Self-reported Attention Deficit Hyperactivity Disorder Symptoms Research Articles

An association between a dopamine transporter gene (SLC6A3) haplotype and ADHD symptom measures in nonclinical adults.

Previous genetic studies have postulated that attention deficit hyperactivity disorder (ADHD) should be regarded as the extreme end of a set of behavioural traits that can be continuously measured in the general population. The current study adopted a quantitative trait approach to examine the relationship between dopamine gene variants and self-reported ADHD symptoms in 517 nonclinical adults. Although genetic associations with variants of both the dopamine transporter (DAT1; SLC6A3) and D4 receptor (DRD4) genes have been reliably reported in children, results in adults are less consistent. We probed two potentially functional variable number of tandem repeat (VNTR) polymorphisms in the 3'UTR and intron 8 of DAT1, the 10-repeat and 6-repeat alleles of which respectively form a haplotype (10/6 DAT1 haplotype) that is associated with childhood ADHD. We also genotyped the exon 3 VNTR of DRD4, the 7-repeat allele of which is also an established risk factor for childhood ADHD. Permutation analysis showed an influence of the 10/6 DAT1 haplotype on both CAARS-G and CAARS-H (DSM-IV ADHD Symptoms Total and ADHD Index respectively), such that ADHD symptom scores increased with each additional copy of the 10/6 DAT1 haplotype. This result survived corrections for multiple comparisons both at the level of genotype and phenotype. A nominal association with CAARS-G was also found for the 7-repeat allele of the DRD4 VNTR however this did not survive multiple comparison correction. Our results provide further support for the influence of variation in the 10/6 DAT1 haplotype and individual differences in ADHD symptoms in adults.

Self-Reported ADHD Symptoms and Interhemispheric Interaction in Adults: A Dimensional Approach

The present study applied the dimensional approach to test whether self-reported symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in adults are associated with the speed of interhemispheric interaction. A sample of first grade students (N = 112) completed Conners' Adult ADHD Rating Scales and letter matching reaction time tasks. In the tasks, participants had to match a single target letter displayed below the fixation cross, either on left or right visual field, with one of two letters displayed above the fixation cross, one letter on each visual field. For each task, identical letters were presented either within the same visual field (within hemisphere condition) or across visual fields (across hemisphere condition). Interhemispheric interaction was indexed as the difference in mean reaction time between within and across hemisphere conditions. Comorbid problems such as depression, anxiety, and stress may affect task performance and are controlled for in this study. Findings indicated that self-reported ADHD symptomology, especially hyperactivity, in the presence of stress was weakly but significantly associated with fast interhemispheric interaction.

Risk behaviours among substance use disorder treatment seekers with and without adult ADHD symptoms

BackgroundImpulsivity and consequent risk-taking are features of both Attention Deficit Hyperactivity Disorder (ADHD) and substance use disorder (SUD). To date there are no data on the impact of comorbid ADHD on the likelihood and frequency of risk-taking behaviour among individuals with SUD. The current study aimed to examine drug-related, sexual and driving-related risk behaviours in people seeking treatment for SUD with co-occurring symptoms of Attention Deficit Hyperactivity Disorder (ADHD), taking into account potential confounders. Methods489 Australian adult SUD treatment seekers were administered a structured interview assessing demographics, drug use and SUD treatment history, psychiatric history, self-reported adult ADHD symptoms and self-reported drug-related, sexual and driving-related risk behaviours. ResultsAlmost a third (32%) screened positive for adult ADHD symptoms with onset prior to age 12. Those screening positive were more likely to report early onset (<15 years) nicotine and illicit drug use and to have a prior diagnosis of childhood ADHD, anxiety, depression and personality disorder. ADHD symptom status was not independently associated with injecting drug use-related or sexual risk-taking in the preceding month, but was an independent predictor of a greater overall number of driving offences, a higher frequency of driving without a seatbelt, a greater likelihood of having driven without a valid licence, more at-fault accidents and having one's licence disqualified at the time of interview. ConclusionsThese findings suggest that the risk-taking behaviour that is common among people with SUD is further increased among those with comorbid ADHD symptoms, particularly with respect to dangerous driving practices.

Impact of stress on different components of impulsivity in borderline personality disorder.

