Attention Deficit Hyperactivity Disorder Group Research Articles

Psychopathological characteristics in ultra-high risk for psychosis with and without comorbid ADHD.

This study investigates the psychopathological characteristics of a sample of individuals at ultra-high risk for psychosis with and without comorbid attention-deficit hyperactivity disorder (ADHD). Twenty-eight subjects (aged 13-21 years; 13 females) with attenuated psychosis syndrome (APS) were recruited in a cross-sectional study and divided into two groups, each with 14 patients, according to the presence or absence of ADHD. The APS group showed a significantly higher prevalence of negative symptoms than the APS + ADHD group. Other characteristics investigated (positive symptoms, aberrant salience, psychotic-like experiences and prodromal symptoms) did not differ between groups. The different profiles of negative symptoms in the APS with or without ADHD might suggest the presence of a specific subtype among individuals at ultra-high risk for psychosis. Longitudinal studies with larger samples will provide information about the role of negative symptoms in determining conversion to full psychosis in those people with 'pure' APS and those with APS + ADHD.

Family resilience and caregiver's well-being across different age groups of children with ADHD in the United States: a cross-sectional study.

This study aimed to investigate the impact of family resilience on caregiver well-being across various age groups of children diagnosed with ADHD (attention-deficit/hyperactivity disorder) groups (0-5, 6-11, and 12-17 years). Utilizing secondary data from the 2022 US National Survey of Child Health, this cross-sectional study involved 2,752 children who were formally diagnosed with ADHD. Statistical analysis included descriptive analysis, Spearman's rank correlation, chi-square tests, and linear regression, conducted using SPSS version 27. The study revealed a moderate positive correlation (r=.35, p<.001) between family resilience and caregiver well-being. Controlling for covariates, family resilience accounted for 25.2%, 21.1%, and 22.1% of caregiver well-being variance in age groups 0-5, 6-11, and 12-17 years, respectively. Additionally, factors like employment status, family structure, and caregiver age showed varying influences on caregiver well-being across these developmental stages. A consistent pattern emerged across these age groups: unemployment and non-traditional family structures were associated with negative impacts on caregiver well-being, whereas older caregiver age positively influenced well-being. This research underscores the importance of age-specific family resilience strategies to improve caregiver well-being and family interactions in ADHD contexts. Investigating these aspects through qualitative studies across various cultures could deepen our understanding of well-being and inform culturally sensitive interventions.

Sleep quality, PIU in adolescents with ADHD. Is there a relationship between sleep quality and problematic internet use in adolescents with attention deficit hyperactivity disorder?

AbstractThis research aimed to compare the sleep quality and problematic internet use (PIU) of adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) compared to the group of healthy control. There were 53 ADHD-diagnosed individuals (19 ADHD- combined type, 34 ADHD- inattentive type) in the research population, ages 12 to 18, and 53 healthy adolescents in the control group. A child psychiatrist applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) to each case, and sociodemographic information was collected. The Pittsburgh Sleep Quality Index (PSQI) and the Internet Addiction Test (IAT) were also applied to all the cases. The Turgay DSM-IV-Based Disruptive Behaviour Disorders, Child and Adolescent Evaluation and Screening Scale (T-DSM-IV-S) was completed by the parents of all the adolescents. The ADHD group's IAT and PSQI total points were found to be statistically significantly higher than those of the healthy control group (p &lt; 0.001). The results of the covariance analysis showed a significant positive correlation between the T-DSM-IV-S subscales and the IAT mood points in the ADHD patients. The T-DSM-IV-S attention deficit points were found to be significantly higher in the ADHD children with PIU (independently of age and gender) compared to those without PIU. The results of the study showed that adolescents with ADHD had greater rates of poor sleep quality and PIU than the control group. The study results also suggested that the severity of the inattentive subtype of ADHD could play a potential role in the development of PIU in children diagnosed with ADHD. Based on this foundation, it is crucial to acknowledge and address poor sleep quality and PIU in adolescents with ADHD.

The underlying neuropsychological and neural correlates of the impaired Chinese reading skills in children with attention deficit hyperactivity disorder.

