Diagnosis Of ADHD Research Articles

Use of ADHD Medication Among Danish Children and Adolescents from 2010-2020 - A Nationwide Study

IntroductionTo ensure rational drug use, there is a need to continuously monitor the use of ADHD medication among children and adolescents.ObjectivesTo describe the use of ADHD medication among Danish children and adolescents from 2010-2020.Methods Using the Danish national healthcare registries, we extracted data on filled prescriptions of ADHD medication (including methylphenidate, atomoxetine, guanfacine, dexamphetamine, and lisdexamphetamine) among children (age 6-12 years) and adolescents (age 13-17 years) between 2010-2020. We examined the annual incidence rate and prevalence proportion of ADHD drug use, and the proportion of children and adolescents having an ADHD diagnosis when initiating ADHD medication.Results From 2010-2020, the incidence followed a u-shaped trend with an incidence rate of 4.9/1,000 children and 4.4/1,000 adolescents in 2010, decreasing to 3.2/1,000 children and 3.0/1,000 adolescents in 2013, and rising to 4.9/1,000 children and 4.8/1,000 adolescents in 2020. The prevalence for children showed a similar trend, shifting from 17/1,000 in 2010, to 15/1,000 in 2016, and peaking at 19/1,000 children in 2020. However, among adolescents the prevalence increased steadily from 19/1,000 in 2010 to 29/1,000 in 2020. 67% of children and 53% of adolescents initiating ADHD medication had an ADHD diagnosis.Conclusions After an initial decline in incidence rates of ADHD medication use among Danish children and adolescents, there has been a rise in use the last five years. The same trend applied for the prevalence among children, whereas the prevalence among adolescents increased steadily over the entire period. More than half of children and adolescents initiating ADHD medication were diagnosed with ADHD.DisclosureNo significant relationships.

ADHD and Intellectual Disability: using ADHD medication

IntroductionMental disorders and ADHD in people with ID are higher than in the general population.Clinicians may be reluctant to diagnose ADHD in people with ID. They could be denied effective treatment.ObjectivesThe purpose of the study was to ascertain antipsychotic use in people with ID before and after the a diagnosis of ADHD.MethodsA casenote review in an ID service for aduls with ADHD. Data collected on psychotropic use before and after the diagnosis.ResultsForty-eight aduls with ADHD-ID were identified. 38(79%) were male and 10(21%) were female. 19 to 58 years of age. Four (8%) had mild ID; 44 (92%) had moderate to severe ID. 27(56%) had anxiety, mood disorders or psychosis. 21(44%) had ADHD only. Challenging behaviour was reported in 24 (50%) of cases. Thirty-three (68%) used psychotropic medication prior to the diagnosis of ADHD and after the diagnosis. Post-diagnosis, 20(60%) continued to use antipsychotic medication indicating the elimiation of antipsychotic use in 13(40%) of people. The level of medication use remained the same in spite of the reduction of antipsychotic medication. The diagnoses of challenging behaviour was not affected by the reduction in antipsychotic medication and the increase in ADHD medication use.ConclusionsThe use of antipsychotic medication in people with intellectual disaibilities and ADHD is high. ADHD should be considered when people present wtih challenging behaviour. ADHD medication can be effective in treating ADHD-ID and can lead to a significant reduction in the use of antipsychotic medication.DisclosureNo significant relationships.

A Case of Adult Attention Deficit Hyperactivity Disorder with Non-Organic Psychosis Comorbidity

IntroductionAlthough ADHD is the most frequently diagnosed psychiatric disorder in childhood, the majority of adults with ADHD are not diagnosed and 90% of the cases remain untreated. One of the main reasons that may lead to the missed diagnosis of ADHD in adults may be the high rate of comorbid psychiatric conditions masking the main symptoms.ObjectivesIn this study, it was aimed to present a case who was followed up with the diagnosis of ADHD since childhood and developed psychosis after a recent traumatic life event.MethodsA 19-year-old male patient was consulted because of his complaints of persecution delusions, and disorganized speech that started 2 years ago. IIt was learned that the first psychiatry application of the patient was 10 years ago with complaints of impulsivity, aggression, increased psychomotor movements, and methylphenidate treatment was started during this period. The patient, whose current clinical picture was evaluated as psychosis, was discharged after the symptoms subsided with paliperidone depot 100mg/month treatment after hospitalization. It is understood that his psychotic complaints completely regressed in the follow-ups.ResultsIt is stated that approximately 80% of adult ADHD cases have at least one accompanying psychiatric disorder. However, there are limited studies in the literature on the relationship between psychotic disorders and ADHD.ConclusionsRecent studies indicate that beyond the fact that ADHD is a feature of the schizophrenia prodrome, ADHD diagnosis may be associated with an increased risk of psychosis in the future. Therefore, this association can be better clarified in further studies on comorbidities.DisclosureNo significant relationships.

