Probable Attention Deficit Hyperactivity Disorder Research Articles

Prevalence of Undiagnosed Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in the Young Adult Population of the United Arab Emirates: A National Cross-Sectional Study

BackgroundAttention deficit hyperactivity disorder (ADHD), a globally prevalent behavioural disorder, remains underdiagnosed, particularly among adults. This issue is exacerbated in the Arab region due to stigma and insufficient healthcare facilities and professionals. Despite the United Arab Emirates (UAE) efforts to improve mental healthcare, shortcomings persist. No studies in the UAE currently assesses the appropriateness of the screening system for ADHD and other behavioural issues. Furthermore, prevalence rates of ADHD, particularly within the young adult population, are absent.AimTo estimate the prevalence of ADHD amongst young adults attending university in UAE and examine its relationship with gender and academic outcomes.MethodsA cross-sectional, correlational design was used. Young adults in their first year at university were recruited from different academic institutions across the UAE. The study utilized the Adult ADHD Self-Report Scale (ASRS) for data collection.ResultsA sample of 406 young adults, aged between 18 and 20 years of age were recruited. Approximately, 34.7% (n = 141) reported symptoms suggestive of probable ADHD. Significantly lower grade point average marks were observed in participants with ADHD symptoms (M = 3.15) compared to those without (M = 3.35). Females reported symptoms of probable ADHD at higher rates than males, indicating possibly a potential screening deficiency and a potential stigma consequence.ConclusionsThe study demonstrates a high prevalence of probable ADHD in young adults, particularly among females attending university in the United Arab Emirates. Implications for early screening, service provision, and greater professional health training on this disorder are required.

Predictors of probable attention deficit hyperactivity disorder in elderly patients with mild cognitive impairment visiting a memory clinic

AbstractAimCharacteristics of attention deficit hyperactivity disorder (ADHD) that persist into old age are often confused with symptoms of mild cognitive impairment (MCI), and the actual rate of probable ADHD in people with MCI is unknown. This study estimated the proportion of MCI patients with probable ADHD and investigated the factors to identify MCI patients with probable ADHD.MethodsWe recruited 36 elderly patients (11 males, 25 females, mean age 72.4 ± 7.6 years) who met the MCI criteria. The MCI patients were classified as those with [MCI/ADHD (+)] and without [MCI/ADHD (−)] probable ADHD, according to the Wender Utah Rating Scale scores. The autism features, inattention, and hyperactivity features during childhood and current periods, estimated intelligence quotient, and demographic data were compared between the groups. Multiple logistic regression analysis was performed to identify factors of MCI/ADHD (+) patients.ResultsNine (25.0%) and 27 patients were added into the MCI/ADHD (+) and MCI/ADHD (−) groups, respectively. The MCI/ADHD (+) group mostly comprised men, those who visited the clinic at a younger age, had more years of schooling, and had strong autism spectrum disorder tendencies. Multiple logistic regression analysis indicated male sex and current hyperactivity as significant predictors of probable ADHD in MCI patients.ConclusionA quarter of the patients with MCI had probable ADHD. Male sex and hyperactivity at the time of MCI diagnosis might help in predicting probable ADHD in MCI patients. However, these results were obtained from a single‐center, small‐case study and should be confirmed via longitudinal studies with a large number of cases.

Frequency of and Factors Associated with the Presence of a History of Probable Attention-Deficit Hyperactivity Disorder in a Population of Patients with Sex Addiction

