caroline Shea ◽  
Lok Fan Lau ◽  
Ching Kwong Dino Wong ◽  
Waiyan Vivian Chiu ◽  
...  

Abstract Introduction Circadian rhythm disturbances, including delayed circadian rhythm and increased motor activity, are commonly seen in attention-deficit hyperactivity disorder (ADHD). Previous research suggested a link between circadian rhythm disturbances and poor psychosocial functioning in children, but such a relationship has not been examined in children with ADHD. This study aimed at examining the association between circadian-related parameters and psychosocial functioning in children with ADHD. Methods Seventy-nine children with ADHD were recruited into this study (age range: 6–12 years, 75.9% male). They were assessed by parent-report questionnaires on sleep problems (Children’s Sleep Habits Questionnaire, CSHQ), ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale, SWAN), and psychosocial functioning (Strengths and Difficulties Questionnaire, SDQ). Actigraphic data collected for seven consecutive days were analyzed using parametric and nonparametric methods. The relationship between circadian parameters and psychosocial functioning was analyzed using multiple regression while controlling for age, sex, ADHD medication, total sleep time, and CSHQ total score. Results Later acrophase was significantly associated with higher scores on SDQ emotional problems (St. β = 0.30, p = 0.03) and SWAN inattention subscale (St. β = 0.27, p = 0.043). Lower relative amplitude was associated with higher scores on SDQ hyperactivity symptoms (St. β = -0.29, p = 0.045) and SDQ total difficulties (St. β = -0.31, p = 0.036). Higher levels of mean activity level during the least active 5-h period (L5) were related to higher scores on SDQ peer problems (St. β = 0.38, p = 0.021), SDQ internalizing problems (St. β = 0.38, p = 0.020) and SDQ total difficulties (St. β = 0.33, p = 0.036). Later onset of L5 was associated with increased SDQ emotional problems (St. β = 0.26, p = 0.046). Conclusion Circadian rest-activity rhythm disturbances (delayed phase, blunted rest-activity rhythms, higher level of nocturnal activity, and later onset of nocturnal rest) were associated with poor psychosocial functioning in children with ADHD. Further longitudinal studies are needed to examine the effects of circadian disruption on psychosocial functioning in children with ADHD. Support (if any) This work was supported by the Health and Medical Research Fund (Project No.: 30160604).


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e35-e35
Author(s):  
Jean-Francois Lemay ◽  
Julie-Anne Lemay ◽  
Hanna Kubas

Abstract BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often negatively impacts behaviour, cognition, and learning. Stimulant medications are the most commonly used treatment for ADHD, with informant reports (e.g., parent questionnaires, surveys) frequently used to evaluate medication impact on behavioural and academic functioning in affected children. OBJECTIVES To determine parental perceptions of medication impact on behaviour and learning in a long-acting methylphenidate (LA-MPH) trial of their children with ADHD. DESIGN/METHODS A randomized controlled LA-MPH medication trial was conducted with children ages 8–12 with a diagnosis of ADHD. Trial began with one-week of baseline assessment, followed by a randomized three-week standard of care medication trial, and a one-week best dose assessment. Following the conclusion of the study (6 months to 2 years’ range post-treatment), families were asked to participate in a voluntary follow-up phone survey to evaluate parental perceptions on child’s behaviour and learning. RESULTS A total of 34/42 (81%) families participated (male to female ratio: 2.1/1). At the time of the follow-up survey, 53% (18/34) and 68% (23/34) of patients were having “difficulty” or “significant difficulty” with their behaviour and learning, respectively. Twenty-three patients (68%) were still on psycho-stimulant medications. Although parents of those 23 children said LA-MPH had in general “significant” or “very significant” impact on their child’s behaviour (87%) and learning (79%), these parents were still reporting challenges with behaviour (52%) and learning (61%) at follow-up. In addition, parents of children not on medication said that their current child’s behaviour and learning was still having the same or more challenging issues (82% and 73% respectively). CONCLUSION Overall, parents reported that medication significantly impacted their child’s behaviour and learning; however, long-term medication impact appears less effective. Thus, an ongoing relationship with families and paediatricians is recommended to better understand the impact of medication on behaviour and learning. Evaluating the effects of medication on behaviour and learning may ultimately lead to targeted intervention that help foster long-term treatment efficacy for children with ADHD.


CNS Spectrums ◽  
2008 ◽  
Vol 13 (S8) ◽  
pp. 11-13 ◽  
Author(s):  
Timothy E. Wilens

There is a complex overlap between major depressive disorder (MDD) and attention-deficit/hyperactivity disorder (ADHD). The different therapeutic options for adult ADHD mirror those used for children with ADHD. Both stimulant and nonstimulant medications are used to treat the disorder.


