Comorbid ADHD Research Articles

Elucidating distinct and common fMRI-complexity patterns in pre-adolescent children with Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Obsessive-Compulsive Disorder diagnoses.

The pathophysiology of ADHD is complicated by high rates of psychiatric comorbidities, thus delineating unique versus shared functional brain perturbations is critical in elucidating illness pathophysiology. To investigate resting-state fMRI (rsfMRI)-complexity alterations among children with ADHD, oppositional defiant disorder (ODD), and obsessive-compulsive disorder (OCD), respectively, and comorbid ADHD, ODD, and OCD, within the cool and hot executive function (EF) networks. We leveraged baseline data (wave 0) from the Adolescent Brain and Cognitive Development (ABCD) Study. The data was collected between September 2016 and September 2019 from 21 sites in the USA. Children who singularly met all DSM-5 behavioral criteria for ADHD ( N = 61), ODD ( N = 38), and OCD ( N = 48), respectively, were extracted, alongside children with comorbid ADHD, ODD, OCD, and/or other psychiatric diagnoses ( N = 833). A control sample of age-, sex-, and developmentally-matched children was also extracted ( N = 269). Voxel-wise sample entropy (SampEn) was computed using the LOFT Complexity Toolbox. Mean SampEn within all regions of the EF networks was calculated for each participant and hierarchical models with Generalized Estimating Equations compared SampEn of comorbid-free and comorbid ADHD, ODD, and OCD within the EF networks. SampEn was reduced in comorbid-free ADHD and ODD in overlapping regions of both EF networks, including the bilateral superior frontal gyrus, anterior/posterior cingulate gyrus, and bilateral caudate (Wald statistic = 5.682 to 10.798, p < 0.05 & BH corrected), with ADHD additionally affected in the right inferior/middle frontal gyrus and bilateral frontal orbital cortex (Wald statistic = 7.231 to 9.420, p < 0.05 & BH corrected). Among comorbid presentations, the additional presence of ADHD symptomatology was associated with significantly lower SampEn in every region of interest ( z = -3.973 to -2.235, p < 0.05 & BH corrected). ADHD and ODD shared common impairments underlying the EF networks in the comorbid-free presentations, with ADHD showing more widespread complexity reduction. When ADHD co-occurred with other psychiatric disorders, the reduction in SampEn extended beyond the regions affected in comorbid-free ADHD, indicating that comorbidities amplify neural complexity deficits.

Symptoms of ADHD and Other Common Mental Disorders Influence Academic Success in South African Undergraduates.

ADHD symptoms are highly prevalent among university students. These symptoms, particularly the inattentive cluster, predispose students to poorer academic performance and worse academic adjustment. Moreover, ADHD symptoms are often comorbid with other common mental disorders; this comorbidity also leads to poor outcomes. South African students often have fewer resources to successfully transition to university. Hence, our longitudinal study used data from a sample of South African first-year undergraduate students to investigate (a) associations between ADHD symptoms and academic performance/adjustment, (b) separate influences of the inattentive and hyperactivity-impulsivity clusters on academic performance/adjustment, and (c) the influence of the combination of ADHD and psychiatric comorbidities on academic performance/adjustment. We collected data three times through the first semester of 2023. Predictors within our regression models included sociodemographic variables, psychological variables (self-reported symptoms of ADHD, depression, anxiety, and risky alcohol use), and high school academic performance. Outcomes were first-semester GPA and self-reported academic adjustment (magnitude of change across the semester and overall adjustment at the end of the semester). Analyses showed that, unlike academic performance (N = 506), magnitude of change in academic adjustment (N = 180) was significantly predicted by ADHD symptoms and the combination of ADHD (p = .02), depression (p < .001), and anxiety symptoms (p = .01). Inattentive ADHD symptoms predicted both academic performance and magnitude of change in academic adjustment. Our findings suggest that the presence of ADHD symptoms (both with and without other common mental disorders) is associated with a smaller magnitude of academic adjustment, and that the presence of inattentive symptoms of ADHD is associated with both poorer academic performance and smaller magnitude of academic adjustment. These findings are significant in informing future interventions targeting the academic outcomes of first-year university students.

