Psychometric properties of the Turkish Maladaptive Daydreaming Scale (MDS-16) and its short form (MDS-5): An item-level examination in adults with ADHD.

FIGURE 1. Changes in cortical thickness provide one measure of brain maturation. A large longitudinal study found that for most areas of cortex, children with attention deficit hyperactivity disorder (ADHD) reach peak cortical thickness several years later than typically developing children, supporting presence of developmental delay. The rate of cortical thinning also differed between the group who continued to meet diagnostic criteria into adulthood (persistent ADHD) and those who did not (remitted ADHD). Areas of cortex in which the rate of thinning correlated with adult symptom level (green, more symptoms associated with more thinning) are approximated on medial and lateral simplified representations of cortex. An earlier study also identified multiple areas in which cortex was thinner in adults with persistent ADHD compared with controls (orange). In addition, this study noted some areas of thicker cortex in remitted ADHD when compared with persistent ADHD (blue).

Treatment Controversies in Adult ADHD.

Attention deficit hyperactivity disorder (ADHD) and irritability commonly co-occur, and follow similar developmental trajectories from childhood to adolescence. Understanding of the developmental relationship between these co-occurrences is limited. This study provides a longitudinal assessment of how ADHD diagnostic status and symptom patterns predict change in irritability. A community sample of 337 participants (45.2% ADHD), recruited for the Childhood Attention Project, completed the Affective Reactivity Index (ARI) to measure irritability at baseline (mean age 10.5 years) and follow-up after 18-months. Latent change score models were used to assess how (a) baseline ADHD vs. control group status, (b) baseline symptom domain (inattention, hyperactivity-impulsivity) and (c) longitudinal change in ADHD symptom severity predicted change in irritability. Irritability was significantly higher among the ADHD group than controls; however, change in irritability over time did not differ between groups. When assessed across the entire cohort, change in irritability was predicted by higher symptom count in the hyperactive-impulsive domain, but not the inattentive domain. Greater declines in ADHD symptoms over time significantly predicted greater declines in irritability. Baseline ADHD symptom severity was found to significantly predict change in irritability; however, baseline irritability did not significantly predict change in ADHD symptoms. ADHD symptoms-particularly hyperactive-impulsive symptoms-predict the degree and trajectory of irritability during childhood and adolescence, even when symptoms are below diagnostic thresholds. The use of longitudinal, dimensional and symptom domain-specific measures provides additional insight into this relationship.

Research found that adults with attention deficit hyperactivity disorder (ADHD) have more problems with financial decision-making than healthy controls. The present study investigates the impact of symptoms of ADHD on impulsive buying and the use of financial decision styles. Furthermore, the influence of personality, symptoms of depression and demographics on the association between ADHD and these aspects of financial decision-making is evaluated. A community sample of 1292 participants (age range 18–93 years, 45.4% male) completed questionnaires related to ADHD, impulsive buying, financial decision styles, personal financial situation, depression and personality. Four groups were formed based on self-reported ADHD symptoms: an ‘ADHD’ group (n = 45), an ‘Adult-only ADHD’ group (n = 57), a ‘Subthreshold ADHD’ group (n = 162) and a ‘No ADHD’ group (n = 265). Groups were compared using ANOVA and chi-square tests. Furthermore, multiple regression analyses in the complete sample were employed to examine the association between ADHD and financial decision-making. The ADHD and Adult-only ADHD groups reported significantly more impulsive buying, used more often an avoidant or spontaneous decision style and less often saved money compared to the No ADHD group. Regression analyses revealed that impulsive buying and financial decision styles were not significantly associated with ADHD symptoms when controlling for personality, symptoms of depression and demographics. The present study confirms previous research on adults with ADHD by indicating more impulsive buying and a more frequent use of disadvantageous financial decision styles (i.e., avoidant and spontaneous styles) in individuals with an elevated number of current symptoms of ADHD compared to individuals without symptoms of ADHD. Personality and demographic variables were found to be related to both impulsive buying and the use of specific financial decision styles and might be of influence on the association between impulsive buying, the use of financial decision styles and ADHD.

ABSTRACTObjectives: To investigate the prevalence of attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) symptoms in adult patients with primary restless legs syndrome (RLS) and to determine the iron biological correlates of these comorbidities. Participants and Methods: We obtained demographic and clinical data from consecutive 105 outpatients with idiopathic RLS who answered validated questionnaires designed to assess the presence of ADHD and OCD symptoms. In these patients, iron blood parameters were routinely checked. Results: Of the total sample, 42.86% of the patients with RLS showed symptoms reminiscent either of ADHD or OCD. Prevalence of ADHD and OCD symptoms was 27.62% and 7.62%, respectively. Compared to other groups, a significantly higher percentage of RLS patients with ADHD symptoms was on antidepressant (p = 0.012); and women with ADHD symptoms, either alone or combined with OCD symptoms, showed significant reduced ferritin concentrations compared to men with either isolated ADHD symptoms or with combined ADHD and OCD symptoms (p = 0.028 and p = 0.025, respectively). Conclusions: Our findings highlight the high prevalence of ADHD and OCD symptoms in adult patients with primary RLS and independently of serum iron stores decrease, except for women with ADHD symptoms either alone or in combination with OCD symptoms. This may suggest an overlapping neurobiological dopaminergic and serotoninergic dysfunction in ADHD, OCD, and RLS, and question the expression of different RLS phenotypes. The efficacy of dopamine agonists in these groups of patients should be questioned in future studies.

