Wender Utah Rating Scale Research Articles

Attention deficit hyperactivity disorder and impulsivity in patients with trichotillomania

Purpose: The aim of this study was to assess impulsivity and attention deficit hyperactivity disorder in adult patients with trichotillomania.Materials and Methods: Subjects diagnosed with trichotillomania primary or comorbid to other psychiatric disorders who met the inclusion criteria were enrolled in the study. Data were collected retrospectively. Minnesota Impulse Control Disorders Interview Scale (MIDI), the Barratt's Impulsivity Scale (BIS), Adult ADD/ADHD DSM IV- Based Diagnostic Screening and Rating Scale, Wender Utah Rating Scale (WURS) were evaluated.Results: 40 patients with trichotillomania and 18 patients with trichotillomania + adult attention deficit hyperactivity disorder were included in the study. Sociodemographic characteristics of two groups were similar. Rate of pathologic gambling was higher in trichotillomania + adult attention deficit hyperactivity disorder group. Trichotillomania + adult attention deficit hyperactivity disorder group had statistically higher scores from attention deficit part of Adult ADD/ADHD DSM IV- Based Diagnostic Screening and Rating Scale. Conclusion: Adult attention deficit hyperactivity is more related to attention deficit in trichotillomania patients and impulsivity is a common feature in both disorders.

Predictive power of the ADHD GWAS 2019 polygenic risk scores in independent samples of bipolar patients with childhood ADHD

BackgroundAlthough there is evidence of genetic correlation between bipolar disorder (BP) and ADHD, the extent of the shared genetic risk and whether childhood ADHD (cADHD) influences the characteristics of the adult BP remain unclear. Our objectives were: (i) to test the ability of polygenic risk scores (PRS) derived from the latest PGC ADHD-GWAS (Demontis et al., 2019) to predict the presence of cADHD in BP patients; (ii) to examine the hypothesis that BP preceded by cADHD is a BP subtype with particular clinical traits and (iii) partially shares its molecular basis with ADHD. MethodPRS derived from the ADHD-GWAS-2019 were tested in BP patients (N = 942) assessed for cADHD with the Wender Utah Rating Scale and in controls from Romania and UK (N = 1616). ResultsThe ADHD-PRS differentiated BP cases with cADHD from controls. Proband sex and BP age-of-onset significantly influenced the discriminative power of the ADHD-PRS. The ADHD-PRS predicted the cADHD score only in males and in BP cases with early age-of-onset (≤21 years). Bipolar patients with cADHD had a younger age-of-onset of mania/depression than patients without cADHD. The ADHD-PRS predicted the BP-affection status in the comparison of early-onset BP cases with controls suggesting a partial molecular overlap between early-onset BP and ADHD. LimitationsRetrospective diagnosis of cADHD, small sample size. ConclusionsThe PRS-analysis indicated an acceptable predictive ability of the ADHD-SNP-set 2019 in independent BP samples. The best prediction of both cADHD and BP-affection status was found in the early-onset BP cases. The results may have impact on the individual disease monitoring.

Test–Retest Reliability of the 25-item version of Wender Utah Rating Scale. Impact of Current ADHD Severity on Retrospectively Assessed Childhood Symptoms

Objective: To investigate test–retest reliability of the 25-item version of Wender Utah Rating Scale (WURS-25) and factors influencing retrospective reports of childhood behavior in adults with ADHD. Method: Eighty-five adults with ADHD and 189 controls completed the WURS-25 and the adult ADHD Self-Rating Scale (ASRS) at two time points (mean interval = 7 years) and provided information about dyslexia, somatic, and psychiatric disorders. Results: The correlation between WURS-25 scores at the two time points was strong, and reports from 60% of the adults with ADHD showed no change in severity level. Reports on the WURS-25 were positively associated with current ADHD symptoms at both time points and the presence of dyslexia and mood disorders, with the strongest association found among adults reporting the most severe WURS-25 score. Conclusion: Although our study showed an acceptable test–retest reliability of WURS-25, the substantial contribution from current ADHD symptoms to the WURS scores emphasizes the importance of collateral information from family members and others who knew the adult in childhood.

Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders

Objective: The objective of this study was to compare psychiatric comorbidity and consumption-related variables in ADHD patients seeking treatment for cocaine, cannabis, or both. Method: Assessment was conducted using European Addiction Severity Index (EuropASI), Conners’ Adult ADHD Diagnostic Interview (CAADID), Structured Clinical Interview for DSM Disorders (SCID), Adult Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Barratt Impulsiveness Scale-11 (BIS-11), and FIDI, with statistical analyses of analysis of variance (ANOVA), Student’s t test, chi-square test, and multinomial regression model. Results: In total, 1,538 patients with substance use disorder (SUD) were evaluated for ADHD; 239 (15.5%) had ADHD, with cannabis 41, cannabis/cocaine 36, and cocaine 74. Men represented 80%, with mean age of 32.9 ± 10 years. Significant variables were—in bivariate analysis—more years of cannabis use in cannabis group and younger age for cocaine use disorder in cannabis/cocaine group, and—in multivariate analysis—lifetime anxiety disorder and younger age at onset of any SUD in cannabis group and working affected scale in cannabis and polysubstance use in cannabis/cocaine group. Conclusion: Groups with cannabis use had higher severity. ADHD features were similar in all groups. The assessment of ADHD and comorbid disorders is important.

Comparison of cognitive flexibility, appropriate risk-taking and reaction time in individuals with and without adult ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental and psychiatric disorder that affects different aspects of an individual life, such as cognitive functions. ADHD comprise a complex symptomatology such as cognitive flexibility and inappropriate risk-taking. We aimed to compare cognitive flexibility and appropriate risk-taking of adults with and without ADHD. For this purpose, the Conners’ Adult ADHD Rating Scale (CAARS) was used to screen 580 students of Tehran University in Iran. Forty participants who scored highest in CAARS were invited to have a clinical interview with a trained psychiatrist. The diagnosis was made based on the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), using the Wender Utah Rating Scale (WURS). Finally, thirty individuals were diagnosed with ADHD. Meanwhile, the 30 students with the lowest scores on the CAARS and General Health Questionnaire (GHQ) were included as the control group. The two groups then were compared using the Cognitive Flexibility Inventory (CFI) and the Iowa Gambling Task (IGT). The results of the one-way ANOVA indicated that scores of case group in the components of cognitive flexibility were significantly lower in the patients compared to the control group. Also, the ADHD group had lower scores concerning appropriate risk-taking and had a shorter reaction time. Findings of the current study might help to open further avenues in the rehabilitation of cognitive flexibility and controlling reward-seeking and risk-seeking impulses.

ADHD-Related Mental Health Issues of Young Adult Male Prisoners in Pravieniškės Correction House-Open Colony (Lithuania).

The aim of this study was to evaluate mental health issues related to attention-deficit/hyperactivity disorder (ADHD) in young adult male prisoners.The study was performed in the Pravieniškės Correction House-Open Prison Colony and represents the first study on adult ADHD in Lithuania. The sample consisted of 100 young males imprisoned for mild to moderate crimes. ADHD symptoms were assessed using the Adult Self-Report Scale v1.1 (ASRS v1.1) and Wender Utah Rating Scale (WURS) self-rating scales. Related mental health issues were evaluated using the DSM-5 Level 1 Cross-Cutting Symptom Measure, the Personality Inventory for DSM-5, and data from both medical files and offenses-incentives lists.Clinically significant ADHD symptoms were found in 17% of the respondents. Prisoners with ADHD were younger and had shorter incentives lists. Personality traits of negative affect, antagonism, disinhibition, and psychoticism with increased personality dysfunction were more prevalent in the respondents with ADHD. Medical files of prisoners with ADHD more frequently included data on substance abuse, psychiatric diagnoses, and psychopharmacological treatment. None of the respondents had been diagnosed or treated for this disorder.Clinically significant ADHD symptoms were highly prevalent among imprisoned males, but ADHD was not diagnosed or treated correctly. These findings show that the problem of ADHD in young male adults with increased risk for criminal behavior needs recognition by the politicians and professionals responsible for health care in Lithuania in order to better care for prisoners with this psychopathology.