Diabetes Glycemic Control in Adults With Type 2 Diabetes Mellitus and ADHD

Introduction: Persistence in treatment is important in balancing diabetes and preventing complications. ADHD impairs quality of life and functioning in many areas of life. The aim of this study is to evaluate the possible association of ADHD and diabetes glycemic control among adults with type 2 diabetes mellitus (T2DM). Methods: All data were obtained from Maccabi Healthcare Services (MHS) automated databases. This retrospective cross-sectional study uses electronic medical records from the Maccabi Healthcare Services database during the years 2010 to 2020. Using a propensity score with the variables of age, gender, and duration of diabetes, we compared a group of 1,582 patients with T2DM and ADHD to 1,582 patients with T2DM and without ADHD. We used a t-test to compare continuous variables and a Mann-Whitney U test for non-parametric testing. In addition, we used multivariate logistic regression with a cutoff of several HbA1c values in T2DM patients with and without ADHD during 2019 to 2020. The proportion of patients with HbA1c values above 10%, 9%, and 8% in the group of patients with ADHD was 4.7 to 5.9 times higher than in patients without ADHD. In addition, the OR in the multivariate logistic regression was 4.2 (95% CI [2.5, 6.8]), 4.3 (95% CI [3.1, 6.1]), and 2.7 (95% CI [2.2, 3.4]) for cutoff of HbA1c of 10%, 9%, and 8%, respectively. Conclusion: Patients with co-morbid ADHD and T2DM have a higher incidence of poor glycemic control. The findings extend the knowledge on the relationship between ADHD and diabetes and highlight the need for further research to improve treatment.

Behavioral manifestations of executive functioning in Swedish youth with ADHD, autism, and psychiatric comorbidity: a comparative analysis with community controls

ABSTRACT While several rating scales reliably and cost-effectively assess behavioral executive functioning (EF) in youths with neurodevelopmental disorders (NDDs), questions remain about the impact of comorbidities and dual NDDs on EF as measured by these scales in clinical samples. This study compared behavioral EF profiles among youths with NDDs, both with and without psychiatric comorbidities, non-NDDs (e.g. anxiety), and controls, as well as youths with single versus dual NDDs. The comparisons were made using the Swedish version of the Behavior Rating Inventory of Executive Function (BRIEF-2) parent form. Participants included 79 youths (mean [SD] age 12.1 [3.0]; 50.6% girls) diagnosed with various psychiatric conditions, and 151 matched controls (mean [SD] age 12.4 [2.8]; 51.7% girls). Results showed significant differences with very large effect sizes in all behavioral EF domains among youths with NDDs, regardless of whether they had non-NDD psychiatric comorbidities, compared to youths with non-NDDs or controls. The latter two groups differed in six of eight behavioral EF domains, with the Shift domain showing the largest effect size (Cohen’s d = 0.94). Surprisingly, no significant differences were found between the NDD-only group and the NDD group with non-NDD psychiatric comorbidities. Youths with dual NDDs had more deficits in four of the nine behavioral EF domains compared to those with a single NDD, with the Shift domain again showing the largest effect size (Cohen’s d = 0.91). This study highlights the essential role of NDD in distinguishing clinically significant parent-rated behavioral EF deficits in youths, regardless of other psychiatric diagnoses.

Approaches to Treating Children With ADHD and Common Comorbidities.

Approaches to Treating Children With ADHD and Common Comorbidities.

Executive Functioning, Family Accommodation, and Treatment Response in Youth with OCD and Comorbid ADHD in a Partial Hospital Program.

Few studies have examined differential treatment response, rates of familial accommodation (FA), and executive functioning (EF) in youth with OCD vs. OCD + ADHD, particularly in a partial hospital program (PHP). The current study includes 138 youth diagnosed with OCD only and 102 youth diagnosed with OCD + ADHD in a PHP setting for a total sample of 240 youth (and their families). Families and clinicians completed several measures assessing child and parent variables of interest. Findings of ANCOVA analyses suggest poorer treatment response and EF in children with comorbid OCD + ADHD compared to their counterparts with OCD only. No significant differences emerged between groups in baseline levels of symptom severity, functional impairment, or FA. Given the high rate of comorbidity between OCD + ADHD, clinicians and researchers should be aware of the need to modify treatment approaches for children with comorbid OCD + ADHD and/or weaker EF performance.

