Psychiatric Comorbidity In Adults Research Articles

Psychiatric Comorbidities in Adults with Epilepsy: A Systematic Review

Abstract Epilepsy is a chronic neurological condition that is highly predisposed to a variety of mental health problems. This systematic literature review identified original research articles that reported the prevalence of psychiatric comorbidities based on clinical assessments amongst patients with epilepsy (PWE). The included articles were published from 2000 to 2022 and focused on adults aged ≥18 years who had psychiatric diagnoses. The primary outcome was the prevalence of psychiatric comorbidities amongst PWE. A modified Newcastle–Ottawa Scale was used to assess the quality of the studies. Thirty-three articles were reviewed in full-text screening. Out of these, 15 articles that were consistent with the inclusion criteria were included in our systematic review. This protocol was registered in PROSPERO with registration ID CRD42023461739. General Anxiety Disorder and Major Depressive Disorder were the most common psychiatric comorbidities, with prevalence rates of 20.14% and 23.94%, respectively. Other reported comorbidities included post-traumatic stress disorder (8.3%), obsessive–compulsive disorder (2.9%), bipolar disorder (7.1%), psychosis (8.2%) and phobia (18.25%). These findings suggest that screening tools for depression and anxiety should be included as part of the training for epilepsy care.

Mental Health Care Needs and Access to Care for Adults With Intellectual Disabilities.

Adults with intellectual disabilities (IDs) are at greater risk for psychiatric disorders than the general population. Yet, they have limited access to mental health services. To examine the prevalence of psychiatric disorders in adults with ID. To describe evidence-based interventions for this population, their access to mental health care, and outline opportunities for improved access. This manuscript summarizes literature regarding psychiatric disorders in adults with ID and their access to behavioral health care. We considered articles referencing mental health care for adults with ID. PubMed and a variety of search terms were used. Studies published in English from 2010 to the date of the searches were included. Quantitative and qualitative study designs, review articles, program descriptions, and opinion papers were considered for inclusion. Additional references from the selected articles were also considered. We identified 2864 records. One hundred two records were included, consisting of work commenting on mental health and ID and access to care in the United States. The articles describe increased psychiatric comorbidities in adults with ID. They highlight the few evidence-based interventions for psychiatric comorbidities and the limited access to care. Our mental health care providers generally have minimal training and experience with people with ID, limiting access to appropriate care for these individuals. Improved access could be created by increasing education and experiences with these populations for mental health providers. Aligning policies, financing, and adequate insurance reimbursement to develop a continuum of care will be critical for these individuals.

Mindfulness-Based Stress Reduction in the Treatment of Adults with Autism Spectrum Disorder: a Systematic Review of Interventional Studies

AbstractAdults with autism spectrum disorder (ASD) have a lower quality of life (QoL) than neurotypical adults and a higher risk of psychiatric comorbidities. We reviewed the effectiveness of mindfulness-based stress reduction (MBSR) in the treatment of adults with ASD. Data were collected from 6 eligible interventional studies (4 adequate quality, 2 weak quality; 245 total participants). The study quality and certainty of findings were assessed using Evaluative Method for Determining Evidence-Based Practices in Autism and GRADE framework. MBSR was effective in all outcomes: ASD symptoms (n = 4, low certainty), QoL (n = 5, low certainty), symptoms of anxiety and depression (n = 4, low and moderate certainty, respectively). MBSR shows promise for improving QoL, reducing ASD symptoms and alleviating psychiatric comorbidities in adults with ASD.

Psychiatric comorbidities in adults with sickle cell disease: A narrative review.

Although descriptions of quality of life and patient reports of mood in sickle cell disease (SCD) have become more common in the literature, less is known about psychiatric illness prevalence, presentation, and treatment, particularly for adults. We provide a narrative review of what is known about common and debilitating psychiatric conditions such as depression, anxiety, and cognitive impairment, specifically for adults with SCD. We discuss the limitations of the current evidence, make provisional recommendations, and identify opportunities for research and improved care.