Comorbidity Patterns Among Patients With Opioid Use Disorder and Problem Gambling: ADHD Status Predicts Class Membership

Objective: Psychiatric comorbidities are highly prevalent among individuals affected by substance use disorders and those with non-substance-related addictive disorders such as gambling disorder. More recently, the frequent co-occurrence of substance use disorders and attention-deficit hyperactivity disorder (ADHD) has received particular attention. The aim of our study was to identify patterns of psychiatric comorbidity and to examine associations between patient group and ADHD status with class membership. Methods: Participants were patients with opioid use disorder enrolled in opioid maintenance treatment (OMT), either recruited from the community (n = 142; M age = 35.8 years; 38.7% female) or prison (n = 133; M age = 35.7 years; 21.8% female), and patients undergoing treatment for problem gambling (PrG; n = 80; M age = 43.1 years; 20% female). To enable direct comparisons, the following instruments were applied: Mini International Neuropsychiatric Interview, Adult ADHD self-report scale, Wender Utah Rating Scale, and European Addiction Severity Index. We used a latent class analysis (LCA) to identify psychiatric comorbidity patterns and a multinomial logistic regression to examine associations between patient group, ADHD status, age, and gender with class membership. Results: The LCA resulted in a three-class solution: (1) a class of individuals with a relatively low probability of current psychiatric comorbidities, except for a high probability of substance use disorders; (2) a class with markedly increased probabilities of current and recurrent psychiatric comorbidities, especially for major depression; and (3) a class with very low probabilities of psychiatric comorbidities, except for moderate probabilities of substance use disorders and antisocial personality disorder. Both OMT patients recruited from the community and those in prison were less likely than PrG patients to be assigned to the most burdened class with respect to psychiatric comorbidity (class 2). Further, both individuals with ADHD in childhood and those with adult ADHD were more likely members of class 2. Conclusions: PrG patients seem to be at an even higher risk for psychiatric comorbidities compared to OMT patients. Raising awareness among practitioners for the high prevalence of psychiatric comorbidities among patients with gambling disorder and individuals with ADHD is crucial to initiate adequate treatment and to improve response.

The importance of avoidant personality in social anxiety disorder with and without attention-deficit/hyperactivity disorder

In the present study, our primary aim was to compare the generalized social anxiety (GSAD) patients with and without attention-deficit/hyperactivity disorder (ADHD) in terms of avoidant personality disorder (AVPD), and some clinical variables. We also investigated the relationship of AVPD and depression with ADHD and GSAD. We hypothesized that ADHD may be associated with AVPD in patients with GSAD. Seventy-six patients with GSAD were evaluated for depression, AVPD, and childhood and adulthood diagnoses of ADHD. The GSAD patients with (n = 34) and without adulthood ADHD (n = 30) were compared with respect to some sociodemographic and clinical variables. GSAD patients with adulthood ADHD had significantly higher comorbid diagnosis of AVPD, more avoidant personality and depression symptoms than those without ADHD. Pearson's correlation coefficient in total sample (n = 76) showed that the mean number of AVPD criteria was significantly associated with the severity of Beck Depression Inventory, Wender Utah Rating Scale (WURS), and inattention symptoms of ADHD. There were no correlations between the total and subscale scores of Liebowitz Social Anxiety Scale and the mean number of AVPD criteria. The scores of WURS significantly predicted the mean number of AVPD criteria (β = 0.305, p= 0.007). The severity of current depression (β = 0.143, p = 0.30) and inattention symptoms of adulthood ADHD (β = 0.112, p = 0.46) were not associated with the severity of AVPD symptoms. These results might demonstrate that comorbid AVPD in adult SAD patients was related to a childhood ADHD independent from depression, and inattention symptoms of ADHD in adulthood.