Impaired basic academic skills (e.g., word recognition) are common in children with Attention Deficit Hyperactivity Disorder (ADHD). The underlying neuropsychological and neural correlates of impaired Chinese reading skills in children with ADHD have not been substantially explored. Three hundred and two children with ADHD (all medication-naïve) and 105 healthy controls underwent the Chinese language skill assessment, and 175 also underwent fMRI scans (84 ADHD and 91 controls). Between-group and mediation analyses were applied to explore the interrelationships of the diagnosis of ADHD, cognitive dysfunction, and impaired reading skills. Five ADHD-related brain functional networks, including the default mode network (DMN) and the dorsal attention network (DAN), were built using predefined regions of interest. Voxel-based group-wise comparisons were performed. The ADHD group performed worse than the control group in word-level reading ability tests, with lower scores in Chinese character recognition (CR) and word chains (WS) (all P < 0.05). With full-scale IQ and sustained attention in the mediation model, the direct effect of ADHD status on the CR score became insignificant (P = 0.066). The underlying neural correlates for the orthographic knowledge (OT) and CR differed between the ADHD and the control group. The ADHD group tended to recruit more DMN regions to maintain their reading performance, while the control group seemed to utilize more DAN regions. Children with ADHD generally presented impaired word-level reading skills, which might be caused by impaired sustained attention and lower IQ. According to the brain functional results, we infer that ADHD children might utilize a different strategy to maintain their orthographic knowledge and character recognition performance.

Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder.

Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder (ADHD) in children, which can easily have adverse effects on children's learning and social interactions. Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD. Compared with children with ADHD alone, children with asthma and ADHD are more likely to show high levels of hyperactivity, hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization. To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors. This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023. Children diagnosed with ADHD at this hospital were selected as the ADHD group, while healthy children without ADHD who underwent physical examinations during the same period served as the control group. Clinical and parental data were collected for all participating children, and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD. Significant differences were detected between the ADHD group and the control group in terms of family history of asthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergy medications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationship status (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidity rate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the control group. The difference in the asthma comorbidity rate between the two groups was statistically significant (P < 0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergy medications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independent risk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05). Children with ADHD were more likely to have comorbid asthma than healthy control children were. A family history of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified as risk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions based on these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for results sections of abstracts in scientific articles.

Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality.

Previous research has found some peculiarities in sexual functioning of adults with attention deficit/hyperactivity disorder (ADHD). Using a set of questionnaires that had to be answered online, we assessed the prevalence of paraphilic fantasies and behaviors in a sample of 160 adults with ADHD in comparison to 75 adults without ADHD and evaluated the association between paraphilias and hypersexuality in the ADHD group. Both groups reported high rates of paraphilic fantasies and behaviors. ADHD individuals were more likely to report about very sexually arousing paraphilic fantasies (ADHD: 58.2% vs. non-ADHD: 40.5%; χ2 = 6.323, p = 0.01) and behaviors (ADHD: 44.9% vs. non-ADHD: 28.4%; χ2 = 5.774, p = 0.02). Furthermore, ADHD individuals reported on average about more very sexually arousing paraphilic behaviors compared to non-ADHD individuals (ADHD: M = 1.28, SD = 0.10 vs. non-ADHD: M = 0.81, SD = 0.09; T = 2.68, p < 0.01). Furthermore, in ADHD individuals both very sexually arousing paraphilic interests in masturbation fantasies (r(158) = 0.17, p = 0.03) and in sexual behaviors (r(158) =0.19, p = 0.02) showed a significant correlation with hypersexuality. In non-ADHD individuals no such significant correlation could be found. Altogether, it can be concluded that individuals with ADHD seem to be more prone to develop and act out paraphilic sexuality than those without ADHD, however, found differences were rather small. The results of the present study add to the current trend to depathologize paraphilic sexuality in the general as well as in clinical populations.