Previous research on impulsivity in borderline personality disorder (BPD) has revealed inconsistent findings. Impulsive behaviour is often observed during states of emotional distress and might be exaggerated by current attention deficit hyperactivity disorder (ADHD) symptoms in individuals with BPD. We aimed to investigate different components of impulsivity dependent on stress induction controlling for self-reported ADHD symptoms in BPD. METHOD. A total of 31 unmedicated women with BPD and 30 healthy women (healthy controls; HCs), matched for age, education and intelligence, completed self-reports and behavioural tasks measuring response inhibition (go/stop task) and feedback-driven decision making (Iowa Gambling Task) under resting conditions and after experimental stress induction. ADHD symptoms were included as a covariate in the analyses of behavioural impulsivity. Additionally, self-reported emotion-regulation capacities were assessed. BPD patients reported higher impulsive traits than HCs. During stress conditions - compared with resting conditions - self-reported impulsivity was elevated in both groups. Patients with BPD reported higher state impulsivity under both conditions and a significantly stronger stress-dependent increase in state impulsivity. On the behavioural level, BPD patients showed significantly impaired performance on the go/stop task under stress conditions, even when considering ADHD symptoms as a covariate, but not under resting conditions. No group differences on the Iowa Gambling Task were observed. Correlations between impulsivity measures and emotion-regulation capacities were observed in BPD patients. Findings suggest a significant impact of stress on self-perceived state impulsivity and on response disinhibition (even when considering current ADHD symptoms) in females with BPD.

Cross-sectional study of self-reported ADHD symptoms and psychological comorbidity among college students in Chandigarh, India.

Background:Existence of attention deficit hyperactivity disorder (ADHD) in adults is scantily researched in India. There is dearth of information on prevalence of ADHD in college students worldwide. Further, fewer studies in the past have evaluated the impact of ADHD on the psychological well-being of college students.Aims:To study the prevalence of ADHD among college students and psychological problems related to ADHD.Design:Cross-sectional study.Subjects and Methods:A total of 237 students were recruited from various medical, engineering, and commerce and arts colleges of Chandigarh, India. They were administered the Adult ADHD Self Report Scale v1.1(ASRS) and the Wender Utah Rating Scale (WURS) to diagnose adult ADHD. To assess comorbidities; General Health Questionnaire-12 (GHQ); Zung Depression Rating Scale (ZDRS); Rosenberg's Self-Esteem Scale (RSES);and questions on emotional stability, social problems, and substance use (alcohol, tobacco, and cannabis) were administered on all participants.Results:A total of 13 students (5.48%) fulfilled the criteria for adult ADHD. These students experienced significantly higher emotional instability and low self-esteem than those without ADHD (N = 224). The occurrence of psychological problems, depression, social problems, and substance abuse was comparable in students with and without ADHD.Conclusions:ADHD is prevalent among the college students studying in the most competitive institutes as well. Students with ADHD experience higher emotional instability and poor self-esteem than others. It has little effect on their psychological well-being and social adjustment. Prompt detection and management of ADHD in college students may help them deal with these problems effectively.

Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: a 24‐week randomized placebo‐controlled trial

AimTo test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and amphetamine dependence.DesignRandomized placebo-controlled 24-week double-blind trial with parallel groups design.SettingParticipants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.ParticipantsFifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and amphetamine dependence.MeasurementsChange in self-reported ADHD symptoms, relapse to any drug use (amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.FindingsThe MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more amphetamine-negative urines (P = 0.019) and better retention to treatment (P = 0.032).ConclusionsMethylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance dependence.

Alpha-2A adrenergic receptor gene variants are associated with increased intra-individual variability in response time

Intra-individual variability in response time has been proposed as an important endophenotype for attention deficit hyperactivity disorder (ADHD). Here we asked whether intra-individual variability is predicted by common variation in catecholamine genes and whether it mediates the relationship between these gene variants and self-reported ADHD symptoms. A total of 402 non-clinical Australian adults of European descent completed a battery of five cognitive tasks and the Conners' Adult ADHD Rating Scale. Exclusion criteria included the presence of major psychiatric or neurologic illnesses and substance dependency. A total of 21 subjects were excluded due to incomplete data or poor quality cognitive or genotyping data. The final sample comprised 381 subjects (201 males; mean age=21.2 years, s.d.=5.1 years). Principal components analysis on variability measures yielded two factors (response selection variability vs selective attention variability). Association of these factors with catecholamine gene variants was tested using single-step linear regressions, with multiple comparisons controlled using permutation analysis. The response selection variability factor was associated with two ADRA2A single-nucleotide polymorphisms (SNPs) (rs1800544, rs602618), p corrected=0.004, 0.012, respectively, whereas the selective attention variability factor was associated with a TH SNP (rs3842727), p corrected=0.024. A bootstrapping analysis indicated that the response selection variability factor mediated the relationship between the ADRA2A SNP rs1800544 and self-reported ADHD symptoms. Thus this study finds evidence that DNA variation in the ADRA2A gene may be causally related to ADHD-like behaviors, in part through its influence on intra-individual variability. Evidence was also found for a novel association between a TH gene variant and intra-individual variability.