Attention-Deficit Hyperactivity Disorder Symptom Status in a Mixed Gender Population of Opioid-Maintained Prison Inmates

Objective: Attention-deficit hyperactivity disorder (ADHD) often coincides with substance abuse and delinquency. A sample of opioid-maintained inmates was assessed for symptoms of ADHD, substance abuse history, types of offense, psychiatric comorbidities, and psychopharmacological treatment using a standardized battery of instruments. Method: Adult inmates (n = 133, mean age 35.7 years, 21.8% female) in opioid-maintenance therapy (OMT) were administered the Adult ADHD self-report scale, Wender Utah Rating Scale, Mini International Neuropsychiatric Interview, ­European Addiction Severity Index. Results: Fifty percent screened positive for childhood and 17% for adult ADHD, four (3.1%) received ADHD medication. Inmates with ADHD symptom status were significantly younger at first substance abuse, reported more drug overdoses, longer duration of cocaine and prescribed medication abuse and more in- and outpatient treatments (all p < 0.05). For all inmates in OMT a high rate of psychiatric comorbidities was observed (78.9%). Conclusion: There is a need for assessment of ADHD and other psychiatric comorbidities in OMT prisoners. Evidence-based treatment should be routinely provided.

Evaluation of Childhood Sluggish Cognitive Tempo (SCT) Among the Patients With Substance Use Disorder, Substance Induced Psychosis and Childhood ADHD

Objective: Substance use disorders (SUDs) include a pathological pattern of behaviors related with the effects of the drug used and are associated with substance-induced psychosis (SIP). Individuals with lower levels of self-control are particularly predisposed to develop SUDs and SIP. The purpose of this study was to evaluate whether childhood sluggish cognitive tempo (SCT), which is a problem distinct from but related with ADHD, is associated with SUDs and SIP. Method: Fifty-seven SUD patients who had childhood ADHD symptoms and at least one SIP attack were enrolled the study. Patients were evaluated by Brief Psychiatric Rating Scale (BPRS), Wender-Utah Rating Scale (WURS), and SCT Scale. Results: The rate of childhood SCT comorbidity was 63.8%. The total BPRS and conceptual disorganization, motor retardation, unusual thought content, blunted affect, excitement, and disorientation scores were higher in the childhood SCT group. SCT and WURS scores were positively correlated with BPRS scores but WURS scores were correlated with more psychotic symptoms and the correlations were stronger in WURS than SCT except “conceptual disorganization,” “motor retardation.” and “blunted affect.” Using linear regression analysis, we found that both childhood SCT and WURS scores significantly predicted the BPRS total, motor retardation, unusual thought content, blunted affect and excitement scores. Finally, the results of multivariate stepwise regression analyses indicated that tension and guilt significantly predicted WURS while blunted affect and conceptual disorganization predicted SCT scores. Conclusion: Approximately, 7 in 10 patients in this group seem to have had childhood SCT. SCT patients showed more proneness to psychotic symptoms when compared with others. In addition, there was a relationship between blunted affect, conceptual disorganization, and SCT.

Attention Deficit Hyperactivity Disorder, Impulsivity, Anxiety, and Depression Symptoms Mediating the Relationship Between Childhood Trauma and Symptoms Severity of Obsessive-Compulsive Disorder.

