scholarly journals Lifetime Co-Occurring Psychiatric Disorders in Newly Diagnosed Adults with Attention Deficit Hyperactivity Disorder (ADHD) or/and Autism Spectrum Disorder (ASD)

2020 ◽  
Author(s):  
Artemios Pehlivanidis ◽  
Katerina Papanikolaou ◽  
Vasilios Mantas ◽  
Eva Kalantzi ◽  
Kalliopi Korobili ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adhd Group ◽  
Newly Diagnosed ◽  
Hyperactivity Disorder ◽  
Significant Difference

Abstract Background Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose.Methods The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD + ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group.Results At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD + ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD, the ASD and NN groups was found for substance use disorder (SUD) (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025).Conclusions Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.

scholarly journals Lifetime co-occurring psychiatric disorders in newly diagnosed adults with Attention Deficit Hyperactivity Disorder (ADHD) or/and Autism Spectrum Disorder (ASD)

2020 ◽  
Author(s):  
Artemios Pehlivanidis ◽  
Katerina Papanikolaou ◽  
Vasilios Mantas ◽  
Eva Kalantzi ◽  
Kalliopi Korobili ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adhd Group ◽  
Newly Diagnosed ◽  
Hyperactivity Disorder ◽  
Significant Difference

Abstract Background: Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose.Methods: The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n=151), the ASD (n=58), the ADHD+ASD (n=28) and the nonADHD/nonASD (NN) (n=88) group. Results: At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p=0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p=0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p=0.025). Conclusions: Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.

scholarly journals Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD

2020 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Artemios Pehlivanidis ◽  
Katerina Papanikolaou ◽  
Kalliopi Korobili ◽  
Eva Kalantzi ◽  
Vasileios Mantas ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Stepwise Logistic Regression ◽  
Autism Spectrum Quotient ◽  
Adhd Group ◽  
Hyperactivity Disorder ◽  
Attention To Detail

This study assessed the co-occurrence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in newly diagnosed adults of normal intelligence and the contribution of trait-based dimensions deriving from the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), the Autism-Spectrum Quotient (AQ), and the Empathy Quotient (EQ) to the differentiation of patients with ADHD, ASD, and ADHD/ASD. A total of 16.1% of patients with ADHD received a co-occurring ASD diagnosis, while 33.3% of patients with ASD received an ADHD diagnosis. Subjects with ADHD or ADHD/ASD had higher scores in all ADHD traits compared to ASD subjects. Compared to the ADHD group, the ASD group had AQ scores that were significantly greater, except for attention to detail. ADHD/ASD co-occurrence significantly increased the score of attention to detail. The total EQ score was greater in the ADHD group. In the stepwise logistic regression analyses, past hyperactivity, current inattention and impulsivity, attention switching, communication, imagination, and total EQ score discriminated ADHD patients from ASD patients. Attention to detail, imagination, and total EQ score discriminated ADHD cases from ADHD/ASD cases, while past hyperactivity and current impulsivity discriminated ASD subjects from ADHD/ASD subjects. Our findings highlight the importance of particular trait-based dimensions when discriminating adults with ADHD, ASD, and co-occurring ADHD/ASD.

scholarly journals Antipsychotic use in pregnancy and risk of attention/deficit-hyperactivity disorder and autism spectrum disorder: a Nordic cohort study

2021 ◽  
pp. ebmental-2021-300311
Author(s):  
Óskar Hálfdánarson ◽  
Jacqueline M Cohen ◽  
Øystein Karlstad ◽  
Carolyn E Cesta ◽  
Marte-Helene Bjørk ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Cohort Study ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
In Utero ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Hyperactivity Disorder ◽  
Increased Risk

BackgroundAntipsychotics are increasingly used among women of childbearing age and during pregnancy.ObjectiveTo determine whether children exposed to antipsychotics in utero are at increased risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), accounting for maternal diagnoses of bipolar, psychotic and other psychiatric disorders.DesignPopulation-based cohort study, including a sibling analysis.SettingNationwide data on all pregnant women and their live-born singletons in Denmark (1997-2017), Finland (1996-2016), Iceland (2004-2017), Norway (2004-2017), and Sweden (2006-2016).Participants4 324 086 children were eligible for inclusion to the study cohort.InterventionAntipsychotic exposure in utero, assessed by pregnancy trimester, type of antipsychotic, and varying patterns of use.Main outcome measuresNon-mutually exclusive diagnoses of ADHD and ASD. We used Cox proportional hazard models to calculate hazard ratios (HRs) controlling for maternal psychiatric disorders and other potential confounding factors.FindingsAmong 4 324 086 singleton births, 15 466 (0.4%) were exposed to antipsychotics in utero. During a median follow-up of 10 years, we identified 72 257 children with ADHD and 38 674 children with ASD. Unadjusted HRs were raised for both outcomes but shifted substantially towards the null after adjustment; 1.10 (95%CI 1.00 to 1.27) for ADHD and 1.12 (0.97 to 1.29) for ASD. Adjusted HRs remained consistent by trimester of exposure and type of antipsychotic. Comparing in utero exposure with pre-pregnancy use yielded HRs of 0.74 (0.62 to 0.87) for ADHD and 0.88 (0.70 to 1.10) for ASD. Sibling analyses yielded HRs of 1.14 (0.79 to 1.64) for ADHD and 1.34 (0.75 to 2.39) for ASD.DiscussionOur findings suggest little or no increased risk of child ADHD or ASD after in utero exposure to antipsychotics.Clinical implicationsResults regarding child neurodevelopment are reassuring for women who need antipsychotics during pregnancy.