In silico evaluation of the role of lisdexamfetamine on attention-deficit/hyperactivity disorder common psychiatric comorbidities: mechanistic insights on binge eating disorder and depression.

Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric condition well recognized in the pediatric population that can persist into adulthood. The vast majority of patients with ADHD present psychiatric comorbidities that have been suggested to share, to some extent, the pathophysiological mechanism of ADHD. Lisdexamfetamine (LDX) is a stimulant prodrug approved for treating ADHD and, in the US, also for binge eating disorder (BED). Herein, we evaluated, through a systems biology-based in silico method, the efficacy of a virtual model of LDX (vLDX) as ADHD treatment to improve five common ADHD psychiatric comorbidities in adults and children, and we explored the molecular mechanisms behind LDX's predicted efficacy. After the molecular characterization of vLDX and the comorbidities (anxiety, BED, bipolar disorder, depression, and tics disorder), we created a protein-protein interaction human network to which we applied artificial neural networks (ANN) algorithms. We also generated virtual populations of adults and children-adolescents totaling 2,600 individuals and obtained the predicted protein activity from Therapeutic Performance Mapping System models. The latter showed that ADHD molecular description shared 53% of its protein effectors with at least one studied psychiatric comorbidity. According to the ANN analysis, proteins targeted by vLDX are predicted to have a high probability of being related to BED and depression. In BED, vLDX was modeled to act upon neurotransmission and neuroplasticity regulators, and, in depression, vLDX regulated the hypothalamic-pituitary-adrenal axis, neuroinflammation, oxidative stress, and glutamatergic excitotoxicity. In conclusion, our modeling results, despite their limitations and although requiring in vitro or in vivo validation, could supplement the design of preclinical and potentially clinical studies that investigate treatment for patients with ADHD with psychiatric comorbidities, especially from a molecular point of view.

Psychiatric Comorbidities in Adults with DiGeorge Syndrome.

ObjectiveDiGeorge Syndrome (DGS) is a common multisystem disorder associated with deletions on chromosome 22q11.2. Our objective is to evaluate the psychiatric comorbidities and demographics of patients suffering from DGS in a nationally representative dataset on inpatient hospitalizations.MethodsThe Nationwide Inpatient Sample for the year 2005−2017 was used for this study. Data on patients with DiGeorge syndrome were collected by using the International Classification of Diseases code. Univariate and multivariate logistic regression analysis was performed.ResultsIn our study, the average age was 30.4 years (n = 6,563), with 59.9% male, and 61.8% of patients were white. There was a high prevalence of mood disorders (24.7%) and anxiety disorders (16.4%), followed by schizophrenia and other psychotic condition (14.0%). In patients with mood disorders, 8% had Major Depressive Disorder, and 7% had bipolar depression. Overall composite of psychiatric comorbidities was present in 2,959 (45.1%) of patients. The mean length of stay was 6.58 days, and 77% of patients had routine discharge to home. In the adjusted analysis, the average length of stay was 8.6 days vs. 6.7 days (p < 0.001) in patients with and without psychiatry comorbidities. In comparison to routine discharge, patients with psychiatry comorbidities were more likely to be discharged to other healthcare facilities (odds ratio [OR] 1.28, p < 0.001) and discharged against medical advice (OR 3.45, p < 0.001).ConclusionPatients with DGS have worse outcomes with a higher rate of discharge to other healthcare facilities and a higher rate of being discharged against medical advice. Further large scale randomize studies are indicated.

Gender Differences in Misdiagnosis and Delayed Diagnosis among Adults with Autism Spectrum Disorder with No Language or Intellectual Disability.