Exploring the Nature of ADHD Comorbidity in Tic Disorders

Introduction: Tic disorders (Tics) are childhood-onset neurodevelopmental conditions, and approximately half of this population also have an ADHD diagnosis. Some of the clinical symptoms of Tics resemble ADHD which could explain the high comorbidity rate. Objectives: This research aims to investigate if the ADHD symptoms seen in children with both Tics and ADHD (Tics+) are true comorbid ADHD or a result of their Tics. Methods: Participants from a community-based study of children aged 6-18 reported their ADHD symptoms using the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale (SWAN). Their cognitive control was assessed using the Stop Signal Task. The symptom profiles of those with Tics and no ADHD diagnosis (Tics-, n=192), ADHD (n=2416), Tics+ (n=119) and controls (n=31908) were compared using logistic regressions. A linear regression model was used to determine if Tics+ was associated with greater cognitive control deficits, a well-established correlate of ADHD. Results: Tics+ demonstrated higher ADHD traits, specifically for hyperactive symptoms (p&lt;0.001). 6 of 9 hyperactive symptoms were reported at significantly higher rates in Tics+ compared to ADHD. Cognitive control was equal between Tics+ and ADHD while both groups had significant deficits compared to Tics- and controls. Conclusion: Children with Tics+ have more hyperactive symptoms which were not associated with worse cognitive control than ADHD. The cognitive control deficits observed in Tics+ were consistent with a true comorbid ADHD. It is of interest to explore shared risk factors to explain the high prevalence of ADHD among this group.

Exploring the Link between the Obesity and ADHD

Obesity is a chronic, multifactorial and recurrent disease. ADHD is a chronic neurodevelopmental disorder in early childhood. The core symptoms include attention deficit, hyperactivity/impulsivity and oppositional defiance. Research shows that there is a significant correlation between obesity and ADHD, and the probability of overweight and obese children suffering from ADHD is significantly higher than that of normal weight children. This paper discusses the association mechanism between ADHD and obesity from the perspectives of genetics, eating disorders, intestinal flora and poor physical exercise. At the same time, in view of the prevention and intervention of the comorbidity of ADHD and obesity, this paper also puts forward various means such as diet intervention, exercise prevention intervention and drug treatment. However, the relationship between obesity and ADHD is complex, and the comorbidity problem needs to be solved urgently. Establishing an effective early screening system, implementing targeted prevention and intervention measures, and strengthening public awareness and understanding of comorbidities are important ways to improve the quality of life of this group. Further research is needed in the future.

Genetic Variants Linked to Dyslexia Co-Morbid ADHD: A Case Study of a Pakistani Outpatient

Genetic Variants Linked to Dyslexia Co-Morbid ADHD: A Case Study of a Pakistani Outpatient

Cortical structure and subcortical volumes in conduct disorder: a coordinated analysis of 15 international cohorts from the ENIGMA-Antisocial Behavior Working Group

Conduct disorder is associated with the highest burden of any mental disorder in childhood, yet its neurobiology remains unclear. Inconsistent findings limit our understanding of the role of brain structure alterations in conduct disorder. This study aims to identify the most robust and replicable brain structural correlates of conduct disorder. The ENIGMA-Antisocial Behavior Working Group performed a coordinated analysis of structural MRI data from 15 international cohorts. Eligibility criteria were a mean sample age of 18 years or less, with data available on sex, age, and diagnosis of conduct disorder, and at least ten participants with conduct disorder and ten typically developing participants. 3D T1-weighted MRI brain scans of all participants were pre-processed using ENIGMA-standardised protocols. We assessed group differences in cortical thickness, surface area, and subcortical volumes using general linear models, adjusting for age, sex, and total intracranial volume. Group-by-sex and group-by-age interactions, and DSM-subtype comparisons (childhood-onset vs adolescent-onset, and low vs high levels of callous-unemotional traits) were investigated. People with lived experience of conduct disorder were not involved in this study. We collated individual participant data from 1185 young people with conduct disorder (339 [28·6%] female and 846 [71·4%] male) and 1253 typically developing young people (446 [35·6%] female and 807 [64·4%] male), with a mean age of 13·5 years (SD 3·0; range 7-21). Information on race and ethnicity was not available. Relative to typically developing young people, the conduct disorder group had lower surface area in 26 cortical regions and lower total surface area (Cohen's d 0·09-0·26). Cortical thickness differed in the caudal anterior cingulate cortex (d 0·16) and the banks of the superior temporal sulcus (d -0·13). The conduct disorder group also had smaller amygdala (d 0·13), nucleus accumbens (d 0·11), thalamus (d 0·14), and hippocampus (d 0·12) volumes. Most differences remained significant after adjusting for ADHD comorbidity or intelligence quotient. No group-by-sex or group-by-age interactions were detected. Few differences were found between DSM-defined conduct disorder subtypes. However, individuals with high callous-unemotional traits showed more widespread differences compared with controls than those with low callous-unemotional traits. Our findings provide robust evidence of subtle yet widespread brain structural alterations in conduct disorder across subtypes and sexes, mostly in surface area. These findings provide further evidence that brain alterations might contribute to conduct disorder. Greater consideration of this under-recognised disorder is needed in research and clinical practice. Academy of Medical Sciences and Economic and Social Research Council.