Investigating Motor Preparation in Autism Spectrum Disorder with and without Attention Deficit/Hyperactivity Disorder

2020 ◽  
Author(s):  
Marta Migó ◽  
Sylvia Guillory ◽  
Christopher S. McLaughlin ◽  
Emily L. Isenstein ◽  
Hannah E. Grosman ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Neurodevelopmental Disorder ◽  
Motor Planning ◽  
Motor Preparation ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adhd Group ◽  
Hyperactivity Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, where motor impairments are common and impact individuals across the lifespan. A growing body of work suggests that alterations in predictive processes may contribute to the ASD symptomatology, such that the anticipation of upcoming events is disrupted. Such an alteration could potentially impact motor planning. Motor planning deficits are not, however, unique to ASD. Attention-deficit/hyperactivity disorder (ADHD) has been linked to motor planning and execution difficulties, and ADHD commonly co-occurs with ASD. Whether motor planning deficits are characteristic of ASD broadly or magnified in the context of co-morbid ADHD is unclear. In this study we examined the lateralized readiness potential (LRP) to assess motor preparation and action-consequence prediction. While electroencephalography (EEG) was recorded, 29 typically developing (TD) controls and 21 ASD children both with (ASD+ADHD; n=12) and without (ASD−ADHD; n=9) comorbid ADHD completed a paradigm wherein voluntary actions either did or did not result in an auditory consequence. Our results revealed differences in LRP amplitude as a function of group and whether an action produced an effect. In TD, LRP amplitude was attenuated when an action produced an effect versus when it did not. In contrast, the ASD−ADHD group demonstrated LRP enhancement when the action led to an effect. Finally, the ASD+ADHD had attenuated LRP responses compared to other groups regardless of action-effect pairings. These findings suggest that the neural mechanisms for motor preparation and prediction differ between ASD and TD, and are influenced by the presence or absence of ADHD comorbidity.

The Effect of Comorbid with Attention-Deficit/Hyperactivity Disorder Symptoms on Face Encoding and Retrieving in Children with Autism Spectrum Disorder

2020 ◽  
Author(s):  
Qi Chen ◽  
Zengjian Wang ◽  
Bin Wan ◽  
Qingxin Chen ◽  
Yu Jin
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adhd Group ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Children With Asd ◽  
Lower Accuracy

Abstract BackgroundVisuospatial working memory (VSWM) impairments were common in Autism Spectrum Disorder (ASD). However, the detailed processing characteristics when facing face stimuli has not been studied. The present study aimed to explore the deficits of face encoding and retrieving, two processing periods of VSWM, in children with ASD. Furthermore, the influence of comorbid with Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms and executive function (EF) on VSWM were discussed.MethodsA sample of 98 children were analyzed in the present study including ASD- (ASD-only, n = 24), ADHD (n = 23), ASD+ (with ADHD symptoms, n = 23) and neurotypical controls (NTC, n = 28). Social Responsive Scale (SRS) and Swanson, Nolan, Pelham-IV rating scales (SNAP-IV) were applied to measure autistic and ADHD-related symptoms. We employed face encoding and retrieving task to examine the ability of VSWM as well as Wisconsin Cart Sorting Test (WCST) to assess the EF.ResultsWe found that the children with ASD- exhibited lower accuracy in both face encoding and retrieving, while subjects with ASD + showed lower accuracy in the face retrieving. No evidence implied a deficit of VSWM in ADHD group. We also found diverse indices of EF contributed to the individuals’ differences of VSWM performance in different clinical groups: categories completed (CC) predicted the accuracy of face retrieving in ASD- group; perseverative responses errors (RPE) predicted the response time (RT) of face retrieving in ADHD and ASD + group; while failure to maintain set (FMS) and RPE predicted the RT of face encoding in ASD + group.LimitationsThe sample size is still small and the sample mainly comprised of intellectually able participants. Therefore, our findings should not be overinterpreted.ConclusionOur findings indicate that comorbid with ADHD symptoms and EF may modulate the deficit of face encoding in children with ASD. The study shed lights on the transdiagnostic neurocognitive basis and re-emphasize the importance of considering ADHD-comorbid condition in ASD.Qi Chen and Zengjian Wang contributed equally to this work as the joint first authors.

Attention Deficit Hyperactivity Disorder in Autism Spectrum Disorder

2020 ◽  
pp. 158-176
Author(s):  
Karen Bearss ◽  
Aaron J. Kaat
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Developmental Trajectory ◽  
Spectrum Disorder ◽  
Adhd Symptoms ◽  
Functional Impairments ◽  
Hyperactivity Disorder ◽  
Delayed Recognition

This chapter will review the available evidence on individuals with co-occurring diagnoses of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This chapter contends that children diagnosed with both disorders (ASD+ADHD) are a subset of the ASD population that is at risk for delayed recognition of their ASD diagnosis, poor treatment response, and poorer functional outcomes compared to those with ASD without ADHD. Specifically, the chapter highlights the best estimates of the prevalence of the comorbidity, the developmental trajectory of people with co-occurring ASD and ADHD, how ADHD symptoms change across development, overlapping genetic and neurobiological risk factors, psychometrics of ADHD diagnostic instruments in an ASD population, neuropsychological and functional impairments associated with co-occurring ASD and ADHD, and the current state of evidence-based treatment for both ASD and ADHD symptoms. Finally, the chapter discusses fruitful avenues of research for improving understanding of this high-risk comorbidity so that mechanism-to-treatment pathways for ADHD in children with ASD can be better developed.

scholarly journals Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Viktoria Johansson ◽  
Sven Sandin ◽  
Zheng Chang ◽  
Mark J. Taylor ◽  
Paul Lichtenstein ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Clinical Studies ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Prescribing Patterns ◽  
Adhd Medication ◽  
Hyperactivity Disorder ◽  
Drug Register

Abstract Background Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. Methods Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. Results Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. Conclusions The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.

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