Autism Spectrum Disorder (ASD) is often unrecognized, especially in mild forms and in women. Studies evaluating features associated with missed/misdiagnosis in men and women with ASD are warranted. 61 subjects (22 females, 39 males, age 28.5 ± 10.8 years) with ASD with no language/intellectual deficit were enrolled in the service for the treatment of psychiatric comorbidities in adults with ASD of the ASST Fatebenefratelli-Sacco in Milan (Italy). A detailed clinical history was gathered, and two self-report questionnaires (Autism Spectrum Quotient-AQ and Adult Autism Subthreshold Spectrum-AdAS Spectrum) were administered. 75.4% received their ASD diagnosis average eight years later than the first evaluation by mental health services. Compared to males, females showed a significantly greater delay in referral to mental health services and a significantly higher age at diagnosis of ASD. Among men, diagnostic delay inversely correlated with scores on the AdAS Spectrum total, Verbal communication, Empathy and Inflexibility and adherence to routine domains. Among women, diagnostic delay positively correlated with the Attention to detail score while the age at diagnosis of ASD positively correlated with the AdAS Spectrum Verbal communication and Restricted interests and rumination domain scores. Females were less likely to be correctly diagnosed and more likely to be misdiagnosed at first evaluation than men. Females reported significantly higher scores than men in the Hyper/Hyporeactivity to sensory input domain only among subjects who were misdiagnosed. Our findings provide gender-specific information about ASD patients seeking help for comorbid conditions and might be a primary ground for future research.

Systematic Literature Review of Psychiatric Comorbidities in Adults with Epilepsy.

Background and PurposeMental illness is disproportionately common in people with epilepsy (PWE). This systematic literature review identified original research articles that reported the prevalence of psychiatric comorbidities based upon clinical assessments in a sample of PWE and assessed the clinical features of the populations found in studies included in our review of mental health comorbidity.MethodsThe included articles were written in English and published from 2008 to 2018, and focused on adults aged ≥18 years who had psychiatric diagnoses determined in clinical assessments, such as those found in medical records, clinician psychiatric evaluations, structured diagnostic interviews, and mental health screening questionnaires specific for a psychiatric disorder. The primary outcome was the prevalence of psychiatric comorbidities as a percentage of the total sample of PWE. Additional data included the overall sample size, mean age, epilepsy type, study design, and method of diagnosis. A modified Newcastle Ottawa Scale was used to assess the quality of the studies. All 23 articles that were consistent with the inclusion criteria were related to observational studies.ResultsMood disorders and anxiety disorders were the most common psychiatric comorbidities, with prevalence rates of 35.0% and 25.6%, respectively. Major depressive disorder was the most common mood disorder, with a prevalence of 24.2%. Post-traumatic stress disorder (PTSD) had the highest reported prevalence among anxiety disorders, at 14.2%, followed by general anxiety disorder at 11.1%. Other comorbidities included psychosis (5.7%), obsessivecompulsive disorder (3.8%), schizophrenia (1.7%), bipolar disorder (6.2%), and substance abuse (7.9%). The pooled prevalence of suicidality, as reported for two studies, was 9.3%. Temporal lobe epilepsy (TLE) was associated with higher levels of psychiatric comorbidity. Two (8.7%) of the 23 studies compared psychiatric comorbidities in TLE with that of extratemporal lobe epilepsy (ETLE), and one of these two studies found that depression was more common in TLE (53.8%) than in ETLE (25%). Regarding seizure types, partial seizures were associated with a higher prevalence of depression vs generalized seizures.ConclusionsThis systematic literature review of recent original research found a relatively high prevalence of mental health comorbidities in PWE. Mood and anxiety disorders are the most common comorbidities, while psychotic spectrum conditions such as schizophrenia and bipolar disorder are much rarer. The prevalence of comorbidity may vary with the epilepsy type and treatment responsiveness. These findings suggest that screening tools for depression and anxiety should be included as part of the training for epilepsy care, while resources for other relatively common conditions such as PTSD and substance abuse disorders should be readily available to neurology specialists who treat PWE.