Extended-Release Mixed Amphetamine Salts for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cannabis Use Disorder: A Pilot, Randomized Double-Blind, Placebo-Controlled Trial

Objective: To determine if treatment of co-occurring adult ADHD and Cannabis Use Disorder (CUD) with extended-release mixed amphetamine salts (MAS-ER) would be effective at improving ADHD symptoms and promoting abstinence. Method: A 12-week randomized, double-blind, two-arm pilot feasibility trial of adults with comorbid ADHD and CUD (n = 28) comparing MAS-ER (80 mg) to placebo. Main outcomes: ADHD: ≥30% symptom reduction, measured by the Adult ADHD Investigator Symptom Rating Scale (AISRS). CUD: Abstinence during last 2 observed weeks of maintenance phase. Results: Overall, medication was well-tolerated. There was no significant difference in ADHD symptom reduction (MAS-ER: 83.3%; placebo: 71.4%; p = .65) or cannabis abstinence (MAS-ER: 15.4%; placebo: 0%; p = .27). MAS-ER group showed a significant decrease in weekly cannabis use days over time compared to placebo (p < .0001). Conclusions: MAS-ER was generally well-tolerated. The small sample size precluded a determination of MAS-ER’s superiority reducing ADHD symptoms or promoting abstinence. Notably, MAS-ER significantly reduced weekly days of use over time.

Healthcare resource utilization and costs associated with psychiatric comorbidities in pediatric patients with attention-deficit/hyperactivity disorder: a claims-based case-cohort study

BackgroundAttention-deficit/hyperactivity disorder (ADHD) has been shown to pose considerable clinical and economic burden; however, research quantifying the excess burden attributable to common psychiatric comorbidities of ADHD among pediatric patients is scarce. This study assessed the impact of anxiety and depression on healthcare resource utilization (HRU) and healthcare costs in pediatric patients with ADHD in the United States.MethodsPatients with ADHD aged 6–17 years were identified in the IQVIA PharMetrics Plus database (10/01/2015-09/30/2021). The index date was the date of initiation of a randomly selected ADHD treatment. Patients with ≥ 1 diagnosis for anxiety and/or depression during both the baseline (6 months pre-index) and study period (12 months post-index) were classified in the ADHD+anxiety/depression cohort; those without diagnoses for anxiety nor depression during both periods were classified in the ADHD-only cohort. Entropy balancing was used to create reweighted cohorts. All-cause HRU and healthcare costs during the study period were compared using regression analyses. Cost analyses were also performed in subgroups by comorbid conditions.ResultsThe reweighted ADHD-only cohort (N = 204,723) and ADHD+anxiety/depression cohort (N = 66,231) had similar characteristics (mean age: 11.9 years; 72.8% male; 56.2% had combined inattentive and hyperactive ADHD type). The ADHD+anxiety/depression cohort had higher HRU than the ADHD-only cohort (incidence rate ratios for inpatient admissions: 10.3; emergency room visits: 1.6; outpatient visits: 2.3; specialist visits: 5.3; and psychotherapy visits: 6.1; all p < 0.001). The higher HRU translated to greater all-cause healthcare costs; the mean per-patient-per-year (PPPY) costs in the ADHD-only cohort vs. ADHD+anxiety/depression cohort was $3,988 vs. $8,682 (p < 0.001). All-cause healthcare costs were highest when both comorbidities were present; among patients with ADHD who had only anxiety, only depression, and both anxiety and depression, the mean all-cause healthcare costs were $7,309, $9,901, and $13,785 PPPY, respectively (all p < 0.001).ConclusionsComorbid anxiety and depression was associated with significantly increased risk of HRU and higher healthcare costs among pediatric patients with ADHD; the presence of both comorbid conditions resulted in 3.5 times higher costs relative to ADHD alone. These findings underscore the need to co-manage ADHD and psychiatric comorbidities to help mitigate the substantial burden borne by patients and the healthcare system.