ADHD in a patient with eating disorder. Case report

Introduction15-year-old female referred to outpatient unit after COVID lockdown for binge eating and purging with depressive symptoms and anxiety.ObjectivesTo show the importance of a correct diagnosis in an impulsive patient with eating disorderMethodscase report and literature reviewResultsThe patient presents emotional instability with interpersonal difficulties with high fear of rejection. She suffered from fear of gaining weight and desires to lose weight with rejection of her body image. Fluoxetine and lorazepam are started together with low doses of olanzapine. During the follow up she presented a worsening of mood, onset of self-injuries and an episode of suicidal attempt. A biographical examination was performed, expressing a feeling of academic failure with difficulty concentrating and performing simple tasks. As a child she is described as impulsive, with frequent arguments with classmates. CPT III was performed with a high probability of ADHD. Treatment was started with lisdexamfetamine up to 50 mg with good tolerance. From the beginning of the treatment the patient expressed a feeling of improvement in the control of emotions as well as in the management of her impulsivity. There was an improvement in her academic performance with a decrease in self-injury episodes. The patient was able to express improvement in the sense of incapacity she felt.ConclusionsThis case shows how marked emotional dysregulation and impulsive symptoms improves after diagnosis and subsequent treatment of ADHD, also improving eating symptoms. ADHD is present in eating disorders, especially in those with impulse dyscontrol such as binge eating disorder or bulimia nervosa.DisclosureNo significant relationships.

Adult ADHD Patients in Community Mental Health Teams – an Unmet Need

AimsThis Service Survey is a part of a Quality improvement project which aims to :1- To assess the extent of the problem regarding accessing Adult ADHD assessment and treatment by getting the views of clinicians.2- Evaluate negative impact on care coordinators of the delay in accessing timely and effective diagnosis and treatment of ADHD; This will: a-Increase understanding of the care needed by this patient group. b-Clarify current practice and any difficulties staff face in condition management when diagnosis not confirmed i.e. outline training needs. c-Determine if waiting time for diagnosis results in iatrogenic harm (deterioration driven by ‘unmet need’). 3-Inform the development of an alternative pathway of care; thus: a-Reduce inequality of healthcare access for those with this neurodevelopmental condition. b-Reduce stigma. c-Improve service user health and well-being. d-Support families and carers. e-Reduce social costs to individual and community. f-Support community staff and increase knowledge and effectiveness.MethodsMethods of the service survey part: 1.Service survey: Sent to 21 consultants who are working in Adult CMHT.2.Service Satisfaction survey for all of the Redcar & Cleveland Affective disorder team's clinical staff members (18).Results: Consultants Service Survey11 consultants responded out of 21 (52%)Approximate number of the diagnosed ADHD patients / team varied between 7–80 patients.Wait time for an ADHD assessment varied between 12 -30 months.Number of patients/ team waiting for assessments by the specialist team 2- 27 patients.50% of the consultants reported significant delays between referral to the services and initiation of treatment 6–36 months.All consultants reported commencing treatment of ADHD, if a patient already had the diagnosis.9/11 (82%) consultants reported making the initial diagnosis and treating ADHD patients in CMHTs. However, all consultant reported the need for further training in assessment and management of ADHD patients.6/11 (55%) consultants stated that ADHD patients should be managed in CMHTs provided they are care coordinated by another clinician.Clinical Staff Satisfaction SurveyAll 3 staffs responded out of 18 staff, reported un satisfaction with the current service provision.Conclusion1.The current service model is not able to meet the increasing demand for the services and leading to significant delay in accessing appropriate treatment.2.There is a need to improve competencies of community mental health teams to manage these patients.3.This survey will be used to model a new care pathway.