Prospective Follow-up Studies of ADHD: Helping Establish a Valid Diagnosis in Adults

Attention Deficit Hyperactivity Disorder and Personality Characteristics in Older Adults in the General Dutch Population

We still need to know more about adolescents with attention deficit hyperactivity disorder who undergo surgery for severe obesity

Thinning of the Cerebral Cortex During Development: A Dimension of ADHD

Externalizing symptoms are associated with risk of future substance use disorder (SUD). Few longitudinal studies exist using general population-based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms. We aimed to study the associations between adolescent ADHD symptoms and subsequent SUD and additionally examine whether the risk of SUD is influenced by comorbid oppositional defiant disorder (ODD) symptoms. The Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33 years (n = 6278, 49.5% male). ADHD/ODD-case status at age 16 years was defined using parent-rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut-off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD/ODD case status. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD/ODD case statuses and subsequent SUD. In all, 552 participants (8.8%) presented with ADHD case status at the age of 16 years, and 154/6278 (2.5%) were diagnosed with SUD during the follow-up. ADHD case status was associated with SUD during the follow-up (HR = 3.84, 95% CI 2.69-5.50). After adjustments for sex, family structure, and parental psychiatric disorder and early substance use the association with ADHD case status and SUD remained statistically significant (HR = 2.60, 95% CI 1.70-3.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms. ADHD in adolescence was associated with incident SUD in those with and without symptoms of ODD. The association of ADHD and SUD persisted even after adjustment for a wide range of potential confounds. This emphasizes the need to identify preventative strategies for adolescents with ADHD so as to improve health outcomes.

Although high rates of attention-deficit hyperactivity disorder (ADHD) symptoms have been observed among internationally adopted children, research on these symptoms in Polish adoptees is lacking. Therefore, we examined ADHD symptoms in Polish adoptees and their relationship to pre-adoptive risk factors, that is, time in institutional care, early deprivation, and prenatal alcohol exposure. We further compared the association patterns and gender distribution of ADHD symptoms in children adopted from Poland to those reported in the literature for ADHD symptoms in non-adopted children. Dutch adoptive parents of 121 Polish adoptees (52% boys; Mage = 10.9 years, range 6.2–15.6; Mageadoption = 3.0 years, range 0.8–6.9) completed questionnaires regarding ADHD symptoms, pre-adoptive risk factors, attachment problems, conduct problems, and executive functioning deficits. Bayesian evaluation of informative hypotheses showed that Polish adoptees had increased levels of ADHD symptoms, compared to Dutch children in the general population. Time in institutional care, early deprivation, and prenatal alcohol exposure were not associated with ADHD symptoms. ADHD symptoms in Polish adoptees were more strongly associated with attachment problems and executive functioning deficits, but less strongly with conduct problems, compared to ADHD symptoms in non-adoptees. Furthermore, ADHD symptoms were more equally distributed among boys and girls than they are in non-adopted children. The findings indicate that Polish adoptees and their adoptive parents need special attention and support. The dissimilarities between ADHD symptoms in Polish adoptees and non-adoptees might indicate a different underlying causal mechanism, which may have important implications for clinical practice.

The interaction between attention deficit hyperactivity disorder and anxiety symptoms Objective: Attention deficit hyperactivity disorder (ADHD) and anxiety disorders are commonly seen in the field of child psychiatry. Childhood ADHD and anxiety disorders are comorbid with an estimated rate of 13% to 50%. In this study, it was aimed to research anxiety symptoms and its relation with ADHD symptoms in children with ADHD. Method: Fifty children with ADHD and 49 healthy controls (aged 8-15 years) who do not have any psychiatric diagnosis were included in study. We used socio-demographic information form, Conners’ Teacher Rating Scale (CTRS), Child Behavior Checklist for 4-18 years (CBCL), The Screen for Child Anxiety Related Emotional Disorders (SCARED) both parent and child report for assessing these children. The diagnosis were made with Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL). Results: The anxiety disorders comorbidity rate was 24% in ADHD group. The total scores of SCARED parent and children reports were higher in ADHD group. SCARED children report scores were higher than SCARED parent report scores in both groups. Discussion: Our results agree with the previously reported common anxiety comorbidity with ADHD and the association between attention deficit symptoms and anxiety symptoms. In our study, parents reported fewer anxiety symptoms in their children than children’s self reports. Clinicians should evaluate anxiety symptoms carefully in children with ADHD that could be unnoticed by their parents. The treatment should be determined according to the comorbidities.