A growing body of research associates childhood trauma with obsessive-compulsive disorder (OCD). The aim of this study was to investigate the relationships between childhood trauma and OCD, including both its severity and OCD patients' comorbid impulsivity, ADHD, anxiety, and depressive symptoms. A convenient sample consisting of 106 patients with OCD was given the Childhood Trauma Questionnaire (CTQ), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Wender Utah Rating Scale (WURS), Hamilton Rating Scale for Depression (HAM-D), Beck Anxiety Inventory (BAI), and Barratt Impulsivity Scale-11 (BIS-11). The results showed that childhood trauma indirectly predicts the severity of OCD and directly predicts comorbidities in OCD patients, including anxiety, ADHD, WURS, and impulsivity. Patients with childhood trauma had higher WURS, BAI, and BIS-11 scores and fewer years of education. Ongoing adult ADHD was more common in individuals with childhood trauma. A history of childhood trauma in OCD patients has indirect effects on the severity of OCD and depressive symptoms and is associated with more severe anxiety, higher levels of impulsivity, higher prevalence of ADHD, and lower levels of education. More research is needed to clarify the effects of childhood trauma on OCD severity and comorbidity.

Types of Adult Attention-Deficit Hyperactivity Disorder (ADHD): A Replication Analysis

Background: Research supports the importance of emotional symptoms in ADHD adults, symptoms not reflected in the DSM-5 or IDC-10 criteria. The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) assesses these symptoms, plus inattention, hyperactivity and impulsivity. This range of ADHD symptoms allowed us to divide adult ADHD into two subtypes in a 2015 publication: ADHD Inattentive presentation and ADHD Emotional dysregulation presentation. In the present study, we refine this observation using a larger, more diverse sample. Methods: WRAADDS data from additional clinical trials (1,493 subjects) were subjected to confirmatory factor analyses and ADHD presentations were compared, including treatment response. Outcome: Our original factor structure fit poorly with these new data. However, an alternative 2 factor solution fit both the original and the new subjects. ADHD Inattentive presentation was defined by the Inattention factor. ADHD Emotional dysregulation presentation was defined by additional elevation of the Emotional Dysregulation factor. The proportion of ADHD Emotional Dysregulation Presentation ranged from 30 to 70% across the 8 studies and it was associated with both a greater severity as measured by the Clinical Global Impression-Severity scale and more manifestations of childhood ADHD as measured by the Wender Utah Rating Scale. Interpretation: Factor analytic results supported the validity of two adult ADHD presentations based on levels of emotional dysregulation. This system offers a more clinically relevant approach to the diagnosis of ADHD in adults than does the DSM system. Funding Statement: Data came from clinical trials supported by Eli Lilly, Glaxo-Welcome, NIMH, Shire, McNeil PPPC, and Medice. This reanalysis was funded by the authors. Declaration of Interests: None of the authors have a financial interest that will be affected by the results of this article. Ethical Approval Statement: The authors selected published clinical trials of psychotropic medications used to treat ADHD in adults conducted using similar protocols. All met Declaration of Helsinki ethical criteria and were approved by relevant research review boards.

The predictors of occupational disability in obsessive-compulsive disorder in a large clinical sample

Aim: Obsessive-compulsive disorder (OCD) is a common mental disorder leading to severe loss of functioning. We aimed to investigate socio-demographic and clinical factors affecting occupational disability in OCD. Material and Methods: It is a cross sectional study with individuals recruited from an outpatient psychiatry clinic. A total of 393 patients were given the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale-17 Item (HAM-D), Beck Anxiety Inventory, Barratt Impulseness Scale-11 and Wender Utah Rating Scale. Occupational disability was defined as the inability to work over the past month due to pychopathology associated with OCD. Housewives, students and retired people were excluded. Results: The rates of occupational disability were 52.9% in the whole sample, 44.3% in men and 60% in women. Higher Y-BOCS scores, higher HAM-D scores, being single, female gender, younger age at first treatment, less school years and previous suicide attempt were associated with a higher risk of occupational disability. The BAI scores, previous hospitalization, age at onset, smoking, childhood ADHD and past or present tic disorder did not statistically affect occupational status. Conclusions: OCD is associated with serious occupational disability causing inability to work in more than half of patients. The severity of OCD and depressive symptoms, marital status, gender, education level, age at first treatment and history of suicide attempt predict occupational disability. Keywords: Occupational disability; disability; functioning; obsessive-compulsive disorder; impulsivity; Attention Deficit and Hyperactivity Disorder (ADHD).