Adult Attention Deficit-Hyperactivity Disorder is associated with Lewy Body Disease and Cognitive Impairment: A prospective cohort Study With 15-year Follow-Up

ObjectivesPast reports have suggested that attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for Lewy body disease (LBD). To confirm this relationship, we conducted the present study. DesignA prospective observational cohort study with a follow-up to 15 years. SettingThe subjects were recruited from cognitive neurology clinics, where they attended for a cognitive complaint or health check-up. ParticipantsTwo groups of subjects: ADHD adults and healthy subjects. MeasurementsThe risk of dementia and LBD was estimated with Kaplan-Meier analysis comparing for the presence or absence of ADHD with the log-rank test. Predictors of conversion were assessed through separate univariate and multivariate Cox regression analyses, adjusting for several variables. ResultsThe baseline sample consisted of 161 subjects with ADHD and 109 without ADHD. At the end of the follow-up, 31 subjects developed dementia, 27 cases in the ADHD group and 4 in comparison group. Dementia with Lewy bodies (DLB) was the most frequent type (N:20) of which 19 corresponded to the ADHD group. The incidence of non-amnestic-MCI in the ADHD group was higher representing 67.1 % of these subjects (N:108), and 17.4% (N:19) of healthy cases. The hazard ratios for dementia and LBD in the multivariate adjusted model were 3.33 (95% CI 1.0915 to 10.1699) and 54.54 (95% CI 7.4849 to 397.5028), respectively in the ADHD group. ConclusionsThis study showed that adult ADHD is independently associated with an increased risk of LBD, dementia, and na-MCI. Future studies should clarify this relationship to develop preventive measures for these patients.

Correlations between developmental trajectories of brain functional connectivity, neurocognitive functions, and clinical symptoms in patients with attention-deficit hyperactivity disorder

Several studies on attention-deficit hyperactivity disorder (ADHD) have suggested a developmental sequence of brain changes: subcortico-subcortical connectivity in children, evolving to subcortico-cortical in adolescence, and culminating in cortico-cortical connectivity in young adulthood. This study hypothesized that children with ADHD would exhibit decreased functional connectivity (FC) between the cortex and striatum compared to adults with ADHD, who may show increased FC in these regions. Seventy-six patients with ADHD (26 children, 26 adolescents, and 24 adults) and 74 healthy controls (25 children, 24 adolescents, and 25 adults) participated in the study. Resting state magnetic resonance images were acquired using a 3.0 T Philips Achieva scanner. The results indicated a gradual decrease in the number of subcategories representing intelligence quotient deficits in the ADHD group with age. In adulthood, the ADHD group exhibited lower working memory compared to the healthy control group. The number of regions showing decreased FC from the cortex to striatum between the ADHD and control groups reduced with age, while regions with increased FC from the default mode network and attention network in the ADHD group increased with age. In adolescents and adults, working memory was positively associated with brain activity in the postcentral gyrus and negatively correlated with ADHD clinical symptoms. In conclusion, the findings suggest that intelligence deficits in certain IQ subcategories may diminish as individuals with ADHD age. Additionally, the study indicates an increasing anticorrelation between cortical and subcortical regions with age in individuals with ADHD.

Birth Order and Number of Siblings in Attention Deficit Hyperactivity Disorder: A Case Control Study

Aim: Studies addressing the etiology of attention-deficit hyperactivity disorder (ADHD) in recent years have focused on family and birth-related factors. The present study examines the relationship between ADHD and birth order and sibling numbers. Method: 239 participants were enrolled, 135 children diagnosed with ADHD and 104 healthy children. All participants were evaluated through DSM-5-based psychiatric examinations, and their sociodemographic data forms were obtained. Conners’ Parent Rating Scale-Revised Short form (CPRS-RS) was also applied to the case group in order to determine the severity of ADHD symptoms. The findings were then compared using statistical methods. Results: No significant difference was observed between the individuals with ADHD and the healthy controls in terms of birth order or number of siblings (p= 0.252 and p= 0.222, respectively). A significant positive correlation was determined in the ADHD group between birth order and hyperactivity and oppositional subscales (r= 0.212, p= 0.022 and r= 0.231, p= 0.012, respectively). A significant positive correlation was also determined in the ADHD group between number of siblings and the oppositional subscale (r= 0.237, p= 0.009). Conclusion: No significant difference was observed between the ADHD and control groups in terms of birth order or number of siblings. However, hyperactivity and oppositional findings increased in line with birth order in the children diagnosed with ADH. Oppositional findings also increased in line with the number of siblings. We think that these findings should be noted in future research into ADHD.