Prevalence of high risk of ADHD among adult users of Instagram in Russian Federation

IntroductionThe problem of diagnosis and treatment of ADHD in adults in the Russian Federation remains very relevant. Unfortunately, very little time is devoted to the topic of adult ADHD in standard and advanced training programs. In connection with these problems, it is important to study the prevalence of ADHD in the Russian population.ObjectivesTo determine the prevalence of an increased risk of adult ADHD on the example of Russian Instagram users.Methods In the professional blog of one of the authors of the article in Instagram (@gentlepsydoc), a link was posted to an anonymous survey conducted using Google docs, in which patients filled out the Adult ADHD Self-Report Scale (ASRS v1.1) in the author’s translationResultsA total of 144 people took part in the screening, 87.5% of them were women, the average age of the participants was 35.5±12.3 years (from 20 to 56). An increased risk of ADHD according to the indicators of the ASRS scale was detected in 13.2 % of participants.ConclusionsAmong Instagram users, the prevalence of an increased risk of ADHD was higher than according to epidemiology data. This indicator could be influenced by a sample of patients, mainly consisting of subscribers of a professional blog of a psychiatrist, as well as the prevalence of women among the participants. In any case, these data speak in favor of the importance of diagnosing this condition in the Russian population, as well as including information about adult ADHD in training programs for mental health professionals.DisclosureNo significant relationships.

White matter microstructure associated with the range of attentional and impulsive performance in school-aged children

IntroductionInhibition capabilities have been shown to be a strong predictor of social and educational life outcomes (Mischel & Ebbesen, 1970; Shoda et al., 1990). Inhibition capabilities have an enormous impact on attention and impulsivity (Bari & Robbins, 2013). These two executive functions are associated with numerous psychiatric disorders but are not well understood in terms of white matter (WM) connectivity (Puiu et al., 2018). Novel techniques and statistical approaches in neuroimaging bring us closer to a biologically sustained model.ObjectivesThis research aims to: 1) identify WM connections associated with attention/impulsivity performance and 2) characterize the differences in WM microstructure associated with the variation of the performance.Methods 157 children (GESTE cohort, 8-12 years, 27 Dx ADHD, 2 Dx ASD) with b=1500mm2/s, 2mm isotropic dMRI acquisitions were included. Tractography was performed with TractoFlow pipeline (Theaud et al., 2020). Dimensionality reduction of diffusion metrics yielded two components : microstructural complexity (DTI Metrics, AFD & NuFo) and axonal density (AFD_fixel) (Chamberland et al., 2019). Attention/impulsivity were evaluated with the CPT3. Multivariate linear regression was performed in python.ResultsLower microstructural complexity was associated with poorer attentional performance on regions of the parietal lobe to the occipital gyrus (P-O, p=0.044, R2=0.14, Figure 1.) and the Broadman’s area 8 to area 6 (SF8-SF6, p=0.002, R2=0.12, Figure 1.). Lower axonal density was associated with a less impulsive pattern on SF8-SF6 (p=0.001, R2=0.13, Figure 1.). Results remained significant when removing children with an ADHD or ASD diagnosis.ConclusionsWe identified underlying difference in WM microstructure that may be associated with the variation in attention/impulsivity performance in school-aged children.DisclosureNo significant relationships.

Trauma-Informed Care on CAMHS ID Unit. Case Study of a Child with Neurodevelopmental Disorder and Self-Injurious Behaviour