Introduction: Since the first description of sex addiction (SA) by Carnes, research on this problematic behaviour has continued to grow, and the association with attention-deficit hyperactivity disorder (ADHD) appears to be frequent. This study aimed to estimate the frequency of a history of probable ADHD in a population of patients with SA and to explore the factors associated with it. Methods: One hundred 85 patients referred to the Nantes University Hospital for SA between 2011 and 2020 were included. Patients completed the Sexual Addiction Screening Test (SAST) or its revised version (SAST-R) to establish the presence of SA. As the SAST-R was not validated in French, we conducted a validation study for the French version. ADHD was screened using the Wender-Utah Rating Scale in childhood and the Adult ADHD Self-Report Scale in adulthood. A multivariate logistic regression model was used to identify factors associated with the presence of a history of probable ADHD. Results: Childhood ADHD was identified in 36% of patients with SA. Factors associated with the presence of a history of probable ADHD were a low education level, an earlier age of onset of problematic sexual behaviour, another addictive disorder, an anxiety disorder, impulsivity (high negative urgency score), and high scores on harm avoidance and novelty-seeking temperament scales. Furthermore, the French version of the SAST-R displayed good psychometric properties, especially excellent sensitivity. Conclusion: The frequency of a history of probable ADHD among patients with SA is consistent with the literature and close to the highest range. Specific personality traits in patients with both SA and a history of probable ADHD could induce lasting problems of adaptation, which may precipitate the development of SA or maintain it.

Polygenic risk score for attention-deficit/hyperactivity disorder and brain functional networks segregation in a community-based sample.

Neuroimaging studies suggest that brain development mechanisms might explain at least some behavioural and cognitive attention-deficit/hyperactivity disorder (ADHD) symptoms. However, the putative mechanisms by which genetic susceptibility factors influence clinical features via alterations of brain development remain largely unknown. Here, we set out to integrate genomics and connectomics tools by investigating the associations between an ADHD polygenic risk score (ADHD-PRS) and functional segregation of large-scale brain networks. With this aim, ADHD symptoms score, genetic and rs-fMRI (resting-state functional magnetic resonance image) data obtained in a longitudinal community-based cohort of 227 children and adolescents were analysed. A follow-up was conducted approximately 3 years after the baseline, with rs-fMRI scanning and ADHD likelihood assessment in both stages. We hypothesised a negative correlation between probable ADHD and the segregation of networks involved in executive functions, and a positive correlation with the default-mode network (DMN). Our findings suggest that ADHD-PRS is correlated with ADHD at baseline, but not at follow-up. Despite not surviving for multiple comparison correction, we found significant correlations between ADHD-PRS and segregation of cingulo-opercular networks and DMN at baseline. ADHD-PRS was negatively correlated with the segregation level of cingulo-opercular networks but positively correlated with the DMN segregation. These directions of associations corroborate the proposed counter-balanced role of attentional networks and DMN in attentional processes. However, the association between ADHD-PRS and brain networks functional segregation was not found at follow-up. Our results provide evidence for specific influences of genetic factors on development of attentional networks and DMN. We found significant correlations between polygenic risk score for ADHD (ADHD-PRS) and segregation of cingulo-opercular networks and default-mode network (DMN) at baseline. ADHD-PRS was negatively correlated with the segregation level of cingulo-opercular networks but positively correlated with the DMN segregation.

Dissociative Absorption May Contribute to Internet Gaming Disorder Independent of Childhood Trauma and ADHD Symptoms Among Male University Students.

We aimed to investigate the relationship between childhood trauma, dissociative experiences, and internet gaming disorder in male university students with probable attention-deficit hyperactivity disorder determined by both childhood and current attention-deficit hyperactivity disorder symptoms. Volunteers were 376 university students who completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale, Wender Utah Rating Scale, Childhood Trauma Questionnaire, Dissociative Experiences Scale, Somatoform Dissociation Questionnaire, and Internet Gaming Disorder Scale-Short Form. Volunteers were divided into 2 groups as with and without probable attention-deficit hyperactivity disorder D based on both childhood and current attentiondeficit hyperactivity disorder symptoms. Childhood Trauma Questionnaire (t=-3.94; P < .01), Dissociative Experiences Scale (t=-5.97; P < .01), Somatoform Dissociation Questionnaire (t=-3.80; P < .01), and Internet Gaming Disorder Scale-Short Form (t=-5.21; P < .01) scores were significantly higher in the group with probable attentiondeficit hyperactivity disorder than in those without. Two different hierarchical regression analysis models in which internet gaming disorder scores were dependent variables showed that dissociative experiences in first model (β=0.15, t=2.28, P = .023) and dissociative absorption in second model (β=0.22, t=2.76, P = .006) were associated with internet gaming disorder after controlling for childhood trauma and attentiondeficit hyperactivity disorder symptoms. Dissociative absorption may contribute to internet gaming disorder independent of childhood trauma and attention-deficit hyperactivity disorder symptoms, however further studies are needed to investigate this claim.