Suboptimal decision making and interpersonal problems in ADHD: longitudinal evidence from a laboratory task

Over half of children with Attention-Deficit/Hyperactivity Disorder (ADHD) display interpersonal and social problems. Several lines of research suggest that suboptimal decision making, the ability to adjust choices to different risk-varying options, influences poorer choices made in social interactions. We thus measured decision making and its prediction of social problems longitudinally with the Cambridge Gambling Task in children with ADHD over four years. Children with ADHD had shown suboptimal decision making driven mainly by delay aversion at baseline and we expected this to be a stabile trait which would predict greater parent-reported social problems. From the baseline assessment (n = 70), 67% participated at the follow-up assessment, 21 from the ADHD group and 26 from the typically developing group. The mean age at the follow-up was 14.5 years old. The results confirmed our expectations that suboptimal decision making was a stabile trait in children and adolescents with ADHD. Although delay aversion did not differ from controls at follow-up it still proved to be the main longitudinal predictor for greater social problems. Our findings indicate that impulsivity in social interactions may be due to a motivational deficit in youth with ADHD.

Assessing the Contribution of Measures of Attention and Executive Function to Diagnosis of ADHD or Autism.

Attention and executive function (EF) dysregulation are common in a number of disorders including autism and attention-deficit/hyperactivity disorder (ADHD). Better understanding of the relationship between indirect and direct measures of attention and EF and common neurodevelopmental diagnoses may contribute to more efficient and effective diagnostic assessment in childhood. We obtained cognitive (NIH Toolbox, Little Man Task, Matrix Reasoning Task, and Rey Delayed Recall) and symptom (CBCL, and BPMT) assessment data from the Adolescent Brain and Cognitive Development (ABCD) database for three groups, autistic (N = 110), ADHD (N = 878), and control without autism or ADHD diagnoses (N = 9130) and used ridge regression to determine which attention and EF assessments were most strongly associated with autism or ADHD. More variance was accounted for in the model for the ADHD group (31%) compared to the autism group (2.7%). Finally, we ran odds ratios (using clinical cutoffs where available and 2 standard deviations below the mean when not) for each assessment measure, which generally demonstrated a greater significance within the indirect measures when compared to the direct measures. These results add to the growing literature of symptom variably across diagnostic groups allowing for better understanding of presentations in autism and ADHD and how best to assess diagnosis. It also highlights the increased difficulty in differentiating autism and controls when compared to ADHD and controls and the importance of indirect measures of attention and EF in this differentiation.

Serum levels of glucose, thyroid stimulating hormone, and free thyroxine in boys diagnosed with attention deficit hyperactivity disorder: a cross-sectional pilot study

BackgroundAlthough attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, its aetiology remains unclear. We aimed to establish a relationship between ADHD diagnosis and serum levels of glucose, free thyroxine (FT4), and thyroid stimulating hormone (TSH) in primary school aged boys.MethodsIn a cross-sectional study, we enrolled 133 participants aged 6.5–12.5 years, 67 of whom met DSM-5 criteria for ADHD and 66 healthy age-matched boys. The ADHDT test (ADHDT) was used to assess ADHD symptoms and the Wechsler Intelligence Scale for Children – Revised was used to exclude participants with cognitive deficits. The ADHD participants were tested using the Iowa Conners’ Teacher Rating Scale.ResultsThe ADHD participants had lower glucose levels, higher TSH values, and significantly lower FT4 values than the control group. The multiple logistic regression analysis showed that TSH is a parameter that is 2.7% more likely to occur in the ADHD group. We found a significant correlation between the TSH level and the symptoms of hyperactivity (r = 0.318, p = 0.009) and impulsivity (r = 0.275, p = 0.024) as well as between the glucose level and the symptoms of hyperactivity (r = 0.312, p = 0.010).ConclusionsCertain ADHD symptoms may correlate with certain hormonal patterns. Our results suggest that the likelihood of suffering from ADHD was lower when FT4 levels were elevated. One biochemical parameter that was significantly and independently associated with the diagnosis of ADHD was the serum TSH level.Trial registrationOn June 26, 2018, at its VI session in 2018, the Ethics Committee of the Institute for Mental Health in Belgrade, Serbia, has considered and unanimously approved the conduct of the research, under the number 1704/1.