AimsCrystal House is a specialist CAMHS ID inpatient 5-bedded unit based in the Kingswood Centre, North West London - for children aged between 13 and 18 years with primary diagnosis of Intellectual Disabilities with or without additional concerns that warrant admission to hospital for purpose of assessment and management. Reporting this case, we wanted to highlight complexities of management of children presenting with neurodevelopmental conditions and history of trauma.MethodsThis is a case of a fourteen-year-old girl with established diagnoses of Moderate Intellectual Disability, Childhood Autism, Foetal Alcohol Syndrome and childhood trauma. She was admitted to our CAMHS ID Assessment and Treatment Unit with a nine- year history of self-injurious behaviour, suicidal ideation and voice-hearing experiences – after failed treatment in the community and in-patient treatment (including under restrictions of long-term segregation) on generic CAMHS unit. Her current treatment includes a person-centred Trauma- Informed Positive Behaviour Support Plan; individual and family therapy psychology sessions based on the principles of trauma-informed care and consultation with staff on trauma-informed care. She also undertook ADHD assessment, and we are in the process of optimising ADHD medication.ResultsTrauma-Informed Positive Behaviour Support Plan was a new concept for the team. Therefore, this was supported by training and consultations with staff. The latter was introduced to create a psychologically oriented environment using trauma-informed care principals and helping the team understand what trauma means and how it affects the individual. ADHD assessment confirmed the diagnosis of ADHD which was followed by optimising ADHD medication.ConclusionSystemic and a person-centred approach is used for this child with concerning presentation and history of neurodevelopmental disorder and childhood trauma.

Pharmacogenetic CYP2D6 variability, phenoconversion and treatment outcomes: A Danish population-based cohort study in 6,798 individuals initiating atomoxetine treatment

IntroductionAtomoxetine, a first-line treatment option for ADHD, is affected by pharmacogenetic (PGx) variation of the drug-metabolizing enzyme CYP2D6. Despite the recommendation of CYP2D6 testing, the use of PGx-guided dosing remains low in Denmark.ObjectivesWe investigated wide-ranging clinical outcomes in atomoxetine users in association with PGx variability.MethodsWe analyzed 6,798 individuals (55% children) with a first prescription for atomoxetine identified from the Danish population-based iPSYCH case-cohort study linking biobank information with Danish registers. Individuals were categorized based on their single-nucleotide-polymorphism-based CYP2D6 genotype into normal (NM), intermediate (IM), and poor metabolizer (PM). Clinical outcomes included treatment switching, discontinuation, psychiatric inpatient-, outpatient-, and emergency contact, suicide attempt/self-harm, sleep problem, and depression. Individuals’ CYP2D6-status could change due to drug-drug-interactions of weak, intermediate, or strong-CYP2D6 inhibitors (phenoconversion), which we accounted for by time-varying phenotype assessment. Incidence rate ratios (IRR) were estimated using Poisson regression analyses and adjusted for a wide range of potential confounders and covariates.ResultsOver two-thirds of the individuals had a hospital diagnosis of ADHD at the first atomoxetine prescription. The distribution of CYP2D6 phenotypes was similar in children and adults. IM/PM children had a significantly higher risk of a sleeping problem compared with NM children (IRR 1.25, 95% CI 1.01-1.54). Compared with NM adults, those with IM/PM had a higher risk of switching (1.15, 95% CI 0.98-1.35).ConclusionsThis is the first study showing the potential impact of PGx variability on clinical outcomes of atomoxetine users in a population-based setting, highlighting the utility of PGx testing.DisclosureNo significant relationships.

Tattooing and piercing are associated with symptoms of ADHD: A cross-sectional study of non-clinical adults

IntroductionPrevious studies suggest that individuals with tattoos and piercings exhibit higher impulsive personality traits compared to peers without body modifications. No studies on body modifications and core-symptoms of ADHD are available.ObjectivesThis study aimed to compare self-reported ADHD symptoms between non-clinical adults with and without body modifications.MethodsA non-clinical adult Swedish population (n=815) completed the Adult ADHD self-report scale (ASRS-v1.1) and answered questions concerning body modification. ADHD diagnosis served as exclusion criterion. Three grouping variables were analysed separately; tattoo status, piercing status and a combination of having both tattoo and piercing. Linear regression compared mean ASRS total- and subscale scores between individuals with and without body modification according to each grouping variable, while adjusting for candidate covariates age and sex.ResultsThe prevalence of each body modification variable was; 30% for tattoo, 18% for piercing other than earlobe and 12% for combination of tattoo and piercing. Any combination of body modification was associated with significantly higher ASRS total- and subscale scores compared to no body modification. The most pronounced differences between groups were for the combination of tattoo and piercing, and on the hyperactivity/impulsivity (HI) subscale; revealing adjusted mean differences of 4.3 points (range 0-72) on the ASRS-total score (p <0.001) and 2.6 points (range 0-36) on the ASRS HI subscale (p <0.001).ConclusionsBody modification was associated with more pronounced ADHD core symptoms amongst non-clinical adults. Although statistically significant, the clinical significance is uncertain. The prevalence rates of body modifications in our cohort indicate that they are becoming cultural normal.DisclosureNo significant relationships.