Suicide attempts in US adults with lifetime DSM-5 eating disorders

BackgroundRates of suicide are increasing in the US. Although psychiatric disorders are associated with suicide risk, there is a dearth of epidemiological research on the relationship between suicide attempts (SAs) and eating disorders (EDs). The study therefore aimed to examine prevalence and correlates of SAs in DSM-5 EDs—anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED)—in a nationally representative sample of US adults. In addition, prevalence and correlates of SAs were examined in the two subtypes of AN—restricting (AN-R) and binge/purge (AN-BP) types.MethodsThe study included 36,171 respondents in the Third National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III) who completed structured diagnostic interviews (AUDADIS-5) and answered questions regarding SA histories and psychosocial impairment associated with EDs. We evaluated lifetime prevalence of SA, psychosocial impairment, clinical profiles, and psychiatric comorbidity in adults with EDs with and without SA histories, and temporal relationships between age onset of SA and EDs.ResultsPrevalence estimates of suicide attempts were 24.9% (for AN), 15.7% (for AN-R), 44.1% (for AN-BP), 31.4% (for BN), and 22.9% (for BED). Relative to respondents without specific EDs, adjusted odds ratios (AORs) of SAs were significantly greater in all EDs: AN = 5.40 (95% confidence intervals [CIs] = 3.80–7.67), AN-R = 3.16 (95% CIs = 1.82–5.42), AN-BP = 12.09 (95% CIs = 6.29–23.24), BN = 6.33 (95% CIs = 3.39–11.81), and BED = 4.83 (95% CIs = 3.54–6.60). Among those with SA history, mean age at first SA and number of SAs were not significantly different across the specific EDs. SA was associated with significantly earlier ED onset in BN and BED, longer duration of AN but shorter duration of BN, greater psychosocial impairment in AN and BN, and with significantly increased risk for psychiatric disorder comorbidity across EDs. Onset of BED was significantly more likely to precede SA (71.2%) but onsets of AN (50.4%) and BN (47.6%) were not.ConclusionsUS adults with lifetime DSM-5 EDs have significantly elevated risk of SA history. Even after adjusting for sociodemographic factors, those with lifetime EDs had a roughly 5-to-6-fold risk of SAs relative to those without specific EDs; the AN binge/purge type had an especially elevated risk of SAs. SA history was associated with distinctively different clinical profiles including greater risk for psychosocial impairment and psychiatric comorbidity. These findings highlight the importance of improving screening for EDs and for suicide histories.

Patterns of Psychiatric Comorbidity and Genetic Correlations Provide New Insights Into Differences Between Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder

BackgroundAttention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) share common genetic factors but seem to have specific patterns of psychiatric comorbidities. There are few systematic studies on adults; therefore, we compared psychiatric comorbidities in adults with these two neurodevelopmental disorders using population-based data and analyzed their genetic correlations to evaluate underlying factors. MethodsUsing data from Norwegian registries, we assessed patterns of psychiatric disorders in adults with ADHD (n = 38,636; 2.3%), ASD (n = 7528; 0.4%), and both diagnoses (n = 1467; 0.1%) compared with the remaining adult population (n = 1,653,575). We calculated their prevalence ratios (PRs) and differences using Poisson regression, also examining sex-specific relations. Genetic correlations (rg) among ADHD, ASD, and the examined psychiatric disorders were calculated by linkage disequilibrium score regression, exploiting summary statistics from relevant genome-wide association studies. ResultsFor all psychiatric comorbidities, PRs differed between ADHD and ASD. Associations were strongest in individuals with ADHD and ADHD+ASD for most comorbidities, in both men and women. The relative prevalence increase of substance use disorder was three times larger in ADHD than in ASD (PRADHD, 6.2; 95% confidence interval [CI], 6.1–6.4; PRASD, 1.9; 95% CI, 1.7–2.2; p < .001); however, the opposite was true for schizophrenia (PRASD, 13.9; 95% CI, 12.7–15.2; PRADHD, 4.4; 95% CI, 4.1–4.7; p < .001). Genetic correlations supported these patterns but were significantly different between ADHD and ASD only for the substance use disorder proxies and personality traits (p < .006 for all). ConclusionsAdults with ADHD, ASD, or both ADHD and ASD have specific patterns of psychiatric comorbidities. This may partly be explained by differences in underlying genetic factors.