Detecting Feigned ADHD in Later Adolescence: An Examination of Three PAI–A Negative Distortion Indicators

The validity of various indicators of response distortion on the Personality Assessment Inventory–Adolescent (PAI–A; Morey, 2007a) and its potential usefulness to detect malingering were evaluated by having 17- and 18-year-old students complete the PAI–A attempting to simulate Attention-Deficit/Hyperactivity Disorder (ADHD) under coached or noncoached conditions. Scores for these respondents on the Negative Impression and Positive Impression scales, the Malingering Index, and the Rogers Discriminant Function (RDF) were compared to those of 17- and 18-year-old patients receiving clinical diagnoses of ADHD. Simulating respondents also completed the Conners Adult ADHD Rating Scale (CAARS) to determine if they could successfully simulate self-reported symptoms of ADHD. A total of 45% of simulating participants obtained CAARS scores reflecting clinically significant symptoms of ADHD. All indicators demonstrated the ability to distinguish between actual patients and feigned responses of successful simulators, with the RDF demonstrating the greatest accuracy in distinguishing these groups.

Investigating the efficacy of integrated cognitive behavioral therapy for adult treatment seeking substance use disorder patients with comorbid ADHD: study protocol of a randomized controlled trial

BackgroundAttention deficit hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders (SUD). The combination of ADHD and SUD is associated with a negative prognosis of both SUD and ADHD. Pharmacological treatments of comorbid ADHD in adult patients with SUD have not been very successful. Recent studies show positive effects of cognitive behavioral therapy (CBT) in ADHD patients without SUD, but CBT has not been studied in ADHD patients with comorbid SUD.Methods/designThis paper presents the protocol of a randomized controlled trial to test the efficacy of an integrated CBT protocol aimed at reducing SUD as well as ADHD symptoms in SUD patients with a comorbid diagnosis of ADHD. The experimental group receives 15 CBT sessions directed at symptom reduction of SUD as well as ADHD. The control group receives treatment as usual, i.e. 10 CBT sessions directed at symptom reduction of SUD only. The primary outcome is the level of self-reported ADHD symptoms. Secondary outcomes include measures of substance use, depression and anxiety, quality of life, health care consumption and neuropsychological functions.DiscussionThis is the first randomized controlled trial to test the efficacy of an integrated CBT protocol for adult SUD patients with a comorbid diagnosis of ADHD. The rationale for the trial, the design, and the strengths and limitations of the study are discussed.Trial registrationThis trial is registered in http://www.clinicaltrials.gov as NCT01431235.

The Use of the ADHD Self-Rating Scale (ASRS-6) in the Homeless

Attention deficit/hyperactivity disorder (ADHD) is prevalent in homeless populations, but no studies have assessed the psychometric properties of assessment instruments for this population. Self-other agreement on the ADHD Self-Rating Scale 6 was studied using a cohort of admissions to an outreach clinic for the homeless (n = 72). Alcohol use was assessed with the fast alcohol screening test. Other drug use was assessed by interview. For the six-item ASRS-6, the self-nurse correlation was .63 (p < .001). Discriminant correlations were low. Higher ASRS-6 scores as rated by both nurse and self-report were associated with illicit drug use but not alcohol problems. Concordance was lower at higher levels of alcohol problems (p < .05) CONCLUSION: The observations of experienced nurses converge well with self-reported symptoms of ADHD. Further research is needed to assess the relative contribution of clinical observation and self-report in assessing homeless patients.