Attention deficit hyperactivity disorder (ADHD) is still a neglected disorder in older adults. The aim of the present study was to examine the prevalence and symptomatology of ADHD and associated psychopathology in adults aged 40–80 years in a German community sample. We examined 539 participants in two age groups: (1) 40–59 years old (n = 256) and (2) 60–80 years old (n = 283). To assess ADHD in both childhood and adulthood as well as current psychopathological impairments, we used self-report instruments and corresponding observer reports. We examined group differences between age groups and between ADHD and non-ADHD groups. The prevalence of ADHD in the total sample was 2.6% with no significant differences between the two age groups (40–59 years: 3.1% vs. 60–80 years: 2.1%). Although differences emerged in impulsivity/emotional lability and self-concept problems, overall ADHD symptom ratings did not differ between the age groups. The ADHD group showed more psychopathological peculiarities compared to individuals without ADHD with medium-to-large effect sizes. Self-reports and observer reports showed good concordance in the assessment of ADHD and comorbid psychopathological symptoms. Regarding current ADHD symptomatology, in 92.1%, self-report was corroborated by observer's information. Our findings underline that ADHD symptoms are relevant across the lifespan. Augmenting self-reports with observer reports could increase the assessment quality of ADHD. For successful treatment, clinicians should also focus on additional psychopathological impairments and comorbidities in older adults with ADHD.

Aim. Attention Deficit Hyperactivity Disorder (ADHD) is a major risk factor for the development of substance use disorders (SUD). Patients with both ADHD and SUD become addicted at a younger age, use more substances and are hospitalized more often than SUD patients without ADHD. However, in clinical practice ADHD patients with SUD are not diagnosed sufficiently, especially in adulthood. This study aims to evaluate characteristics of ADHD patients with SUD. Method. This is a retrospective, non-randomized study. All the files of the patients who had applied for treatment for substance use disorders were screened. The patients who had been suffering just for alcoholism were excluded. The patients who had illegal substance use were included and divided into two groups. The first group was consisted with the patients who had both ADHD and SUD together. The second group was consisted with the patients who had only SUD. All the files of the patients were screened for onset of SUD, substance preferences, comorbid psychiatric disorders and history of family SUD . Results. Of the 72 patients were affected by SUD (57 males and 15 females), 55 of them were met the ADHD criteria according to DSM-IV. No statistical significant differences were observed between ADHD and non-ADHD subjects as far as mean age, gender, education level were concerned. The two groups did not show any significant differences in primary substance choice. Cannabis was the most commonly used substance for abuse and dependence. We divided drugs into different categories such as cannabis, heroin, hallucinogen, amphetamine, volatile, nicotine, alcohol, cocaine and no statistical significant differences were found between ADHD and non-ADHD groups (all values, p > 0.05). Using ecstasy showed statistically significant difference between ADHD and non-ADHD groups [χ2 (1) = 4.124, p 0.05). Abuse of synthetic cannabinoids were found significantly different between ADHD group and non-ADHD group [χ2 (1) = 5.493, p < 0.05]. ADHD group uses synthetic cannabinoids significantly higher than the non-ADHD group. The age of onset of substance use in ADHD and non-ADHD groups differed significantly [χ2 (1)= 32,998 p < 0.001]. Subjects with ADHD had an earlier onset of SUD compared to the subjects of non- ADHD. Most of the ADHD group starts using illicit drugs before 15 years of age. Discussion. Findings of this study consistent with previous studies reported that ADHD can be considered as an important risk factor for the development of addiction.The results of the present study show that ADHD is not rare among the patients with SUD who are seeking treatment. Moreover, even if the patient suffers just only for SUD he/she should be evaluated for ADHD for an effective treatment.

Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that shares a high comorbidity with anxiety disorders. However, the early development of comorbid ADHD and anxiety symptoms is not well-understood. In this study, the bidirectional relation between ADHD and anxiety symptoms was examined by testing two models of the development of ADHD and anxiety comorbidity: an anxiety effects model, which posits that anxiety symptoms contribute to the development of ADHD symptoms, and an ADHD effects model, which posits that ADHD symptoms contribute to the development of anxiety symptoms. Within the ADHD effects model, parenting practices were tested as mediators of this relation. Participants included children who were 3years old at baseline (n = 258) and their caregivers who reported on their children's ADHD and anxiety symptoms annually for 3years. The bidirectional relation of parent-reported anxiety and ADHD symptoms was tested using a series of cross-lagged models. Results indicated that ADHD symptoms predicted later anxiety symptoms, but anxiety symptoms did not predict later ADHD symptoms. Parenting practices did not mediate the relation between ADHD and anxiety symptoms within the ADHD effects model. These findings suggest that ADHD-anxiety comorbidity may develop in part because early symptoms of ADHD contribute to the development of anxiety symptoms; future research should be conducted to elucidate the mechanisms of this relation.