ADHD is a major burden in adulthood, where co-morbid conditions such as depression, substance use disorder and obesity often dominate the clinical picture. ADHD has substantial shared heritability ...with other mental disorders, contributing to comorbidity. However, environmental risk factors exist but their interaction with genetic makeup, especially in relation to comorbid disorders, remains elusive. This review for the first time summarizes present knowledge on gene x environment (GxE) interactions regarding the dopamine system. Hitherto, mainly candidate (GxE) studies were performed, focusing on the genes DRD4, DAT1 and MAOA. Some evidence suggest that the variable number tandem repeats in DRD4 and MAOA may mediate GxE interactions in ADHD generally, and comorbid conditions specifically. Nevertheless, even for these genes, common variants are bound to suggest risk only in the context of gender and specific environments. For other polymorphisms, evidence is contradictory and less convincing. Particularly lacking are longitudinal studies testing the interaction of well-defined environmental factors with polygenic risk scores reflecting the dopamine system in its entirety.
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•Much of health burden by ADHD is owing to co-morbidities.•Major co-morbidities include depression, substance use disorder and obesity.•Co-morbidities have early origin and genetic and environmental components.•Genes shaping the dopamine system impact ADHD and co-morbidities over life course.•The whole dopamine gene cluster should be examined in gene × environment analyses.
Summary
Background
Asthma and attention‐deficit/hyperactivity disorder (ADHD) are prevalent in childhood and may cause functional impairment and stress in families. Previous research supports an ...association between asthma and ADHD in children, but several aspects of this relationship are unclear.
Objective
Our aim was to study whether the association between asthma and ADHD is restricted to either the inattentive or the hyperactive/impulsive symptoms of ADHD, to explore the impact of asthma severity and asthma medication and the contribution of shared genetic and environmental risk factors on the asthma–ADHD relationship.
Methods
Data on asthma, ADHD, zygosity and possible confounders were collected from parental questionnaires at 9 or 12 years on 20 072 twins through the Swedish Twin Register, linked to the Swedish Medical Birth Register, the National Patient Register and the Prescribed Drug Register. The association between asthma and ADHD, the impact of asthma severity and medication, was assessed by generalized estimating equations. Cross‐twin–cross‐trait correlations (CTCT) were estimated to explore the relative importance of genes and environment for the association.
Results
Asthmatic children had a higher risk of also having ADHD odds ratio (OR) 1.53, 95% confidence interval (CI): 1.16–2.02. The association was not restricted to either of the two dimensions of ADHD. The magnitude of the association increased with asthma severity (OR 2.84, 95% CI: 1.86–4.35) for ≥ 4 asthma attacks in the last 12 months and was not affected by asthma treatment. The CTCTs possibly indicate that the genetic component in overlap of the disorders is weak.
Conclusions and Clinical Relevance
Childhood asthma, especially severe asthma, is associated with ADHD. Asthma medication seems not to increase the risk of ADHD. Clinicians should be aware of the potential of ADHD in asthma. Optimal asthma care needs to be integrated with effective evaluation and treatment of ADHD in children with co‐existing disorders.
Objective: To determine the prevalence and psychosocial correlates of ADHD among adolescents in Jos, Nigeria. Method: A cross-sectional descriptive two-stage study of 487 randomly selected ...participants using Kiddie–Schedule for Affective Disorders and Schizophrenia–Present and Lifetime Version (K-SADS-PL), Raven’s Standard Progressive Matrix (SPM) and the Children’s Global Assessment Score (CGAS). Results: The prevalence of ADHD was 8.8%. The subtypes found were inattentive (3.08%), hyperactive-impulsive (2.05%), and combined (3.08%); male:female ratio of 1.4:1. ADHD was significantly associated with use of substance by father (odds ratio OR = 0.35; 95% confidence interval CI = 0.154, 0.781), use of substance by mother (OR = 0.2; 95% CI = 0.055, 0.711), and lower education of mother (OR = 0.3 95% CI = 0.116, 0.693). Poor quality of handwriting (χ2 = 8.120; p = .010) and impaired global functioning (t test = 10.756; p < .001) were significantly associated with ADHD in the adolescents. Conclusion: Given the burden of ADHD, efforts should be made to establish a system for the early identification and management.