Evaluation of clinical and suicidal behavior characteristics among urban, Turkish middle-age depressive patients with comorbid attention deficit hyperactivity disorder.

Background:In the presence of attention deficit hyperactivity disorder (ADHD) together with additional psychiatric diseases, the treatment process and prognosis of both ADHD and psychiatric comorbidity are adversely affected.Aims:The aim of this study is to compare the characteristics concerning suicidal behavior of the patients diagnosed with major depressive disorder either having (ADHD+) or not having (ADHD−) adult ADHD comorbidity and their responses to depression treatment.Materials and Methods:Ninety-six inpatients were included in the study. Sociodemographic data form, the Hamilton Depression Rating Scale (HDRS), the Wender Utah Rating Scale (WURS), the Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale, and the Personal and Social Performance Scale (PSP) were applied to the cases.Results:HDRS scores were found to be significantly high (P < 0.000) in the ADHD+ group during admission and discharge. However, there was no difference found in terms of PSP scores (P = 0.46) during discharge. In the ADHD+ group, the depressive episode started at an earlier age (P < 0.011). The idea of suicide (P < 0.018) and suicidal attempts (P < 0.022) was found to be higher in this group compared to the ADHD− group. ADHD+ patients had more suicidal attempts requiring more medical intervention (P < 0.001).Conclusion:Depression starts at an early age in individuals with comorbid ADHD diagnosis, and the progress of the depression treatment changes negatively. This patient group is at greater risk in terms of suicidal behavior. Therefore, it should be considered by the clinicians that ADHD can associate with depression while making the follow-up plans for the cases diagnosed with depression.

Effects of parents attachment styles and attention deficit symptoms on social responsiveness in children with ADHD

Objective: The aim of this study is to investigate the effects of parental attachment styles and parental inattentiveness symptoms on social responsiveness problem scores of school age children diagnosed with attention deficit hyperactivity disorder (ADHD). Methods: One hundred and seventy-nine children with ADHD diagnosed between 7 and 12 years and their parents were the sample of the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version was used to determine the presence of psychiatric disorders in the children. Parents were asked to fill out the Parental Attachment Scale, Wender Utah Rating Scale, and Social Responsiveness Scale. Results: As a result of the path analysis, it was shown that avoidant and ambivalent attachment levels of mothers had a significant increase effect on the levels of social responsiveness of children and mothers' attention deficit symptoms mediated this effect. The attachment style scores of fathers were not correlated with social responsiveness of children. Conclusion: In children with attention deficit hyperactivity disorder comorbid with social responsiveness problems, it is recommended to consider the attachment patterns of parents, especially mothers, and possible attention deficit symptoms.

Wender Utah Rating Scale-25 (WURS-25): psychometric properties and diagnostic accuracy of the Swedish translation

Objective: The aim of this study was to examine the psychometric properties and diagnostic accuracy of the Swedish version of the Wender Utah Rating Scale (WURS) in psychiatric patients with similar symptoms but diagnosed with either attention deficit hyperactivity disorder (ADHD), bipolar disorder (BP), and/or borderline personality disorder (BPD).Methods: A total of 121 patients from an outpatient psychiatric clinic for young adults (18–25 years) were diagnosed using the Structured Clinical Interview for DSM Axis I and Axis II (SCID-I and SCID-II), and ADHD was diagnosed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). WURS were filled in by the participants and compared with a diagnosis of ADHD according to K-SADS.Results: Internal consistency of the WURS was 0.94. The principal component analysis resulted in a three-factor solution that accounted for 61.3% of the variance. The ADHD group had significantly higher mean scores compared to all other groups. The diagnostic accuracy of the WURS was examined using AUC and ROC analysis, and the optimal cut-off score was 39, with a sensitivity of 0.88 and specificity of 0.70, with AUC 0.87, 95% CI 0.80–0.94, PPV 0.59, and NPV 0.92.Conclusion: The psychometric properties of the Swedish WURS were good. For assessment of adult ADHD, in patients with symptoms of emotional instability, impulsivity, and attention problems but of different origins, a somewhat higher cut-off score than the originally suggested was preferable for identification of ADHD.