Young adults with SLD and/or ADHD conscripted for military service: risk, resources, and resilience

ABSTRACT This study explored multisystem protective/risk factors for explaining resilience/adjustment in emerging adults with/without neurodevelopmental disorders facing the transition to a stressful non-academic context, mandatory military service. Participants were 904 conscripts (498 males, 55%) ages 18–25 years (M = 18.70, SD = .77) in four groups, with ADHD or SLD or comorbid ADHD+SLD or typical development (TD). Data collection tapped multiple information sources. Youngsters’ multidimensional protective/risk variables spanned three levels: (a) individual level – formally diagnosed disorders (SLD, ADHD, or ADHD+SLD), ego-resiliency, sense of coherence, attachment patterns; (b) family level – family cohesion/adaptability; and (c) community/system level – youngsters’ appraisal of their commander as a secure extrafamilial attachment figure. Youngsters’ five resilience/adjustment measures comprised: positive/negative affect, vocational-institutional satisfaction, social adaptation, and commander-rated overall functioning. MANOVAs yielded significant group differences on youngsters’ protective/risk factors and resilience measures. Regression analyses revealed significant risk posed by ADHD and/or SLD and significant protection offered by ego-resiliency, sense of coherence, attachment patterns, family cohesion, and commander as a ‘secure base’ – for explaining youngsters’ resilience. Discussion focused on factors’ unique protective/risk value for explaining resilient functioning in ADHD, SLD, comorbid, and TD emerging adults, while facing highly demanding environment.

Neurocognitive Test Performance in relation to symptom severity and age of onset of trichotillomania

Prior research has yielded inconsistent findings on neurocognitive deficits, particularly in response inhibition and set shifting, when comparing patients with trichotillomania (TTM) to healthy comparison groups. This study used baseline data (N = 36) from a clinical trial of behavior therapy for TTM to test two possible explanations for these mixed results: (a) neurocognitive deficits are only noted among more severely symptomatic patients with TTM; and (b) age of onset is differentially associated with deficits in response inhibition vs. set shifting. Results were inconsistent with these hypotheses. Age of onset was not significantly correlated with either neurocognitive assessment. Interviewer ratings of TTM symptom severity or impairment were not significantly related to neurocognitive test performance. Self-reported symptom severity correlated significantly with motor response inhibition, but in the direction opposite to our expectation, such that faster reaction times to inhibit a dominant response were associated with more severe symptoms. Discussion centered on several possible explanations, including the possibilities that either (a) measurement methods or (b) variation across samples in the prevalence of ADHD comorbidity, not measured in this study, could explain mixed findings on the neuropsychological profile of TTM.

Attention Deficit Hyperactivity Disorder: A Risk Factor for Premature Discontinuation of Inpatient Opioid Withdrawal Treatment.

Background: Substance use disorders present a tremendous challenge within contemporary healthcare systems. Specifically, in the domain of opioid use disorders (OUDs), several foundational elements are crucial for the efficacious management of afflicted individuals. Regrettably, the premature discontinuation of inpatient opioid withdrawal treatment is a prevalent phenomenon. This study aims to elucidate the prevalence of the premature termination of inpatient opioid withdrawal treatment among patients with comorbid ADHD. Methods: We conducted a comprehensive assessment of all participants currently undergoing inpatient opioid withdrawal treatment. Our assessment protocol included the administration of the ADHD Self-Report Scale (ADHD-SR) and the Wender Utah Rating Scale (WURS-k). Additionally, participants who met the thresholds on one or both questionnaires underwent further evaluation using the Diagnostic Interview for ADHD in Adults (DIVA-2.0). Results: The prevalence of individuals diagnosed with ADHD within the studied cohort was determined to be 29.3%. Among the subset of participants identified as ADHD-positive, a notable 54.5% prematurely ceased therapy. In contrast, among those identified as ADHD-negative, the premature discontinuation rate was substantially lower at 28.3%. Conclusions: In summary, the impact of ADHD as a comorbid condition on the efficacy of inpatient opioid withdrawal treatment has been underscored. By identifying comorbid ADHD early in the treatment process, tailored therapeutic approaches may help to maximize the effectiveness of interventions and may improve patient outcomes. This underscores the importance of proactive screening for ADHD as a psychiatric comorbidity in optimizing the management of individuals undergoing inpatient opioid withdrawal treatment.