Validation of a Korean Version of the Short UPPS-P Impulsive Behavior Scale for Children.

Impulsivity is a multifaceted construct that plays an important role in various problem behaviors in children and adolescents. The purpose of this study was to validate a Korean version of the short UPPS-P Impulsive Behavior Scale for Children. Participants were 330 children (166 female) from 2 elementary schools in Korea and 94 attention deficit hyperactivity disorder (ADHD) children (23 female) from two major hospitals. The Korean short UPPS-P Impulsive Behavior Scale for Children (UPPS-P-C) (20 items), Child Behavior Checklist for Ages 6-18 (CBCL 6-18), and Barratt Impulsiveness Scale-11 (BIS-11) were administered. 107 children from the control group were retested 6 months later. Confirmatory factor analysis (CFA) conducted in the control group supported a 5-factor hierarchical model in which 1) positive and negative urgency factors are loaded on a higher-order factor of general urgency; 2) lack of perseveration and lack of premeditation factors are loaded on a higher-order factor of lack of conscientiousness; and 3) sensation seeking remained as a separate dimension. Reliability analysis demonstrated that the 5 factors of the Korean short UPPS-P-C had acceptable internal consistency and test-retest reliability. Lack of premeditation and lack of perseveration subscales showed significant correlations with measures of problem behaviors in CBCL and all the subscales were correlated with the BIS-11. The ADHD group showed significantly higher scores in lack of premeditation, lack of perseveration, positive urgency, and negative urgency subscales. This study indicates that the Korean version of short UPPS-P-C has adequate reliability and validity. It may be a valid tool to assess impulsivity of healthy children as well as ADHD.

Detecting Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Using Multimodal Time-Frequency Analysis with Machine Learning Using the Electroretinogram from Two Flash Strengths.

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are conditions that similarly alter cognitive functioning ability and challenge the social interaction, attention, and communication skills of affected individuals. Yet these are distinct neurological conditions that can exhibit diverse characteristics which require different management strategies. It is desirable to develop tools to assist with early distinction so that appropriate early interventions and support may be tailored to an individual's specific requirements. The current diagnostic procedures for ASD and ADHD require a multidisciplinary approach and can be lengthy. This study investigated the potential of electroretinogram (ERG), an eye test measuring retinal responses to light, for rapid screening of ASD and ADHD. Previous studies identified differences in ERG amplitude between ASD and ADHD, but this study explored time-frequency analysis (TFS) to capture dynamic changes in the signal. ERG data from 286 subjects (146 control, 94 ASD, 46 ADHD) was analyzed using two TFS techniques. Key features were selected, and machine learning models were trained to classify individuals based on their ERG response. The best model achieved 70% overall accuracy in distinguishing control, ASD, and ADHD groups. The ERG to the stronger flash strength provided better separation and the high frequency dynamics (80-300Hz) were more informative features than lower frequency components. To further improve classification a greater number of different flash strengths may be required along with a discrimination comparison to participants who meet both ASD and ADHD classifications and carry both diagnoses.

Reduced dopamine transporter availability in drug‐naive adult attention‐deficit/hyperactivity disorder

AbstractAimThis study aimed to clarify the abnormalities in dopamine transporter (DAT) availability in drug‐naive adult patients with attention‐deficit/hyperactivity disorder (ADHD) and the relationship between ADHD symptoms and abnormalities in DAT availability.MethodsSingle‐photon emission tomography (SPECT) was performed using iodine‐123‐β‐carbomethoxy‐3β‐(4‐iodophenyltropane) (I‐123 β CIT) as a tracer to measure in vivo DAT availability in 20 drug‐naive patients with ADHD [mean age ± standard deviation (SD)]: 25 ± 3.44 years; male:female = 11:9] and 20 age‐ and sex‐matched healthy controls (HCs) (mean age ± SD: 23.9 ± 2.27 years). Comparisons of DAT availability between HCs and adult patients with ADHD and the association between symptom severity and DAT availability within the ADHD group were analyzed using Statistical Parametric Mapping 12.ResultsDrug‐naive adults with ADHD showed significantly reduced DAT availability in the bilateral nucleus accumbens compared with HCs. Correlation analyses revealed a negative correlation between the severity of inattentive symptoms in adult patients with ADHD and DAT availability in the bilateral heads of the caudate nucleus, indicating the association between severe inattentive symptoms and lower DAT availability in the caudate nucleus.ConclusionIn drug‐naive adult patients with ADHD, DAT availability was reduced in the nucleus accumbens, an important part of the reward system. This finding indicates the importance of the DAT in the reward system in the pathogenesis of ADHD. Inattentiveness was associated with DAT availability in the caudate nucleus, suggesting involvement of the cortico‐striato‐thalamo‐cortical circuit.