Associations between symptoms of attention-deficit/ hyperactivity disorder and life satisfaction in medical students: the mediating effect of resilience

BackgroundResearch on symptoms of attention-deficit/hyperactivity disorder (ADHD) in medical students is rather scant. Studying the disorder in this population, especially its associations with positive psychological constructs can further the understanding of mental health in future physicians. The objectives of the present study were to investigate the prevalence of ADHD symptoms in medical students, to examine the relationships between ADHD symptoms and life satisfaction, and to explore the mediating role of resilience on the associations.MethodsThis cross-sectional study was carried out at one medical university in China, in June 2016. Self-reported questionnaires consisting of Adult ADHD Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Conner-Davidson Resilience Scale (CD-RISC), Satisfaction With Life Scale (SWLS), and socio-demographic characteristics, were distributed to the students. Hierarchical linear regression analyses were used to examine the effects of ADHD symptoms on life satisfaction, and asymptotic and resampling strategies were used to explore the mediating role of resilience.ResultsA total number of 521 medical students became final subjects. Based on the cutoffs of the scales, 1.54% of the medical students were highly likely to have ADHD, and 6.91% of the students were likely to have ADHD. Only inattention was negatively correlated with life satisfaction in the students. Resilience functioned as a mediator in the relationship between inattention and life satisfaction.ConclusionsThe prevalence of ADHD symptoms among Chinese medical students could be relatively high. Inattention is significantly related to life satisfaction among the students. Early identification of medical students with ADHD symptoms should be warranted. Resilience intervention programs might be undertaken to enhance life satisfaction in medical students, especially for those with inattention symptoms.

Examining the factors that are correlated with mindfulness with a focus on attention deficit hyperactivity symptoms.

We hypothesized that attention deficit hyperactivity symptoms would negatively correlate with the level of mindfulness. Seventy-six subjects referred to the outpatient psychiatry unit and 32 healthy control subjects filled out the Mindful Attention Awareness Scale (MAAS), the Depression Anxiety Stress Scale (DASS), the Adult ADHD Self-Report Scale (ASRS), and the Wender Utah Rating Scale (WURS). Patients scored higher on ADH symptoms compared to controls (p≤.001). Higher scores on the ASRS and WURS revealed lower mindfulness in the study group (p≤.001). WURS, DASS depression, ASRS attention subscale-based scores (p<.05) were significant predictors on MAAS scores. Besides emotional symptoms ADH symptoms had a significant predictive value on mindfulness.

Prevalence and clinical correlates of intermittent explosive disorder in Turkish psychiatric outpatients