Attention-deficit/hyperactivity disorder (ADHD) in adult obese patients referred to bariatric surgery

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by symptoms of inattention, hyperactivity, and impulsivity, which only rarely remits in adulthood[1]. A positive association between ADHD and obesity has been repeatedly observed, especially in adult samples[2]. However, only a few studies investigated the prevalence and correlates of ADHD in obese patients seeking bariatric treatment[3,4].ObjectivesOur study was aimed to examine the prevalence of probable ADHD comorbidity in a sample of obese patients referred for bariatric surgery. Secondly, we sought to characterize differences in eating behaviour between obese subjects with and without probable ADHD.MethodsThe study sample was composed of 110 adult obese patients (BMI ≥ 30 kg/m2) consecutively referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between November 2010 and May 2012. Probable ADHD was identified using a recently developed screening scale based on items selected from Symptom Check‐List‐90‐R (SCL-90-R)[5]. The extent of binge-eating/purging and night-eating behaviours were respectively estimated using the Bulimic Investigatory Test, Edinburgh (BITE)[6] and the Night-eating Questionnaire (NEQ)[7]. Wilcoxon test was used for statistical comparisons, with a significance level of p&lt;0.05 set for all tests.ResultsProbable ADHD was found in 14 subjects (12.7%, 95%CI=7.1-20.4%). Patients with probable ADHD showed significantly higher BITE symptom score (20.4±9.3 vs. 12.1±7.5, r=0.31, p=0.001) and NEQ total score (16.1±9.2 vs. 9.5±3.9, r=0.27, p=0.005).ConclusionsADHD is a relatively common comorbidity in obese patients seeking bariatric treatment, which is positively associated with disordered eating habits, such as binge-eating/purging and night-eating behaviours.DisclosureNo significant relationships.

Internet gaming disorder’s correspondence with attention deficit hyperactivity disorder and game/in-game purchases among university students

This study investigated the relationship between internet game addiction, attention deficit hyperactivity disorder (ADHD), and the online gaming characteristics of 290 university students in 11 faculties. The students completed questionnaires on their socio-demographic characteristics, personal habits like smoking, drinking, and game/in-game purchasing attitudes. They completed the Computer Gaming Addiction Scale (CGAS) and Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS). The data indicated that 9.3% of the study sample was addicted to gaming. The students who played action/adventure, shooter, and strategy games had higher CGAS scores, and those who played action games had higher ASRS total scores (p < 0.05). The CGAS scores of students and the amount of money they spent on game purchases and in-game purchases were positively correlated. The logistic regression analysis showed that male gender and computer game addiction scores were determinants for game purchases. However, the factors determining in-game purchases were male gender, CGAS score, and probable ADHD hyperactivity impulsivity dominant type. Young adults with hyperactivity and impulsivity predominant ADHD may be prone to excessive in-game purchases.

Comorbidity of ADHD and allergic diseases in early adolescence: The role of parental smoking at home.