Prevalence of somatic diseases in adults with attention deficit hyperactivity disorder in Japan is highest in people aged ≥40 years with mental disorders: a cross-sectional study of a Japanese health insurance claims database.

Studies have reported an association between attention deficit hyperactivity disorder (ADHD) and somatic diseases; however, the correlation of mental disorders with the association between ADHD and somatic diseases remains uninvestigated. This study investigated and compared the prevalence of somatic diseases among adults with/without ADHD, stratified by the presence or absence of mental disorders. This cross-sectional study (October 2020-September 2021), using data (June 2013-September 2021) from a Japanese health insurance claims database, included adult participants with a medical record of and receiving medication for ADHD (ADHD group); the control group (matched 1:5 by age/sex) comprised participants without ADHD. The prevalence and odds ratio (OR; ADHD versus control) of type 2 diabetes mellitus (T2DM), diabetes complications, hypertension, cardiovascular disease (CVD), dyslipidemia, gout and hyperuricemia, chronic obstructive pulmonary disease (COPD), non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH), and atopic dermatitis were investigated. Pooled ORs for stratified analysis were calculated using the Mantel-Haenszel method. In the matched analysis sets, the ORs for all somatic diseases were significantly higher for the ADHD group (n=15,028) versus the control group (n=74,796). On stratified analysis, the Mantel-Haenszel ORs were significant for NAFLD/NASH (1.53; 95% confidence interval [CI]: 1.34, 1.73), diabetes complications (1.39; 95% CI: 1.09, 1.77), and gout and hyperuricemia (1.34; 95% CI: 1.19, 1.51). Furthermore, the stratum-specific ORs for T2DM, hypertension, and dyslipidemia were >1 and <1 in the presence and absence of mental disorders, respectively. The prevalence of all somatic diseases except atopic dermatitis increased with age. For participants aged ≥40 years, the Mantel-Haenszel ORs were significant for all somatic diseases except CVD, COPD, and atopic dermatitis. The prevalence of several somatic diseases, including chronic disorders, was high among adults with ADHD, particularly in those aged ≥40years and those with mental disorders.

Impact of stimulant treatment on refractive errors and pupil diameter in attention deficit hyperactivity disorder

AbstractPurposeThe relationship between attention deficit hyperactivity disorder (ADHD) and visual impairment remains poorly understood, and the impact of visual impairment on the development of ADHD is uncertain. The aim of this study was to investigate the refractive profile and ocular biometric characteristics in patients diagnosed with ADHD and compare them with a control group. Additionally, we aimed to explore the potential influence of sex and medication intake.MethodsA cohort of 100 participants, including 50 individuals with ADHD and 50 age‐ and sex‐matched control subjects, was included in this study. Ocular biometric parameters were measured, and refractive error was assessed using cycloplegic and non‐cycloplegic autorefraction. Subgroup analyses were performed within the ADHD group based on sex, medication intake and age to investigate potential associations with the ocular findings.ResultsWe observed no statistically significant differences in axial length, corneal topography parameters or anterior chamber characteristics between ADHD and control subjects. However, subgroup analysis within the ADHD group revealed that the prevalence of ametropia under cycloplegia was significantly higher in unmedicated (69.6%) compared to medicated (37.5%) (X2(2) = 7.320, p = 0.026) participants. Pupil diameter was significantly larger in medicated (3.91 mm) compared to unmedicated (3.58 mm; p = 0.017) individuals. Males had flatter (p = 0.004) and thicker (p = 0.008) corneas than females. Older ADHD participants had higher refractive error (p = 0.008 for non‐cycloplegic and p = 0.0.003 for cycloplegic), axial length (p = 0.002) and corneal astigmatism (p = 0.049).ConclusionsOur study provides compelling evidence that individuals diagnosed with ADHD exhibit a similar incidence of refractive errors and ocular parameters compared to normal subjects. Nonetheless, the prevalence of refractive errors appears to be higher in unmedicated ADHD patients, suggesting the potential benefit of stimulant treatment. Additionally, stimulant use is associated with an increase in pupil diameter.