Use of machine learning on clinical questionnaires data to support the diagnostic classification of Attention DeficitHyperactivity Disorder: a personalized medicine approach

IntroductionAttention Deficit / Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental condition characterized by inattention, motor hyperactivity and impulsivity. ADHD cognitive and behavioral presentation is characterized by a high heterogeneity (APA, 2013). Indeed, a complex diagnostic process, that considers several validated tools, is, to date, necessary.ObjectivesThe main aim is to develop supervised machine learning (ML) algorithms that could be used to support the diagnostic process for ADHD, by identifying the most relevant features in discriminating between the presence or absence of the ADHD diagnosis in children.MethodsWe analyzed data from 342 children (Mean age: 8y 8m ± 1y; 61 F) referred for possible ADHD symptomatology. Assessments were performed by an expert clinician and through questionnaires: Social Responsiveness Scale (SRS), Child Behavior Checklist (CBCL), Conners Rating Scale for Parents (CPRS) and for Teachers (CTRS). Data were analyzed using a decision tree classifier and random forest algorithms.ResultsThe decision tree model performed an accuracy of 0.71. The random forest model that was identified as the best tested, performed an accuracy of 0.77 (Figure 1) and it identified as most informative parent- and teacher-rated DSM-oriented ADHD symptoms (Figure 2).Figure 1: Random forest confusion matrix and statistics.Figure 2: Ranking of variables importance.ConclusionsA random forest classifier could represent an effective algorithm to support the identification of ADHD children and to simplify the diagnostic process as an initial step. The use of supervised machine learning algorithms could be useful in helping the diagnostic process, highlighting the importance of a personalized medicine approach.DisclosureNo significant relationships.

0510 Parent and Child Perception of Sleep for Children with Sensory Processing Difficulties

Abstract Introduction Roughly 5.3 million elementary children in the United States experience sensory processing (SP) difficulties, like sensitivity to touch and overstimulation with movement. These difficulties cause high levels of daytime stress and daytime dysfunction (e.g., difficulties with attention, academics, and emotional regulation). In typically developing children (without SP difficulties), high levels of daytime stress impact sleep; however, research has yet to explore sleep health in children with SP difficulties. Our study aims to use validated self- and parent-reported questionnaires to characterize differences in sleep health for children with and without SP difficulties. Methods Children (ages 6-10) with (n=22) and without (n=33) SP difficulties (per parent report; Autism and ADHD diagnosis excluded) were recruited for this convergent mixed-methods study. Sleep was assessed using validated self- and parent-report questionnaires, the Sleep Self-Report (SSR) and Children’s Sleep Habits Questionnaire (CSHQ), and through qualitative interviews with parents. Groups were compared using t-test and Mann-Whitney U tests, with significance set a priori at α=0.05. A rapid qualitative analysis produced themes and were integrated with the quantitative data. Results Parents of children with SP report significantly worse sleep quality on the CSHQ difficulties (MedianSP= 50.5, SDSP= 11.45) than parents of children without SP difficulties (MedianCON=43.0, SDCON=7.27, U= -2.92, p=.004). Children with SP deficits also report significantly worse sleep on the SSR (MSPD=42.18, SDSPD=8.26) compared to their peers (MCON=33.55, SDCON=6.71, t(53)= -4.26, p<.001). Qualitative themes highlight the higher prevalence of rigid, lengthy bedtime routines and adaptations within the sleep environment (e.g. specific pajamas, special bedding) to support sleep for children with SP difficulties. Parents of children with SP difficulties also report higher frequencies of an adult being in the room while the child falls asleep and co-sleeping in the middle of the night. Conclusion Parents and children both report poorer sleep in children with SP difficulties when compared to peers. Future studies should incorporate other sleep health measurement tools (e.g. actigraphy) to further understand areas to target for intervention. Support (If Any) Sensory Integration Education Network PhD Grant (PI: Hartman, 2021); University of Pittsburgh’s School of Health and Rehabilitation Science’s PhD Student Award (PI: Hartman, 2021).