A growing body of research suggests an association between attention deficit hyperactivity disorder (ADHD) and allergic disorders, but little work has been done to explore the role of external factors such as parental smoking at home in the development of comorbid ADHD and allergic disorders. This study aimed to examine the association between allergic diseases and ADHD adjusted for exposure to parental smoking at home in early adolescents. We recruited 250 male (41.7%) and 350 female (58.3%) adolescents (mean [SD] age, 13.29 [0.52] years) via chain-referral sampling. Their ADHD symptoms were assessed by the parent proxy-report version of the Chinese Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviours (SWAN) rating scale. Data on the participants’ history of clinician-diagnosed allergic diseases, family socio-demographics, and parental smoking habit were collected using a parent-completed questionnaire. Regression analyses were performed to examine the associations of interest. The levels of ADHD symptoms were comparable between allergic and non-allergic participants after controlling for child and family demographics and parental smoking at home. Notably, the risk of probable ADHD was particularly high in participants with food allergies (odd ratio = 4.51, p = 0.011) but not in those with allergic rhinitis after adjusting for parental smoking at home. Our findings suggest that second-hand smoke exposure at home is a potential risk factor underlying the link between ADHD and allergic diseases. Current management guidelines should emphasize the importance of early identification and cessation of tobacco smoke exposure for prevention of comorbidity of ADHD and allergic disorders.Clinical Trial Registration (if any): NA.

Do Emotion Dysregulation, Alexithymia and Personality Dimensions Explain the Association Between Attention-Deficit/Hyperactivity Disorder and Binge Eating Among Bariatric Surgery Candidates?

Background: Addictive-like eating and attention-deficit/hyperactivity disorder (ADHD) are both common among persons seeking treatment for severe obesity. Given that ADHD and addictive-like eating, especially binge eating (BE) and food addiction (FA), are both strongly associated with personality dimensions and emotion dysregulation, it is possible emotional and personality characteristics contribute to the link between addictive-like eating behaviors and ADHD in people with severe obesity. This study aimed to investigate the psychological factors associated with BE and FA in bariatric surgery candidates, and to explore the mediational role of emotional factors (emotion dysregulation and alexithymia) and personality dimensions in the association between ADHD and BE.Method: Two hundred and eighty-two (n = 282) bariatric surgery candidates were recruited during the systematic preoperative psychiatric assessment (University Hospital of Tours, France). We assessed significant BE (Binge Eating Scale), probable adult ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (Yale Food Addiction Scale 2.0, YFAS 2.0), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), alexithymia (Toronto Alexithymia Scale-20) and personality dimensions (Big Five Inventory). Mediation analyses were performed using the PROCESS macro for IBM SPSS Statistics 22.Results: Prevalence of probable adult ADHD, significant BE and FA were 8.2, 19.1, and 26.6%, respectively. Participants who screened positive for addictive-like eating showed higher prevalence of probable adult ADHD, as well as higher scores on adult and childhood ADHD symptoms. They also reported lower conscientiousness, but higher emotion dysregulation, higher alexithymia, and higher neuroticism. Only BE (as opposed to FA) was also associated with lower scores on agreeableness and openness. Analysis of the association between adult ADHD and BE suggests that emotion dysregulation, conscientiousness, agreeableness, and neuroticism are total mediators and alexithymia a partial mediator.Conclusion: Our findings suggest a significant association between ADHD and addictive-like eating among bariatric surgery candidates, and also suggest a significant role of emotion dysregulation and personality dimensions in this association. For individuals with ADHD and obesity, eating may be a way to cope with negative emotions, potentially increasing the risk for addictive-like eating behavior.

Prevalence of probable attention-deficit/hyperactivity disorder in inmates and its relationship with recidivism.

The aim of the current study was to determine the prevalence of probable attention-deficit/hyperactivity disorder (ADHD) in prisoners and to assess the relationship between ADHD and recidivism. We studied 356 inmates, who were evaluated using the Wender Utah Rating Scale and Adult ADHD Self-Report Scale. Type of crime and other crime-related data were compared between inmates with and without ADHD. The group with probable ADHD had a higher average number of convictions compared to the group without ADHD. The probable ADHD group also demonstrated higher incidence of extortion crime, drug trade, disciplinary action at school, and military service than the group without ADHD. Linear regression analysis revealed that the presence of probable ADHD was effective on the number of convictions. The findings of our study support that the presence of probable ADHD carries a potential risk of being prone to certain crimes and demonstrate a correlation between the presence of probable ADHD and early involvement in crime and the number of convictions.