Psychiatric disorders among people with cancer in low- and lower-middle-income countries: study protocol for a systematic review and meta-analysis

IntroductionCancer is a rapidly growing public health problem in low- and lower-middle-income countries (LLMICs). There is evidence from upper-income countries that comorbid mental illness is common and can adversely impact...

Psychiatric disorders in adults with intellectual disabilities: A preliminary study of prevalence and associated factors

IntroductionStudies have shown that people with Intellectual Disabilities (ID) develop mental illness at rates similar to or higher than general population1.ObjectivesThere is no previous study on mental health of adults with ID in Turkey.AimThe purpose of this study was to investigate the prevalence and associated factors of mental disorders in adults with ID in Turkey.Methods151 participants with ID aged 18 and over were recruited from care homes, rehabilitation centers and from people attending to psychiatry outpatients for the first time. Every participant underwent face to face assessment by a psychiatrist supported by an informant and previous notes. A structured purpose designed socio-demographic form was used. Diagnoses were drawn according to DSM-5. Point prevalence of disorders was calculated and associated factors were investigated.Results63.5% of the participants met criteria for one psychiatric disorder, 21% had more than one disorder. The most common disorders were: challenging behavior (34%), autism spectrum disorders (%13.9), and anxiety disorders (13.9%) and attention deficit hyperactivity disorder (10.6%). Living in a care home and being young were associated with mental ill health (P &lt; 0.05) [1].ConclusionThis study demonstrates high psychiatric comorbidity in adults with ID. Young age and care homes were the associated factors in this sample. These results are important to raise awareness of professionals and service providers about mental health of adults with ID.Disclosure of interestThis project was funded by the Scientific and Technological Research Council of Turkey (TUBITAK) with a project number of BİDEB 115C015. The funding body did not have any involvement with data collection, analysis or writing up.

Psychiatric disorders in adults with mental retardation: prevalence and associated factors

Aim: Mental Retardation (MR) is a spectrum of disorders characterized by deficits in intellectual and adaptive functioning which could result from several different etiological factors. Studies have shown that people with MR develop mental illness at rates similar to or higher than general population. We have not found any previous study carried out on adults with MR in Turkey. The aim of this study to determine the prevalence of mental disorders in Turkish population and to investigate associated factors. Methods: Participants aged 18 years and above and with a confirmed diagnosis of were recruited from care homes, rehabilitation centers and from people attending to outpatients for the first time for psychiatric assessment. A structured purpose designed socio-demographic form was used. Each participant underwent face to face assessment by a psychiatrist and their previous reports were also seen where available. Collateral history was provided by their families or caregivers who had known the person for at least 6 months. Diagnoses were established according to the DSM-5 criteria. Point prevalence of disorders were calculated and associated factors were investigated. Results: 63.5% of the participants met the criteria for one psychiatric disorder, whilst 21% received more than one diagnoses. The most common disorders were as follows: conduct disorder (34%), autism spectrum disorders (13.9%), anxiety-related disorders (13.9%) and attention deficit hyperactivity disorder (10.6%). Living in a care home and being young seemed to be associated with ill mental health. Conclusion: Our study demonstrates high psychiatric comorbidity in adults with MR. Young age and being in a care home seemed to be the only risk factors in our sample. These results highlight a need for increased awareness of mental health professionals and service providers about mental health of adults with MR for early diagnosis and interventions.

Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder.

We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset <7 years (early-onset); (2) attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental disorders, 5th edition would not over-diagnose attention-deficit/hyperactivity disorder in the adult population. Recalled childhood attention-deficit/hyperactivity disorder symptom severity was correlated with conduct disorder, oppositional defiant disorder, dysthymia and sleep disorders.