The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review

Objective: This review aimed to systematically gather empirical data on the link between social anxiety disorder and ADHD in both clinical and non-clinical populations among adolescents and adults. Method: Literature searches were conducted in PsycInfo, PubMed, Scopus, and Web of Science, resulting in 1,739 articles. After screening, 41 articles were included. Results were summarized using a narrative approach. Results: The prevalence of ADHD in adolescents and adults with SAD ranged from 1.1% to 72.3%, while the prevalence of SAD in those with ADHD ranged from 0.04% to 49.5%. Studies indicate that individuals with both SAD and ADHD exhibit greater impairments. All studies were judged to be of weak quality, except for two studies which were rated moderate quality. Discussion: Individuals with SAD should be screened for ADHD and vice versa, to identify this common comorbidity earlier. Further research is needed to better understand the prevalence of comorbid ADHD and SAD in adolescents.

Implementing policies and predictive stochastic models to attend to borderline personality disorder crises: rationalising ssri antidepressants prescription in suicide prevention

Introduction We are facing increased suicide attempts and deliberate self-harm from persons with borderline personality disorder (BPD) who are also on antidepressants, multiple antidepressant prescriptions and antidepressant augmentations. Our previous observations suggest that antidepressants might increase suicide attempts in those on this medication and who have BPD. The absent response to antidepressants is due mainly to the comorbid dysthymia, cyclothymia, rumination, autism and ADHD in BPD.ObjectivesTo generate forecasting models and preventive policies to deal with BPD crises and improve the effectiveness of the UK National Healthcare Service (NHS) in suicide prevention.MethodsThe underlying analysis framework is stochastic forecasting. We used current knowledge and data to complete systematic future predictions extracted from recent trends. A logical-mathematical model generated the required expressions. The software for logic prediction and annotation was Wolfram Alpha (Wolframalpha.com). The four parameters for stochastic predictions are, BPD (A), antidepressant No. 1 (B), antidepressant No. 2 (C), and suicide attempts (D). Boolean function metrics can help analyse the impact and truth of forecast modelling with truth density.ResultsThe logic expression for suicide prediction due to liberal antidepressant prescribing is Ψ = A intersects B, intersects C, intersects D; that is,. Ψ = A ∩ B ∩ C ∩ D, which yields a Boolean truth density of 6.25%. The truth table always has a positive outcome as long as any of the factors exist except when none is present.ConclusionsThe predictive Boolean function and truth table suggest that suicide presentation is predictable if there is a prescribing of one or more antidepressants in BPD and if there is an antidepressant augmentation or dose maximisation. We speculate that SSRI antidepressants block self-regulatory mechanisms of fear of death while triggering impulses to self-harm and suicide from overstimulation of SSRI receptors. Without fear mechanisms, death by suicide is felt as not terrifying.Disclosure of InterestNone Declared

Association and predictor role of MASC scores in pharmacological or psychological treatment indication in a sample of children and adolescent in Spain