The relationship between probable ADHD and playing MMORPGs with the severity of disordered gaming: The effect of gaming motivations

Objective: The main aim of the present study was to consider the impact of gaming motivations among young adults when evaluating the relationship between probable attention deficit hyperactivity disorder (ADHD) and massively multiplayer online role-playing games (MMORPGs), with disordered gaming. Method: In the present study, participants were assessed with the Adult ADHD Self-Report Scales (ASRS-v1.1), the Motives for Online Gaming Questionnaire (MOGQ), and the nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Results: Participants with probable ADHD (n=143, 19.2%) and without probable ADHD (n=602, 80.8%) did not differ according to the current age, gender, presence of romantic relationship, marital status, where and with whom they are living, employment status and time spent on the gaming. Compared to participants without probable ADHD, those with probable ADHD had higher rates of having a game console, purchasing games, gaming more than usual on weekends, having problems related to gaming, probable internet gaming disorder (IGD) according to IGDS9-SF cut-off score and higher scales scores (IGDS9-SF and MOGQ), whereas they had a lower age at first gaming. Among different game types, those with probable ADHD were gaming more with multiplayer online battle arena games, social network games, music games, MMORPGs, sports games/car games, and horror-themed/survival games. Scores of all six types of gaming motives were higher among those with probable ADHD, and among them coping/escape, social, skill development, and fantasy distinguished the presence of probable ADHD. In the ANCOVA analysis, the presence of probable ADHD and the use of MMORPGs (as well as online gaming motives [coping/escape, recreation, fantasy, social and competition]) predicted the severity of IGD symptoms, and also these effects also interacted, involving probable ADHD and using MMORPGs. Conclusion: These findings suggest that those with probable ADHD may have different gaming characteristics than those without probable ADHD. Probable ADHD and using MMORPGs are related to the severity of disordered gaming, along with almost all type of online gaming motivations. Also, the effects of probable ADHD and MMORPGs use interacted with each other.

The association of probable ADHD with the increase in video gaming and the disordered gaming symptom severity during COVID-19 pandemic in Turkey

Objective: The objective of the study is to examine the association of probable attention deficit hyperactivity disorder (ADHD) with the increase in video gaming and the severity of disordered gaming symptoms among young adults during the COVID-19 pandemic restrictions. The second objective was to examine the mediating role of COVID-19 related dysfunctional anxiety and current age. Methods: The Adult ADHD Self-Report Scale (ASRS-v1.1), the nine-item Internet Gaming Disorder Scale- Short Form (IGDS9-SF), and the Coronavirus Anxiety Scale (CAS) were used to evaluate university students. Results: Participants with probable ADHD (n=117, 21.2%) did not differ in terms of age, gender, romantic relationship, employment status, and time spent on the gaming when compared with participants without probable ADHD (n=441, 79.0%). However, they had a higher rate of problems related to gaming, diagnosis of anxiety disorder before the COVID-19 pandemic and higher scale scores (IGDS9-SF and CAS). In the hierarchical logistic regression analysis, probable ADHD predicted the increase in video gaming during the pandemic, but when the current age and the dysfunctional anxiety related with COVID-19 were included in the analysis, they were significant predictors, whereas probable ADHD was no more a predictor. While probable ADHD was associated with the symptom severity of disordered gaming in ANCOVA, COVID-19 related dysfunctional anxiety was a significant covariate. Conclusion: Findings of the current study may suggest that the relationship between probable ADHD and the increase in video gaming during the pandemic was mediated by lower age and COVID-19 related dysfunctional anxiety among young adults. Additionally, while COVID-19 related dysfunctional anxiety was a significant covariate for the severity of disordered gaming symptoms, probable ADHD was independently associated with the symptom severity of disordered gaming.