Four-Year Outcome in Psychopharmacologically Treated Adults With Attention-Deficit/Hyperactivity Disorder

In adults with attention-deficit/hyperactivity disorder (ADHD), pharmacotherapy is a recommended treatment option. However, research on long-term outcome with such treatment has been scarce. A questionnaire survey was completed by adults with ADHD, diagnosed according to ICD-10/DSM-IV criteria and approved for pharmacotherapy during 2003 to 2005, living in southeastern Norway. The questionnaire was conducted from November 2008 to April 2009. Of an eligible number of 1,096 subjects, 1,080 remained at follow-up; 371 subjects (34.4%) agreed to participate, and 368 of these reported having ever been treated with ADHD medication. Baseline characteristics and self-reported outcome were studied by time on psychopharmacologic treatment. Primary outcome measures were the Adult ADHD Self-Report Scale version 1.1 (ASRS) Screener and the Mental Health Index-5 (MHI-5). Based on cutoff scores for these instruments, 2 groups (favorable outcome vs others) were created to study possible predictors of outcome status. Self-reported baseline ADHD symptoms and impairment did not differ between participants and nonparticipants. Mean observation time was 4.5 years (range, 3.5-6.0 years). At follow-up, mean age was 36.5 years. Altogether, 270 patients (73.4%) had been treated for more than 24 months. They reported better outcome on all measures compared to those treated for 24 months or less (mean values: ASRS Screener score: 12.8 vs 15.3; MHI-5 score: 63.7 vs 57. 7). The favorable outcome group consisted of 79 participants (21.5%). Comorbidity at baseline predicted poorer outcome than did no comorbid illness. In adults with ADHD, pharmacologic treatment for more than 2 years was associated with better functioning than treatment for 2 years or less. Comorbidity at baseline predicted poorer outcome.

ADHD symptoms across the lifespan in a population-based Swedish sample aged 65 to 80

The purpose of the study was to examine the attention deficit hyperactivity disorder (ADHD) symptomatology across the lifespan by comparing older individuals' self-reports about current ADHD symptoms and symptoms in childhood. The 25-item Wender Utah Rating Scale (WURS) was initially administered in a population-based sample of 1,599 persons aged 65-80 years. We also asked about current health, memory, and problems in childhood. Based on their WURS scores (below and above 36), we randomly drew two subsamples, each with 30 individuals. They were followed up by the Wender Riktad ADHD Symtom Skala (WRASS)-scale, a Swedish version of the Targeted Attention Deficit Disorder Rating Scale (TADDS). Our main finding was that higher WURS scores were significantly related to higher scores on the WRASS scale, indicating persistence of self-reported ADHD symptoms over the whole lifespan. Among those with a WURS score of 36 or more, 16 (53.3%) individuals scored 70 or more; the clinical cut-off used in Sweden. None of the individuals with a WURS score below 36 scored higher than 70 on the WRASS scale. Our findings support the idea of a significant persistence of ADHD symptoms from childhood to old age. The results encourage studies of ADHD using a lifespan perspective, particularly in examining ADHD symptoms in old age.

Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder

BackgroundAdults with attention-deficit hyperactivity disorder (ADHD) frequently report emotional lability (EL). However, it is not known whether EL may be accounted for by comorbid psychiatric conditions or symptoms. This study evaluates the influence of comorbid clinical symptoms on EL, and investigates the relationship between EL and impairment. MethodsOver 500 consecutive male adult referrals at the ADHD Clinic for adults at the South London and Maudsley Hospital (U.K) were screened. 41 individuals with ADHD without comorbidity, current medication or frequent substance were identified, and compared with 47 matched healthy male control participants. Measures included IQ, clinical interview and self-reported ADHD symptoms, EL, impairment and antisocial behaviour. ResultsADHD participants reported elevated EL, showing good case-control differentiation in receiver operating curve analysis. EL was most strongly predicted by hyperactivity–impulsivity rather than subsyndromal comorbid symptoms, and contributed independently to impairment in daily life. LimitationsResults may not generalise to children with ADHD, or many adults with ADHD, who are frequently affected by comorbid psychiatric conditions and substance use disorders. ConclusionsEL in adults with ADHD appears to be primarily associated with ADHD itself rather than comorbid conditions, and helps to explain some of the impairments not accounted for by classical features of the disorder. Results indicate that adults presenting with long-term problems with EL should routinely be screened for the presence of ADHD.