Irony Understanding in Children With Attention-Deficit/Hyperactivity Disorder: A Comparative Analysis.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly impact a child's daily life and academic performance. Some studies have noted challenges in social cognition among children with ADHD, specifically in aspects like emotion perception and processing, empathy, Theory of Mind, and pragmatics. One of the lesser-explored aspects of ADHD is its potential impact on higher-level language skills, such as irony understanding. Our goal in this study was to compare irony comprehension in two groups: schoolchildren with normal development and schoolchildren with ADHD. We performed a comparative cross-sectional study on a total of 35 children aged between 6 and 12 years: 17 with ADHD and 18 not neurodevelopmentally impaired. Irony comprehension was evaluated using an assessment method validated for the Portuguese population: Turtle on the Island - Battery of Assessment of Executive Functions in Children (TI-BAFEC). We also applied the EACE (Emotional Awareness and Coping in Children) scale. It is the Portuguese adaptation of the Assessment of Children's Emotion Skills and assesses children's emotional knowledge. We obtained two comparable groups concerning sociodemographic data. The analysis of the data, using the Mann-Whitney U Test, showed that in all parameters, the control group consistently exhibited superior performance compared to the ADHD group. However, only TI-BAFEC (p = 0.005) and emotional behavior (p = 0.007) showed a significant statistical variance between the two groups. This article shows that children with ADHD encounter challenges in grasping irony. However, the underlying cognitive processes contributing to these difficulties warrant further investigation.

Internet Gaming Disorder in Children and Adolescents with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have been related to an increased risk for behavioral addictions including online gaming. However, the relationship between these two conditions and Internet gaming disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ASD youth and ADHD youth, compared with a normal control group, and by assessing selected psychopathological and neuropsychological features in ASD and ADHD patients with and without IGD. This study included 77 ASD patients (67 males, mean age 13.58 ± 2.75 years), 94 ADHD patients (79 males, mean age 11.46 ± 2.47 years), and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) that received structured measures for IGD (IAT, IGDS9-SF, and UADI). In the ADHD group, 72.34% of the sample were above the IGD cut-off, compared with 45.45% in the ASD group and 9.5% in the NC group. ASD patients with IGD presented with greater severity and more severe attention problems, with no difference in the ASD core symptoms between patients with and without IGD. In the comparison between the ASD and ADHD groups according to the presence of IGD, ASD patients with IGD were the most severe group according to the CGI (Clinical Global Impression) scale. The follow-up, conducted on 45 patients affected by ASD, showed an improvement in CGI and CGAS (Children's Global Assessment Scale) scores, but not in the IGD symptoms. These findings could place the diagnosis of ASD as a negative prognostic factor in the follow-up of aspects of video game addiction compared with ADHD.

Identifying cognitive profiles in children with neurodevelopmental disorders using online cognitive testing.

Children with neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) tend to exhibit similar deficits in attention and memory ability. Early screening of cognitive deficits in children with NDDs, particularly in preschool children, is fundamental to improving cognitive and academic outcomes. In order to determine cognitive profiles in children with ASD and ADHD, we developed accessible audiovisual instructions for an online battery of 13 cognitive tests. Children ages 4-16 who were diagnosed with ADHD (n = 83), or ASD (n = 37), or who were typically developing children (TD) (n = 86) were recruited. Data were analyzed using a stepwise Discriminant Analysis to determine which cognitive tasks were the strongest discriminators between the diagnostic groups. Results revealed four tasks reflective of working memory, reasoning, and attentional processes, which correctly classified approximately 53-60% of each group. The ADHD group had lower scores on attentional tasks compared to TD, while ASD group had lower scores on reasoning tasks compared to the TD children, and made more attempts across all four tasks. The results from this study stress the need for cognitive screening assessments that include domain-specific items to improve the characterization of executive function deficits and promote academic achievement in all children with NDDs.