Alcohol- and cigarette-use-related behaviors across gender, dysfunctional COVID-19 anxiety, and the presence of probable ADHD during the pandemic: A cross-sectional study in a sample of Turkish young adults

Objective: The objective of the study is to evaluate the alcohol- and cigarette-use-related behaviors among young adults during the COVID-19 pandemic restrictions in Turkey. The second objective was to evaluate whether the gender, dysfunctional COVID-19 anxiety, and presence of probable attention-deficit/hyperactivity disorder (ADHD) are associated with the increase in alcohol consumption and cigarette smoking while controlling the effects of current age and diagnosis of anxiety disorder before the COVID-19 pandemic. Method: The study was conducted with an online survey among volunteer participants of young adults. The Adult ADHD Self-Report Scale (ASRS-v1.1) and the Coronavirus Anxiety Scale (CAS) were used to evaluate a group of university students. Results: A total of 1,042 respondents (mean age 26.9±10.9 years; 61.6% female) filled out the survey. Of these, 17.6% reported an increase and 7.7% reported reduced cigarette smoking, whereas 10.8% reported an increase and 8.5% reported reduced alcohol consumption during the pandemic. Both rates of increased cigarette smoking and alcohol consumption were higher among males and those with probable ADHD. In the logistic regression analyses, male gender, COVID-19 related dysfunctional anxiety, and presence of probable ADHD were related to the increase in alcohol consumption and cigarette smoking, while the current age and diagnosis of anxiety disorder before the COVID-19 pandemic were not. Conclusion: Findings of the current study may suggest that the pandemic period is related to both anv increase and a reduction of alcohol consumption and cigarette smoking. Males with probable ADHD and higher levels of COVID-19 related dysfunctional anxiety have a higher risk of increasing both alcohol consumption and cigarette smoking.

Attainment, attendance, and school difficulties in UK primary schoolchildren with probable ADHD.

Among children aged 6-16, there is a clear association between attention-deficit/hyperactivity disorder (ADHD) symptoms and academic attainment. We wanted to know whether this association was replicated in younger children. To explore the relationship between children aged 4-8 with probable ADHD and their academic attainment and school attendance. Secondly, the study aimed to explore their behaviour within school and their reported attitudes towards school. A total of 1,152 children who were taking part in the Supporting Teachers and Children in Schools (STARS) cluster randomized controlled trial. ADHD status was established by using the Strengths and Difficulties Questionnaire predictive algorithm to identify children with probable ADHD. Using baseline data, random-effects regression models on ADHD status were fitted to attainment, attendance, special educational needs (SEN) provision, and attitudes towards school and classroom behaviour; models that were also fitted to attainment were evaluated again at 9, 18, and 30months after baseline. Children with probable ADHD (n=47) were more likely than controls (n=1,105) to have below-expected attainment in literacy (odds ratio (OR) 16.7, 95% CI 6.93-to-40.1), numeracy (OR 11.3, 95% CI 5.34-to-24.1) and to be identified as having SEN (OR-55.2, 95%-CI 22.1-to-137). Their attendance was poorer with more unauthorized absences (rate ratio (RR)-1.91, 95%-CI-1.57-to-2.31). They had more teacher-reported behavioural problems (mean difference (MD) 5.0, 95%-CI 4.6-to-5.4) and less positive attitudes towards school (MD -1.1, 95% CI -0.56 to -1.85). Poorer attainment in literacy and numeracy persisted at all follow-ups. Children aged as young as 4 whose behaviour indicates probable ADHD struggle to cope at school in terms of academic attainment, attendance, classroom behaviour, and attitude towards school when compared to other children. Early identification and intervention to help these children manage in school are needed.