Le jeu pathologique à l’adolescence

Today's juveniles are the first generation to be raised in an environment where gambling is very accessible and socially acceptable. The recent legalization of Internet gambling has increased this accessibility. With 28,8 millions of gamblers in France in 2010, many believe that gambling is an innocent leisure activity. The first results of the national survey on the prevalence of gambling practices conducted in France show that in 2010, 1.3% of the population had a gambling problem. Also, despite the prohibition of gambling to minors, the mean age of onset of gambling behavior in the world is 11.5 years. Gambling (even non-problematic) in adolescence is associated with poor school performance, criminal behavior and family conflict. Recreational gambling shares with pathological gambling high rates of psychiatric comorbidities in adults, and risk behaviors among adolescents. Similarly, international studies show prevalence of problem gambling 2 to 4 times higher among adolescents than among adult, 3.5% to 8% of adolescents between 12 and 17 are pathological gamblers. The validity of the screening instruments and the frequency of spontaneous recovery in adulthood are discussed to explain the high prevalence in adolescence. This article proposes a focus on the practice of gambling in adolescence and its characteristics when the practice becomes pathological. We discuss the epidemiological, diagnostic, etiologic and therapeutic aspects of this problem. Three major types of risk factors implicated in gambling problems are identified: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors) like Internet with the recent legalization of gambling online, and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling in youth seems to be conditioned by the interaction of a person and a gambling activity, in a particular context. This conceptual model is based on the well-known theory of Olivenstein on toxicomania, which was proposed in the seventies. In France, very few is known about problem gambling in this age and its implications in terms of treatment, prevention and research. There is little in the way of specific treatments for adolescent pathological gamblers so we briefly reviewed possibilities and limits. We discuss the importance to develop prevention, in particular to delay the initiation, and the necessity of research to develop screening instruments and news studies to have a better knowledge of this population.

Cost of Illness and Comorbidities in Adults Diagnosed With Attention-Deficit/Hyperactivity Disorder

This retrospective study assessed the cost of illness and medical and psychiatric comorbidities in adults with attention-deficit/hyperactivity disorder (ADHD) compared with adults without ADHD (matched 1:3) and adults with depression (1:1). Individuals with depression were included as a benchmark against which the burden of ADHD could be measured. Measures of health care and employment-related costs were compared to generate estimates of medical expenditures, workplace absences, and comorbidities in adults with ADHD (using ICD-9-CM codes) who were enrolled in employer-sponsored health plans throughout 2006. Individuals with ADHD (31,752) were matched with 95,256 non-ADHD controls. The majority of individuals with ADHD (n = 29,965) were also matched with an equal number of individuals with a depression diagnosis (using ICD-9-CM codes). In this adult population with ADHD enrolled in an employer-sponsored health plan, medical and psychiatric comorbidities were the primary drivers of health care utilization and cost. Of note, depression was significantly prevalent among those with ADHD compared to matched non-ADHD controls (14% vs 3.2%; P ≤ .0001). Subgroup analysis demonstrated that ADHD patients with depression had a significantly higher number of medical and other psychiatric comorbid illnesses including diabetes, hypertension, asthma, irritable bowel syndrome, bipolar disorder, anxiety, alcohol abuse, and substance abuse compared to those with ADHD alone (P ≤ .0001). Patients with ADHD incurred higher total annual health care expenditures than control subjects ($4,306 vs $2,418); approximately 15% of costs were paid by the patient. The total annual costs associated with productivity losses were also higher (driven by differences in short-term disability costs) in the ADHD group compared with controls ($4,403 vs $4,209). Medical and psychiatric comorbidities were primary drivers of the direct health care cost associated with ADHD in adult patients. The present study demonstrated that the total costs of ADHD among adults are doubled when indirect costs associated with workplace productivity losses are included.