2015 ◽  
Vol 30 (S2) ◽  
pp. S27-S28
Author(s):  
B. Rolland ◽  
D. Da Fonseca ◽  
M. Fatseas ◽  
N. Simon

Attention-deficit/hyperactivity disorder (ADHD) was initially considered as a childhood psychiatric disorder. However, longitudinal observations have revealed that ADHD symptoms may persist in adulthood among approximately 50% of the patients . Adult ADHD is associated with impaired social outcome and frequent comorbidities such as mood disorders, personality disorders, and substance use disorders [2,3]. Correctly identifying and treating ADHD can significantly improve the global functioning and cognition of adult subjects, and reduce the intensity and frequency of the comorbid states [2,3]. Nonetheless, the clinical features of adult ADHD are clearly different from the youth form [1,2], and ADHD symptoms are easily mixed up in adults with symptoms of the comorbid conditions [2,3]. These clinical intricacies can make the diagnosis of ADHD difficult in adults. Moreover, the management of methylphenidate in adult subjects is also associated with specific risks and pitfalls, such as abuse and tampering behaviors, and additional safety risks . Put together, it appears crucial to identify and treat ADHD in adults, but the clinical and therapeutic complexities of adult ADHD require improved expertise and caution from adult psychiatrists and addiction specialists. In this thematic session of the 2015 French Psychiatry Congress, three French leading experts of adult ADHD will address the aforementioned clinical and therapeutic issues of the adulthood form of this disorder. David Da Fonseca, professor of child psychiatry in Marseille, will disentangle the clinical features of adult ADHD from the typical symptoms observed in the youth form. Mélina FATSEAS, associate professor of psychiatry and addiction medicine in Bordeaux, will specifically focus on the many and complex relationships observed between adult ADHD and substance use disorders. Last, Nicolas Simon, professor of addiction medicine and psychopharmacology in Marseille, will synthesize what are the very risks and issues with prescribing methylphenidate in adults.


2004 ◽  
Vol 10 (5) ◽  
pp. 338-340 ◽  
Author(s):  
Dave Coghill

That Zwi & York (2004) have opened the discussion on adult attention-deficit hyperactivity disorder (ADHD) is to be applauded. Their main conclusion is that the diagnostic validity of adult ADHD remains uncertain and that further study is needed. This is based on a review of the ADHD concept in childhood and the longitudinal studies that have followed children with ADHD into adulthood.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Katja Becker ◽  
Tobias Banaschewski ◽  
Daniel Brandeis ◽  
Christina Dose ◽  
Christopher Hautmann ◽  
...  

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a psychosocially impairing and cost-intensive mental disorder, with first symptoms occurring in early childhood. It can usually be diagnosed reliably at preschool age. Early detection of children with ADHD symptoms and an early, age-appropriate treatment are needed in order to reduce symptoms, prevent secondary problems and enable a better school start. Despite existing ADHD treatment research and guideline recommendations for the treatment of ADHD in preschool children, there is still a need to optimise individualised treatment strategies in order to improve outcomes. Therefore, the ESCApreschool study (Evidence-Based, Stepped Care of ADHD in Preschool Children aged 3 years and 0 months to 6 years and 11 months of age (3;0 to 6;11 years) addresses the treatment of 3–6-year-old preschool children with elevated ADHD symptoms within a large multicentre trial. The study aims to investigate the efficacy of an individualised stepwise-intensifying treatment programme. Methods The target sample size of ESCApreschool is 200 children (boys and girls) aged 3;0 to 6;11 years with an ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or a diagnosis of oppositional defiant disorder (ODD) plus additional substantial ADHD symptoms. The first step of the adaptive, stepped care design used in ESCApreschool consists of a telephone-assisted self-help (TASH) intervention for parents. Participants are randomised to either the TASH group or a waiting control group. The treatment in step 2 depends on the outcome of step 1: TASH responders without significant residual ADHD/ODD symptoms receive booster sessions of TASH. Partial or non-responders of step 1 are randomised again to either parent management and preschool teacher training or treatment as usual. Discussion The ESCApreschool trial aims to improve knowledge about individualised treatment strategies for preschool children with ADHD following an adaptive stepped care approach, and to provide a scientific basis for individualised medicine for preschool children with ADHD in routine clinical care. Trial registration The trial was registered at the German Clinical Trials Register (DRKS) as a Current Controlled Trial under DRKS00008971 on 1 October 2015. This manuscript is based on protocol version 3 (14 October 2016).


CNS Spectrums ◽  
2007 ◽  
Vol 12 (S23) ◽  
pp. 6-9 ◽  
Author(s):  
Lenard A. Adler

How common is attention-deficit/hyperactivity disorder (ADHD), and does the prevalence change from adolescence to adulthood?A number of studies have reviewed the persistence of attention-deficit/hyperactivity disorder (ADHD) from childhood into adolescence and adulthood as well as how the disorder changes over the lifespan of the illness. Recently, a metaanalysis found that the worldwide prevalence of childhood ADHD is ∼8%, and approximately two thirds of children with ADHD continue to have the disorder as adults. The National Comorbidity Survey is possibly the most comprehensive, up-to-date study examining the prevalence of community-based prevalence of adult ADHD; 4.4% of patients in that study were found to have ADHD. The prevalence of ADHD among adolescent patients seems to lie somewhere between the prevalence rates for children and adults.


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