Neuropsychological performance, impulsivity, symptoms of ADHD, and Cloninger's personality traits in pathological gambling

Pathological gambling (PG) is a prevalent public health problem associated with fronto-temporal dysfunction and maladaptive personality traits. To further test these associations, we assessed neuropsychological performance in pathological gamblers (PGs) and controls. We also examined selected personality characteristics and symptoms of attention deficit hyperactivity disorder (ADHD). Subjects were recruited from the community. All received a comprehensive neuropsychological battery, the ADHD Rating Scale, and personality measures including the Barratt Impulsiveness Scale and a version of the Temperament and Character Inventory. People with DSM-IV PG (n = 54) and controls (n = 65) were comparable in age, sex, and education level. PGs were more likely to have comorbid lifetime mood, anxiety, and substance use disorders; antisocial personality disorder; and other impulse control disorders. PGs performed significantly worse on the Wisconsin Card Sort Test-64 perseverative responses subscale and the Trails B test; they also had lower performance and full scale IQs. PGs had elevated levels of depression, ADHD symptoms, trait impulsivity, novelty seeking, and harm avoidance, but lower levels of reward dependence. High levels of self-reported impulsivity or ADHD symptoms in PGs did not predict worse neuropsychological performance. We conclude that PGs performed worse than controls on two measures of executive function and had lower IQs. They also had more psychiatric comorbidity, higher levels of trait impulsivity and ADHD symptoms, and both novelty seeking and harm-avoidance, but lower levels of reward-dependence. This study does not support the notion that there is a pattern of neuropsychological deficits associated with high levels of impulsivity or ADHD symptoms in PGs.

Neuropsychological performance, impulsivity, ADHD symptoms, and novelty seeking in compulsive buying disorder

We examined the neuropsychological performance of people with compulsive buying disorder (CBD) and control subjects, along with trait impulsivity, symptoms of attention deficit hyperactivity disorder (ADHD), and selected personality characteristics. Subjects received a comprehensive neuropsychological test battery, depression and ADHD symptom assessment, the Barratt Impulsiveness Scale, and a version of the Temperament and Character Inventory. Persons with CBD (n=26) and controls (n=32) were comparable in terms of age, sex, and years of education. Subjects with CBD had a mean age of 36.3 years (S.D.=15.7) and an age at onset of 19.7 years (S.D.=7.0). Compulsive buyers had more lifetime mood, anxiety, and impulse control disorders. People with Compulsive buying performed significantly better on the Wechsler Abbreviated Scale of Intelligence Picture Completion task, a test of visual perception; otherwise, there were no consistent differences in neuropsychological measures. They also had elevated levels of self-reported depression, ADHD symptoms, trait impulsivity, and novelty seeking. In conclusion, compulsive buyers have greater lifetime psychiatric comorbidity than controls, and higher levels of self-rated depression, ADHD symptoms, trait impulsivity, and novelty seeking. The present study does not support the notion that there is a pattern of neuropsychological deficits associated with CBD.

The effects of distraction and a brief intervention on auditory and visual-spatial working memory in college students with attention deficit hyperactivity disorder

Two studies addressed how young adult college students with attention deficit hyperactivity disorder (ADHD) (n = 44) compare to their nonaffected peers (n = 42) on tests of auditory and visual–spatial working memory (WM), are vulnerable to auditory and visual distractions, and are affected by a simple intervention. Students with ADHD demonstrated worse auditory WM than did controls. A near significant trend indicated that auditory distractions interfered with the visual WM of both groups and that, whereas controls were also vulnerable to visual distractions, visual distractions improved visual WM in the ADHD group. The intervention was ineffective. Limited correlations emerged between self-reported ADHD symptoms and objective test performances; students with ADHD who perceived themselves as more symptomatic often had better WM and were less vulnerable to distractions than their ADHD peers.

Long-Acting Methylphenidate Reduces Collision Rates of Young Adult Drivers With Attention-Deficit/Hyperactivity Disorder