Background Although it is known that childhood attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, childhood predictors of this persistence have not been widely studied. ...Methods Childhood history of ADHD and adult ADHD were assessed in 10 countries in the World Health Organization World Mental Health Surveys. Logistic regression analysis was used to study associations of retrospectively reported childhood risk factors with adult persistence among the 629 adult respondents with childhood ADHD. Risk factors included age; sex; childhood ADHD symptom profiles, severity, and treatment; comorbid child/adolescent DSM-IV disorders; childhood family adversities; and child/adolescent exposure to traumatic events. Results An average of 50% of children with ADHD (range: 32.8%–84.1% across countries) continued to meet DSM-IV criteria for ADHD as adults. Persistence was strongly related to childhood ADHD symptom profile (highest persistence associated with the attentional plus impulsive-hyperactive type, odds ratio OR = 12.4, compared with the lowest associated with the impulsive-hyperactive type), symptom severity (OR = 2.0), comorbid major depressive disorder (MDD; OR = 2.2), high comorbidity (≥3 child/adolescent disorders in addition to ADHD; OR = 1.7), paternal (but not maternal) anxiety mood disorder (OR = 2.4), and parental antisocial personality disorder (OR = 2.2). A multivariate risk profile of these variables significantly predicts persistence of ADHD into adulthood (area under the receiving operator characteristic curve = .76). Conclusions A substantial proportion of children with ADHD continue to meet full criteria for ADHD as adults. A multivariate risk index comprising variables that can be assessed in adolescence predicts persistence with good accuracy.
Social Cognition in Children With ADHD Parke, Elyse M.; Becker, Megan L.; Graves, Stacey J. ...
Journal of attention disorders,
02/2021, Letnik:
25, Številka:
4
Journal Article
Recenzirano
Objective: Despite evidence of social skill deficits in children with ADHD, there is no consensus regarding a social cognitive profile and whether these skills predict behavior. Therefore, a ...comprehensive battery was used to investigate the relationship between social cognition and behavioral functioning. Method: Children ages 7 to 13 with ADHD (n = 25) and controls (n = 25) completed tests assessing social cognitive domains (affect recognition and theory of mind ToM). Parents completed measures of social cognition (pragmatic language ability and empathy), behavioral symptoms, and adaptive functioning. Results: Children with ADHD performed significantly worse on measures of cognitive ToM and affect recognition and received lower ratings of pragmatic language and cognitive empathy than typically developing peers. These domains, particularly pragmatic language, predicted parent ratings of problematic and adaptive behaviors. Conclusion: Results establish a relationship between specific social cognitive abilities and daily functioning, which has implications for treatment.
Both symptoms and functional impairment should be assessed in college students seeking evaluations for Attention Deficit Hyperactivity Disorder (ADHD). However, impairment is not specific to ADHD. ...Although it is well documented that self-reported symptoms can be reported noncredibly, there is less research examining credibility of self-reported impairment, and few clinicians rule out alternative causes for impairment.
Participants (N = 428) completed self-report measures of functional impairment, sleep, perceived stress, and in an ADHD symptom measure with embedded validity indicators.
Noncredible reporters endorsed greater functional impairment than credible reporters in several domains, but impairment was reported at a high rate even in credible responders (N = 323) in several domains. Participants who reported prior ADHD and participants who reported prior psychiatric diagnoses reported greater impairment and higher rates of clinically significant impairment than those who reported no prior diagnoses. Few differences in reported impairment emerged between those who reported ADHD and psychiatric diagnoses. Sleep and stress accounted for significant variance in impairment, and the ADHD group reported greater impairment than the psychiatric diagnosis and no diagnosis groups after controlling for these variables.
Results reinforce the importance of considering the validity of, and alternative sources for, self-reported impairment in college students with ADHD concerns.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder characterized by inattention, hyperactivity, and impulsivity. We hypothesized that chiropractic adjustments could improve ...these symptoms by enhancing prefrontal cortex function. This pilot study aimed to explore the feasibility and efficacy of 4 weeks of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with ADHD.