State-Level Estimates of the Prevalence of Parent-Reported ADHD Diagnosis and Treatment Among U.S. Children and Adolescents, 2016 to 2019

Objective: To provide state-level estimates of diagnosed ADHD and associated treatment among children in the United States in 2016 to 2019. Method: This study used the National Survey of Children’s Health to produce national and state-level estimates of lifetime diagnosis and current ADHD among all children aged 3 to 17 years (n=114,476), and national and state-level estimates of medication and behavioral treatment use among children with current ADHD. Results: The state-level estimates of diagnosed ADHD ranged from 6.1% to 16.3%. Among children with current ADHD, state-level estimates of ADHD medication usage ranged from 37.8% to 81.4%, and state-level estimates of behavioral treatment ranged from 38.8% to 61.8%. Conclusion: There was substantial state-level variation for indicators of ADHD diagnosis and associated treatment. These state-level results can be used by policymakers, public health practitioners, health care providers, and other stakeholders to help address the service needs of children with ADHD in their states.

Geographical variation in ADHD: do diagnoses reflect symptom levels?

Rates of ADHD diagnosis vary across regions in many countries. However, no prior study has investigated how much within-country geographic variation in ADHD diagnoses is explained by variation in ADHD symptom levels. We examine whether ADHD symptom levels explain variation in ADHD diagnoses among children and adolescents using nationwide survey and register data in Norway. Geographical variation in incidence of ADHD diagnosis was measured using Norwegian registry data from the child and adolescent mental health services for 2011–2016. Geographical variation in ADHD symptom levels in clinics’ catchment areas was measured using data from the Norwegian mother, father and child cohort study for 2011–2016 (n = 39,850). Cross-sectional associations between ADHD symptom levels and the incidence of ADHD diagnoses were assessed with fractional response models. Geographical variation in ADHD diagnosis rates is much larger than what can be explained by geographical variation in ADHD symptoms levels. Treatment in the Norwegian child and adolescent mental health services is free, universally available upon referral, and practically without competition from the private sector. Factors beyond health care access and unequal symptom levels seem responsible for the geographical variation in ADHD diagnosis.

The Effect of SMS Reminders on Adherence in a Self-Guided Internet-Delivered Intervention for Adults With ADHD.

BackgroundSelf-guided Internet-delivered interventions may serve as an accessible and flexible non-pharmacological treatment supplement for adults with ADHD. However, these interventions are challenged by low adherence.ObjectiveTo examine whether weekly SMS reminders improve adherence to a self-guided Internet-delivered intervention for adults with ADHD.MethodThe study used a multiple randomized trial design where the participants who had not completed their weekly module within 2 days were randomized to either receive or not receive an SMS reminder. The primary outcome was adherence, defined as module completion, logins, time spent on intervention, and self-reported practice of coping strategies.ResultsA total of 109 adults with a self-reported ADHD diagnosis were included in the study. The results showed that SMS reminders were associated with an increased likelihood of login within 48 h during the second module of the intervention, but not for the remaining modules. Moreover, receiving an SMS reminder was associated spending more time on the modules and faster login time in module three and five, specifically. However, the overall results did not show an effect of SMS reminders on module completion, number of logins or practice of coping strategies.ConclusionThe results showed that SMS reminders do not improve number of logins, module completion rates or practice of coping strategies, but they may lead to faster login time and more time spent on the modules. To utilize the potential of self-guided Internet-delivered intervention in making non-pharmacological accessible for adults with ADHD, new methods to facilitate meaningful engagement should be developed and tested.Trial RegistrationClinicalTrials.gov NCT04511169.

Clinical and Socio-Demographic Variables Associated with the Diagnosis of Long COVID Syndrome in Youth: A Population-Based Study.