Conduct disorder and attention-deficit/hyperactivity disorder as risk factors for prescription opioid use

BackgroundExisting studies of attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and substance use or substance use disorders have produced mixed results, with some identifying a direct link between ADHD and general or disordered substance use and others suggesting that comorbid CD may explain this relationship. Insufficient research has addressed the issue, which is particularly relevant in the context of the opioid crisis. This study examined the association of probable ADHD and childhood CD with self-reported opioid use in a general-population sample. MethodThe 2011–2013 cycles of the CAMH Monitor, a cross-sectional survey of adults (18+ years) from Ontario, Canada provided data from 6074 respondents. Binary logistic regressions were conducted of self-reported medical, non-medical, and any prescription opioid use in the previous 12 months, assessing demographic characteristics, perceived physical and mental health, and probable ADHD, childhood (before age 15 years) symptoms of CD, or their combination. ResultsAdjusting for potential covariates, probable ADHD alone was not associated with prescription opioid use. Childhood symptoms of CD significantly predicted non-medical use (OR = 2.10, 95% CI = 1.10, 4.03). ADHD and CD symptoms combined significantly predicted medical (OR = 3.27, 95% CI = 1.20, 8.91), non-medical (OR = 4.73, 95% CI = 1.05, 21.30), and any (OR = 3.02, 95% CI = 1.13, 8.11) prescription opioid use, although a low base rate of non-medical use may have negatively affected model fit. ConclusionsPrevious findings relating ADHD to opioid use could be explained, in part, by the high rate of comorbidity between ADHD and CD. These data support prevention and treatment programs targeting individuals with comorbid ADHD and CD symptoms.

Increased prevalence of inattention-related symptoms in a large cohort of patients with congenital heart disease.

The objective of this study is to assess the prevalence and risk factors for attention-deficit hyperactivity disorder (ADHD) in a large cohort of patients with congenital heart disease (CHD). Patients (n = 695) with CHD who were aged 6-15years and visited the outpatient clinics in our hospital from June 2015 to May 2017 were enrolled. Their medical records were collected, and the Chinese version of the Swanson, Nolan, and Pelham rating scale (SNAP-IVc) and a questionnaire about neuropsychiatric care-seeking behavior were completed by parents and counselors. Of the 695 patients, the overall prevalence of ADHD was 12.4%, including 3.2% for the combined subtype, 6.8% for the inattentive-predominant subtype, and 2.4% for the hyperactivity/impulsive-predominant subtype. Only the inattention-predominant subtype was significantly more prevalent than in the general population. The prevalence of the inattention-predominant subtype was highest in the patients with cyanotic CHD, high severity index, and in those who had received surgery or cardiopulmonary bypass. Multivariate regression analysis indicated that the risk factors for inattention-related symptoms included postoperative seizure and previous cardiopulmonary bypass (odds ratio: 3.22 and 3.82; P = 0.027 and < 0.001, respectively). Only 58.7% of the patients with probable ADHD ever sought neuropsychiatric care, and only 27% regularly attended neuropsychiatric clinics. The inattention-predominant subtype of ADHD was more prevalent in our CHD patients, especially in those with cyanotic CHD, higher disease severity index, and in those who had undergone a surgical intervention. The percentage of patients receiving regular neuropsychiatric clinic follow-up was low.

Relationships of Internet addiction and Internet gaming disorder symptom severities with probable attention deficit/hyperactivity disorder, aggression and negative affect among university students.

The aim of the present study was to evaluate relationships of Internet addiction (IA) and Internet gaming disorder (IGD) symptom severities with probable attention deficit/hyperactivity disorder (ADHD) and aggression among university students, while controlling the effects of anxiety and depressive symptoms. The study was conducted with online survey among 1509 volunteered university students in Ankara who regularly use the Internet, among whom we conducted analyses related with IA. Among these students, 987 of them, who play video games, were included in the analyses related with IGD. Correlation analyses revealed that the severities of the scale scores were mildly correlated with each other both among students who regularly use the Internet and students who play video games. Probable ADHD was associated with the severity of IA symptoms, together with depression and aggression, particularly physical aggression and hostility, in ANCOVA analyses. Similarly probable ADHD was also associated with the severity of IGD symptoms, together with depression and aggression, particularly physical aggression, anger and hostility, in ANCOVA analyses. These findings suggest that the presence of probable ADHD is related with both severity of IA and IGD symptoms, together with aggression and depression.