Comorbid Psychiatric Disorders in Adults with ADHD

Adults with ADHD have been found in prior studies to have a greater risk for various psychiatric disorders. Chief among these are oppositional defiant disorder (ODD) and conduct disorder (CD). Approximately 24–35% of clinic–referred adults diagnosed with ADHD have ODD and 17–25% have CD, either currently or over the course of their earlier development (Barkley, Murphy, & Kwasnik, 1996; Biederman, et al., 1993; Murphy & Barkley, 1996; Murphy, Barkley, & Bush, 2002; Spencer, 2004). These figures for clinic–referred adults are below those reported in studies of ADHD children, particularly studies of hyperactive children followed to adulthood, where levels of ODD and CD may be double or triple these rates reported for adults diagnosed with ADHD (see Barkley, 2006, for a review; Barkley, Fischer, Edelbrock, & Smallish, 1990; Fischer, Barkley, Smallish, & Fletcher, 2002; Weiss & Hechtman, 1993). Among parents of children having ADHD who also meet criteria for ADHD, disruptive behavior disorders are also significantly more common (McGough et al., 2005; Minde, et al., 2003). For instance, one study found that 53% have had ODD and 33% have had CD sometime in their lives (Biederman et al., 1993), figures closer to those seen in follow–up studies of hyperactive or ADHD children. Antisocial Personality Disorder is often an associated adult outcome in a large minority of those children or adolescents who have both ADHD and CD; thus it is not surprising to find that 7–44% of clinic–referred adults diagnosed with ADHD also qualify for a diagnosis of this personality disorder (Biederman et al., 1993; Shekim, Asarnow, Hess, Zaucha, & Wheeler, 1990; Torgersen, Gjervab, & Rasmussen, 2006). Even among those who do not qualify for this diagnosis, many receive higher than normal ratings on those personality traits associated with this personality disorder (Tzelepis, Schubiner, & Warbase, 1995). Substance dependence and abuse are known to occur to a more frequent degree among hyperactive or ADHD children who develop CD by adolescence or Antisocial Personality Disorder by adulthood (Barkley, 2006; Tercyak, Peshkin, Walker, & Stein, 2002). Arecent study of a large general population sample likewise found an association between ADHD and antisocial disorder (Kessler, et al., 2006). Adults clinically diagnosed with ADHD seem to be no exception to this rule linking ADHD, antisocial activities, and drug use disorders. Studies have found lifetime rates of alcohol dependence or abuse disorders ranging between 21% and 53% of adults diagnosed with ADHD, whereas 8–32% may manifest some other form of substance dependence or abuse disorder (Barkley,

Psychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) is a chronic, lifelong disorder with childhood-onset, which seriously impairs the affected adults in a variety of daily living functions like educational and occupational functioning, partnership and parenting. ADHD is associated with a high percentage of comorbid psychiatric disorders in every lifespan. In adulthood between 65-89% of all patients with ADHD suffer from one or more additional psychiatric disorders, above all mood and anxiety disorders, substance use disorders and personality disorders, which complicates the clinical picture in terms of diagnostics, treatment and outcome issues. The present overview provides information of comorbid psychiatric disorders in adults with ADHD, underlying associations and clinical implications.

Psychiatric comorbidity in adult patients with hypothalamic hamartoma

The objective was to investigate the prevalence of psychiatric comorbidity in adults with hypothalamic hamartoma (HH). A standardized clinical interview and assessment scales were used to assess for depression, anxiety, personality, and sexual behavior, based on previous findings in the pediatric population. We found a high prevalence of mood and anxiety disorders, with Major Depressive Disorder and Social Anxiety Disorder being the most common. “Anxious” personality types were the most common. Symptoms of Asperger syndrome were high in males versus females. We concluded that depression and anxiety are common in adult patients with HH. Remission of cognitive, behavioral, and autistic symptoms has been reported with surgical tumor resection. Whether this can correct the psychiatric disturbances remains to be investigated. The need for adjunctive psychiatric treatment may nevertheless remain.