67 children with ADHD were randomly allocated to receive either chiropractic adjustments plus usual care (Chiro+UC) or sham chiropractic plus usual care (Sham+UC). The Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS), Swanson, Nolan and Pelham Teacher and Parents Rating Scale (SNAP-IV), and ADHD Rating Scale-IV were used to assess outcomes at baseline, 4 weeks, and 8 weeks. Feasibility measures such as recruitment, retention, blinding, safety, and adherence were recorded. Linear mixed regression models were used for data analysis.
56 participants (mean age ± SD: 10.70 ± 3.93 years) were included in the analysis. Both the Chiro+UC and Sham+UC groups showed significant improvements in total and subscale ADHD scores at 4 weeks and 8 weeks. However, there were no significant differences between the two groups.
This pilot study demonstrated that it was feasible to examine the effects of chiropractic adjustment when added to usual care on ADHD outcomes in children. While both groups showed improvements, the lack of significant between-group differences requires caution in interpretation due to the small sample size. Further research with larger samples and longer follow-up periods is needed to conclusively evaluate the effects of chiropractic adjustments on ADHD in children.
Objectives:
Depression and ADHD often co-occur and are both characterized by altered attentional processing. Differences and overlap in the profile of attention to emotional information may help ...explain the co-occurence. We examined negative attention bias in ADHD as neurocognitive marker for comorbid depression.
Methods:
Patients with depression (n = 63), ADHD (n = 43), ADHD and depression (n = 25), and non-psychiatric controls (n = 68) were compared on attention allocation toward emotional faces. The following eye-tracking indices were used: gaze duration, number of revisits, and location and duration of first fixation.
Results:
Controls revisited the happy faces more than the other facial expressions. Both the depression and the comorbid group showed significantly less revisits of the happy faces compared to the ADHD and the control group. Interestingly, after controlling for depressive symptoms, the groups no longer differed on the number of revisits.
Conclusion:
ADHD patients show a relative positive attention bias, while negative attention bias in ADHD likely indicates (sub)clinical comorbid depression.
To review literature regarding existing and recommended roles for nurses in the management of children with ADHD.
MEDLINE and CINAHL were searched from 2010 to the end of 2019 with the following ...keywords: ADHD, nurse, child, and inclusion criteria published in an English journal.
Forty-three records were found. However, only five articles scientifically evaluated the nurse role. The nurse role in ADHD management seemed to vary across countries with nurses working independently or as part of a team with delegated responsibility.
The literature review gave information to suggest that nurses can have a significant role in providing a range of medical and non-medical management.
Objective
Stimulation of the peripheral visual field has been previously reported as beneficial for cognitive performance in ADHD. This study assesses the safety and efficacy of a novel intervention ...involving peripheral visual stimuli in managing attention deficit hyperactivity disorder (ADHD).
Methods
One hundred and eight adults, 18–40 years old, with ADHD, were enrolled in a two-month open-label study. The intervention (i.e., Neuro-glasses) consisted of standard eyeglasses with personalized peripheral visual stimuli embedded on the lenses. Participants were assessed at baseline and at the end of the study with self-report measures of ADHD symptoms (the Adult ADHD Self-Report Scale; ASRS), and executive functions (The Behavior Rating Inventory of Executive Function Adult Version; BRIEF-A). A computerized test of continuous performance (The Conners’ Continuous Performance Test-3; CPT-3) was tested at baseline with standard eyeglasses and at the end of study using Neuro-glasses. The Clinical Global Impression-Improvement scale (CGI-I) was assessed at the intervention endpoint. Safety was monitored by documentation of adverse events.
Results
The efficacy analysis included 97 participants. Significant improvements were demonstrated in self-reported measures of inattentive symptoms (ASRS inattentive index;
p
= 0.037) and metacognitive functions concerning self-management and performance monitoring (BRIEF-A;
p
= 0.029). A continuous-performance test (CPT-3) indicated significant improvement in detectability (d’;
p
= 0.027) and reduced commission errors (
p
= 0.004), suggesting that the Neuro-glasses have positive effects on response inhibition. Sixty-two percent of the participants met the response criteria assessed by a clinician (CGI-I). No major adverse events were reported.
Conclusion
Neuro-glasses may offer a safe and effective approach to managing adult ADHD. Results encourage future controlled efficacy studies to confirm current findings in adults and possibly children with ADHD.
Clinical trial registration
:
https://www.clinicaltrials.gov/
, Identifier NCT05777785.
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