This study investigated whether methylphenidate delivered through a long-acting transdermal system (MTS) would reduce collision rates of young adult drivers with attention-deficit/hyperactivity disorder (ADHD).Seventeen young adults completing the study (mean [SD] age, 20.82 [2.40] years; 14 men and 13 white) met the following inclusion criteria: ADHD diagnoses but not routinely taking ADHD medication, previously responsive to ADHD medication, active drivers with more than 1 collision or citation in the past 2 years, and no significant comorbidities. In this open-labeled, crossover design drivers were randomly assigned either to the no-medication condition for 3 months and then MTS for 3 months or to the reverse sequence. In-car video monitoring of routine driving occurred during these 6 months. At baseline and after each condition, participants completed the Conners Adult ADHD Rating Scale and the Cox Assessment of Risky Driving Scale, and their blood pressure, heart rate, and body weight were monitored.Compared with the no-medication condition, participants in the MTS condition self-reported fewer total ADHD (P < 0.04) and inattentive symptoms (P = 0.014) and a trend for risky driving behaviors (P = 0.059) and had fewer video-recorded collisions (P < 0.005) and other problematic driving events. There were no significant changes in blood pressure, heart rate, or body weight across conditions or any significant skin reactions to the MTS patch.This is the first study demonstrating that long-acting methylphenidate improves activities of daily living among young adults with ADHD. Specifically, methylphenidate improved safety in routine driving while reducing ADHD symptoms with minimal adverse effects.

Current Self-Reported Symptoms of Attention Deficit/Hyperactivity Disorder Are Associated with Total Brain Volume in Healthy Adults

BackgroundReduced total brain volume is a consistent finding in children with Attention Deficit/Hyperactivity Disorder (ADHD). In order to get a better understanding of the neurobiology of ADHD, we take the first step in studying the dimensionality of current self-reported adult ADHD symptoms, by looking at its relation with total brain volume.Methodology/Principal FindingsIn a sample of 652 highly educated adults, the association between total brain volume, assessed with magnetic resonance imaging, and current number of self-reported ADHD symptoms was studied. The results showed an association between these self-reported ADHD symptoms and total brain volume. Post-hoc analysis revealed that the symptom domain of inattention had the strongest association with total brain volume. In addition, the threshold for impairment coincides with the threshold for brain volume reduction.Conclusions/SignificanceThis finding improves our understanding of the biological substrates of self-reported ADHD symptoms, and suggests total brain volume as a target intermediate phenotype for future gene-finding in ADHD.

The FMR1 Premutation and Attention-Deficit Hyperactivity Disorder (ADHD): Evidence for a Complex Inheritance

We recently reported elevated symptoms associated with attention-deficit hyperactivity disorder (ADHD) among adult female carriers of the FMR1 premutation. To gain insight into the contribution of this mutation in the context of polygenes, we examined the proportion of variation in these symptoms due to residual genetic factors after adjustment for the effect of the premutation. To accomplish this, we performed a familial aggregation analysis of ADHD symptoms among 231 females from 82 pedigrees using scores from the Connors Adult ADHD Rating Scales. Results indicate that after accounting for the effect of FMR1, there are significant residual polygenic effects on self-reported symptoms of ADHD, as measured by the ADHD Index (p=0.0117) and problems with self-concept (p=0.0110), one specific symptom domain associated with ADHD. For both measures, FMR1 accounts for ~5% of the variance while polygenes account for ~50% of the residual variance, suggesting that the premutation acts in concert with additional genetic loci to influence the severity of ADHD symptoms.

Attention deficit hyperactivity disorder symptom self-report among medical students in Eldoret, Kenya

To determine the prevalence of self-reported attention deficit hyperactivity disorder (ADHD) symptoms among medical students in Eldoret, Kenya. A cross-sectional descriptive study of all medical students who gave consent to participate in the study. Undertaken at Moi University's School of Medicine in Eldoret, Kenya. Comprising two hundred and fifty three (253) undergraduate medical students, with a mean age of 23.7 years (19-42, s.d. 4.1), of whom 51% were female. Measuring ADHD symptomatology using the Adult ADHD Self-Report Scale (ASRS v1.1). The prevalence rate of self-reported ADHD symptoms using the ASRS screener was 23.7%. This was significantly associated with being in the age-group 17-20 years compared (p<0.05). The prevalence rate was higher among females (25.6%) than among males (21.8%), but this difference was not statistically significant. Preclinical students had a higher prevalence rate of ADHD symptoms (28.7%) compared to clinical students (19.6%), but this was also not statistically significant. Using a modification of the ASRS full symptom checklist to approximate a Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) ADHD diagnosis yielded a 'possible ADHD' prevalence rate of 8.7%. Of these, the inattentive type was the most common (40.9%). The prevalence rate of self-reported ADHD symptoms among medical students in Eldoret is very high and possibly interferes with the students' social and academic functioning. Further studies are suggested to generate information on the real ADHD prevalence in the general population and in special populations such as schools and colleges.