ObjectiveIntermittent explosive disorder (IED) is defined as the failure to resist aggressive impulses resulting in repeated acts of verbal and/or physical aggression. Although it is frequently encountered in clinical psychiatric practice, there is a paucity of data concerning IED in the scientific literature both internationally and in Turkey. The aim of this study was to evaluate the prevalence of IED and associated sociodemographic and clinical features in a clinical setting. MethodsA total of 406 patients who were referred to our psychiatry outpatient clinic for the first time in a six-month period were included in the study. The diagnosis of IED was made using both Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) and DSM-5 criteria. Axis I disorder and personality disorder diagnoses were made according to DSM-5 criteria. Diagnoses were based on information from the Structured Clinical Interview for DSM-IV (SCID I) and the Structured Clinical Interview for DSM-IV personality disorders (SCID II), Symptom Checklist-90 (SCL-90), Wender Utah Rating Scale, Adult Attention Deficit Hyperactivity Disorder (ADHD) DSM-IV Based Diagnostic Screening and Rating Scale, a clinical interview conducted by the researcher, and a sociodemographic data form. In addition, participants were administered the Buss-Perry Aggression Scale and Barratt Impulsiveness Scale Version 11 (BIS-11) to assess aggression and impulsivity. ResultsLifetime and 12-month prevalence of IED according to DSM-5 were 16.7% and 11.3%, respectively. Mean age at onset was 16.4 years. The prevalence of lifetime IED was 3.8 times higher in males than females (95% CI = 1.9–7.5); twice as high in individuals living in rural areas compared to those living in urban centers (95% CI = 1.1–3.7); 2.7 times higher among those with lifetime suicide attempt versus those without (95% CI = 1.3–5.6); 4.5 times higher in those with lifetime self-injurious behavior compared to those without (95% CI = 2.3–8.7); and 3 times higher in individuals reporting aggression/anger problems in the family compared to those without (95% CI = 1.5–5.9). The prevalences of childhood ADHD, conduct disorder, and oppositional defiant disorder were significantly higher in the IED group. ConclusionThe result of the current study has revealed that approximately one-sixth of respondents experienced lifetime IED according to DSM-5 diagnostic criteria. Statistically significant sociodemographic correlates of IED include gender, urbanicity, history of suicide attempt, history of self-injurious behavior, and family history of aggression/anger problems.

P.2.017 - ADHD and related aspects in a standardised investigation in Austrian prisons – incarcerated patients with substance use disorders

Aim The burden of psychiatric and somatic comorbidities is higher in people who inject drugs, especially in prison [1]. As stated in previous work symptoms of attention deficit-hyperactivity disorder (ADHD) are correlated to delinquent behaviour and ADHD is knowingly increased in persons who suffer from substance-use disorders (SUD) [2,3]. Prisoners enrolled in opioid maintenance therapy (OMT) have an outlasting history of opioid abuse and potentially represent a high-risk group for ADHD. Evidence concerning prevalence of ADHD and pharmacological treatment in custodial settings is limited. Methods Standardized and structured psychiatric assessment was administered to incarcerated persons in Austrian prisons enrolled in OMT. The study was approved by IRB & Ministry of Justice. Applied instruments For the evaluation of childhood and adulthood ADHD the Wender Utah Rating Scale – germane short form (WURS-k) was applied, as well as the Adult ADHD self-report scale (ASRS-v1.1). Psychiatric comorbidities were assessed using the Mini International Neuropsychiatric Interview (MINI). Assessment of sociodemographic data, medical status, substance use and delinquency were conducted using the Europe ASI and ASI crime module. Results Of N = 132 inmates in OMT 50.0% screened positive in the WURS-k for childhood ADHD. Participants with positive results in both ADHD screenings (17.2%) were those, likely suffering from adult ADHD. Four participants received medication for ADHD. Statistical characteristics of participants with and without ADHD were assessed using Mann-Whitney-U test. Analysis showed a significant higher prevalence in subjects with adult ADHD for the following psychiatric comorbidities: Hypomanic episode (p Conclusions Although a significant proportion of inmates in OMT suffer from ADHD, pharmacological treatment of the disease is underrepresented. The implementation of a consistent diagnostic and treatment strategy for ADHD in prisoners should be conducted and attention should be paid to those with a history of substance abuse. Early and effective treatment in addition to OMT could yield to reduced concomitant consumption and higher treatment retention; next to increase the individual’s quality of life. Further, our investigation showed a significant earlier onset of substance abuse for almost all substance categories in participants with childhood ADHD. This emphasizes the need of ADHD assessment in adolescents with substance abuse.