IntroductionAnxiety is one of the most common Mental Health diagnosis in underage population. We decided to study if there was any variable that would lead us to a specific treatment indication using the MASC (Multidimensional Anxiety Scale for Children).ObjectivesPrevalence of psychiatric disorders and comorbidities in an underage population.Possible association between MASC questionnaire scores and the indication for pharmacological and/or psychological treatment.MethodsThis is a descriptive, observational, retrospective, quantitative study with data from patients between June 2016 and 2023. Inclusion criteria: 3-18 year-old-spanish-speakers who met criteria for a ICD-11 disorder. Exclusion criteria: absence of legal representatives, intellectual disability. Variables: Age, sex, psychiatric family history, ICD-11 diagnosis, treatment indication and MASC’s subscales (physical symptoms, harm avoidance, social anxiety and separation anxiety). Statistical analyzes were performed with STATA-15 program, using as independent variables MASC questionnaire, and dependent ones the indication treatment and diagnosis.ResultsThe sample contains 1024 patients, with a mean age of 12 (SD 4.028). Table 1 shows that the most frequent diagnosis is ADHD, with combined presentation with a prevalence of 22.27%, followed by Anxiety Disorders, without differentiating by subtypes (17.93%). It also shows that Defiant and Oppositional Disorder is the most prevalent comorbidity (9.66%) followed by Anxiety Disorder not specified (4.99%). Table 2 stands that there are significantly higher scores in all MASC subscales in those patients who do have prior psychiatry family history. We founf in Table 3 statistically significant differences were found between the score on the Physical Symptoms subscale based on whether the patient was undergoing previous treatment, both pharmacological (8.45 vs. 7.59) and psychological treatment (9.01 vs. 7.95) compared to those who were not (pharmacological 7.36 vs. 7.06), psychological (7.21 vs. 6.92). All these data have been adjusted.Image:Image 2:Image 3:ConclusionsAnxiety disorders are the most common form of Mental Disorder in young people, with a global prevalence of 6.5% (Rapee et al.2023). However, in our sample the most common one is ADHD as our center is specialized in it. We found that the most prevalent one was Oppositional Defiant Disorder, as it is the most frequent comorbidity of ADHD (Vallejo-Valdivielso et al,2019; Faraone et al,2021). The increase of one point in the Physical Anxiety subscale increases the probability of indicating pharmacological treatment, which could be explained because of how functional limitation these symptoms cause. The increase in all the subscales of the MASC implies an increase in the probability of an indication for psychological treatment as it is the gold-standard treatment for anxiety in children.Disclosure of InterestNone Declared

Link between neurodevelopmental disorders and suicidal risk in children

IntroductionSuicide represents a significant public health issue among children and adolescents. However, in this population, while the literature seems to support a link between suicidal risk and neurodevelopmental disorders, there are still few studies on the subject. The psychopathological description of children who have realized a suicide attempt with a high potential for lethality, which can be defined as “serious”, appears to resemble that of children who have died by suicide. This study aimed to characterize the dimensional aspects of the neurodevelopmental profile of a population of children and adolescents hospitalized at Necker-Enfants–Malades Hospital for a serious suicide attempt. MethodsThis is an observational, prospective, and single-center study. Questionnaires for collecting general information and dimensional scales of neurodevelopment (Autism-Tics, ADHD, and Other Comorbidities Inventory, Social Responsiveness Scale, and Conners-3 for parents) were used. This study included 21 patients aged 9 to 15 years at the time of their hospitalization. ResultsThe results supported the presence of at least one neurodevelopmental disorder (autistic traits, attention-deficit/hyperactivity disorder, learning disorder, or motor disorder) in 70% (n=14) of the subjects, and at least one behavioral disorder (oppositional defiant disorder, conduct disorder) in 65% (n=13) of these subjects. ConclusionThe observed frequency of traits indicative of neurodevelopmental disorders in our population was higher than that observed in the general population, without the presented symptoms being eligible for categorical diagnosis. Considering the dimensional aspects of neurodevelopmental symptoms would therefore enable better identification of children at suicidal risk and more tailored interventions to contribute to the prevention of suicide in children.

Altered Intrinsic Brain Spontaneous Activities in Children With Autism Spectrum Disorder Comorbid ADHD

Objective: The study involved 17 children with Autism Spectrum Disorder (ASD), 21 with ADHD, 30 with both (ASD + ADHD), and 28 typically developing children (TD). Methods: The amplitude of low-frequency fluctuations (ALFF) was measured as a regional brain function index. Intrinsic functional connectivity (iFC) was also analyzed using the region of interest (ROI) identified in ALFF analysis. Statistical analysis was done via one-way ANCOVA, Gaussian random field (GRF) theory, and post-hoc pair-wise comparisons. Results: The ASD + ADHD group showed increased ALFF in the left middle frontal gyrus (MFG.L) compared to the TD group. In terms of global brain function, the ASD group displayed underconnectivity in specific regions compared to the ASD + ADHD and TD groups. Conclusion: The findings contribute to understanding the neural mechanisms underlying ASD + ADHD.