This study examines the demographic, clinical and socioeconomic factors associated with diagnosis of long COVID syndrome (LCS). Data of 20,601 COVID-19-positive children aged 5 to 18 years were collected between 2020 and 2021 in an Israeli database. Logistic regression analysis was used to evaluate the adjusted odds ratio for the characteristics of the COVID-19 infection and pre-COVID-19 morbidities. Children with LCS were significantly more likely to have been severely symptomatic, required hospitalization, and experienced recurrent acute infection within 180 days. In addition, children with LCS were significantly more likely to have had ADHD, chronic urticaria, and allergic rhinitis. Diagnosis of LCS is significantly associated with pre-COVID-19 ADHD diagnosis, suggesting clinicians treating ADHD children who become infected with COVID-19 remain vigilant for the possibility of LCS. Although the risk of severe COVID-19 infection and LCS in children is low, further research on possible morbidity related to LCS in children is needed.

Neurodevelopmental disorders and comorbidity in young adults attending a psychiatric outpatient clinic

“Missed” cases with neurodevelopmental disorders (NDDs) within adult psychiatry services have attracted increasing attention in the last decade. Key questions have been what the prevalence of NDDs (particularly attention-deficit/hyperactivity disorder/ADHD and autism spectrum disorder/ASD) is, and what the clinical and gender characteristics of those with NDD in adult psychiatry are. All first-time attenders at an adult psychiatry clinic serving 18–25 years old were invited to take part in the study regardless of cause of concern. Participation in the study included diagnostic in-depth evaluation performed by experienced adult psychiatrists. Clinical diagnoses (DSM-IV-TR and DSM-5 criteria) were based on all available information (clinical psychiatric interview, clinical observation, and self-rating questionnaires). Almost two thirds (63%) of the study group met criteria for ADHD or ASD. Most of the patients with NDD (particularly the "NDD females") had not been diagnosed in childhood. Twelve percent of the females included had been given an ADHD diagnosis in childhood. In the current study we found that 48% of the females had ADHD. The high male:female NDD ratio reported among children, was not obvious in our NDD group. The results underscore the importance of screening for NDD in adult psychiatric services regardless of referral reason.

A Study on the Parenting Styles and Parental Stress of Parents of (Attention Deficit Hyperactivity Disorder) ADHD Children

Background: There are several steps involved in deciding if a child has ADHD. No single test is available to diagnose ADHD and many other problems such as depression, anxiety, sleep problems and certain types of learning disabilities can also have similar symptoms. One of the process involves doing a medical examination, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosis of ADHD includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child itself. Aim & Objectives: To know the prevalence of psychiatric co-morbidities in ADHD and to assess parental stress and parenting style among parents of children having ADHD.Material & Methods:A total of 78 children (6 to 18 years of age) and their parents were selected for the completion this study. The study was carried out in the Department of Psychiatry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Bivariate table and chi-square/Fisher Exact test were used. Correlation test has also been applied to know the association between demographic variables and their responses. Conclusions:We conclude that specific scales of the CBCL may help to identify specific comorbidities within ADHD cases in the primary care setting.

Mental Health Diagnosis: A Case for Explainable Artificial Intelligence

Mental illnesses are becoming increasingly prevalent, in turn leading to an increased interest in exploring artificial intelligence (AI) solutions to facilitate and enhance healthcare processes ranging from diagnosis to monitoring and treatment. In contrast to application areas where black box systems may be acceptable, explainability in healthcare applications is essential, especially in the case of diagnosing complex and sensitive mental health issues. In this paper, we first summarize recent developments in AI research for mental health, followed by an overview of approaches to explainable AI and their potential benefits in healthcare settings. We then present a recent case study of applying explainable AI for ADHD diagnosis which is used as a basis to identify challenges in realizing explainable AI solutions for mental health diagnosis and potential future research directions to address these challenges.

P58. Impact of Genetic and Environmental Risk Factors on ADHD Diagnosis Among School Aged Children in the ABCD Study

Risk for ADHD is associated with both genetic and environmental factors, but the relative burden of these classes of risk remains uncertain. We sought to determine attributable risk estimates for known genetic and environmental risk factors in a large study of youth age 9-10.