Association of symptoms of attention deficit-hyperactivity disorder and impulsive-aggression with severity of suicidal behavior in adult attempters

Literature emphasizes the relationship between attention deficit-hyperactivity disorder (ADHD) and suicidal behavior (SB). However, the link between ADHD and the severity of SB is yet to be determined. We investigated the association between a probable diagnosis of ADHD and the severity of SB in 539 hospitalized suicide attempters, and determined the role of comorbid psychiatric diagnoses. The severity of SB was defined as the number of suicide attempts, age at first suicide attempt, seriousness and violence of suicide attempts. A diagnosis of probable adult ADHD (probable ADHD) was defined as the presence of both current ADHD symptoms and ADHD symptoms in childhood. We evaluated the combined effect of high impulsive-aggression levels and probable ADHD. Probable ADHD was not associated with early or frequent suicide attempts after adjustment for psychiatric disorders and treatment intake. High levels of impulsive-aggression increased the risk of an early suicide attempt, particularly in patients with ADHD symptoms, and independently of other clinical factors. The association between serious suicide attempts and probable ADHD remained significant after adjustment. Although ADHD is involved in suicidal vulnerability, psychiatric comorbidities and impulsive-aggression appear to largely explain the severity of SB in adult attempters with ADHD symptoms.

The impact of depression, anxiety, neuroticism, and severity of Internet addiction symptoms on the relationship between probable ADHD and severity of insomnia among young adults

The aim of the present study was to evaluate the impact of depression, anxiety, neuroticism, and severity of Internet addiction symptoms (IAS) on the relationship between probable attention deficit/hyperactivity disorder (ADHD) and severity of insomnia among young adults. The study was conducted with online survey among 1010 volunteered university students in Ankara, people who are in the e-mail database of a company located in Istanbul that organizes e-sports tournaments and Turkish gamers from gaming forums. Scale scores were higher among the group with high probability of insomnia (n = 200, 19.8%). Also risk of high probability of insomnia was 2.7 times higher among those with probable ADHD. In linear regression analysis, both inattentiveness and hyperactivity/impulsivity dimensions of ADHD were related with the severity of insomnia, together with severities of anxiety, depression, neuroticism and IAS. Similarly, presence of probable ADHD was related with the severity of insomnia in ANCOVA, together with severities of anxiety, depression, neuroticism and IAS. These findings suggest that the presence of probable ADHD and the severity of ADHD symptoms are related with the severity of insomnia, even after controlling the depression, anxiety, neuroticism and IAS, which are all related with the severity of insomnia, among young adults.

Relationship of internet addiction severity with probable ADHD and difficulties in emotion regulation among young adults

The aim of the present study was to evaluate relationship of Internet addiction (IA) symptom severity with probable attention deficit/hyperactivity disorder (ADHD) and difficulties in emotion regulation, while controlling the effects of depression, anxiety and neuroticism. The study was conducted with online survey among 1010 volunteered participants of university students and/or amateur or professional gamers. Scale scores were higher among the group with high probability of ADHD (n = 190, 18.8%). In linear regression analysis, both Inattentiveness and hyperactivity/impulsivity dimensions of ADHD were related with the severity of IA symptoms, together with depression and non-accept dimension of the Difficulties in Emotion Regulation Scale (DERS). Similarly, presence of probable ADHD was related with the severity of IA symptoms in ANCOVA, together with depression, neuroticism and non-accept dimension of DERS. Participants were two different groups of non-clinical samples and all scales were self-rated. Also common comorbidities were not screened. Finally, since this study is cross-sectional the findings of this study cannot address the causal relationships among the primary constructs of interest. These findings suggest that the presence of probable ADHD is related with the severity of IA symptoms, together with the difficulties in emotion regulation, particularly non-accept dimension, depression and neuroticism among young adults.