Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder.
ABSTRACT Although attention deficit hyperactivity disorder is a common disorder of childhood, its status as a disorder in adults is not clear. The authors reasoned that if the adult diagnosis of the disorder is a valid clinical entity, it should be similar to the childhood disorder with regard to patterns of psychiatric and cognitive findings.
Eighty-four adults with a clinical diagnosis of childhood-onset attention deficit hyperactivity disorder confirmed by structured interview who were referred for treatment were studied. Findings were compared with those from a preexisting study group of referred children with attention deficit hyperactivity disorder, nonreferred adult relatives of those children who also had attention deficit hyperactivity disorder, and adults without the disorder who were relatives of normal children. Subjects were evaluated with a comprehensive battery of psychiatric, cognitive, and psychosocial assessments.
The referred and nonreferred adults with attention deficit hyperactivity disorder were similar to one another but more disturbed and impaired than the comparison subjects without the disorder. The pattern of psychopathology, cognition, and functioning among the adults with attention deficit hyperactivity disorder approximated the findings for children with the disorder.
These results show that referred and nonreferred adults with attention deficit hyperactivity disorder have a pattern of demographic, psychosocial, psychiatric, and cognitive features that mirrors well-documented findings among children with the disorder. These findings further support the validity of the diagnosis for adults.
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ABSTRACT: Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders. In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and four weeks after the start of the medication using Conners' Parent Questionnaire, Hamilton's Rating Scale for Anxiety, Clinical Global Assessment Scale, Clinical Global Impression-Severity Scale and Side Effects Form. Data were analyzed using repeated measure, analyses of variance (ANOVA), Tukey post hoc test and paired t-test. There were significant reduction in the total score of ADHD (F = 31.441; P <0.001) at the end of the treatment compared to baseline (Table 1). The differences between T0 and T2 in the subscales of attention deficit, hyperactivity and confrontation (F = 20.691; P <0.001, F = 28.810; P < 0.001, and F = 17.463; P <0.001, respectively) were also significant. Findings also indicated significant differences between T0 and T1 (P<0.01) and T1 and T2 (P<0.01) in all of the subscales except for confrontation. A significant improvement was observed in the severity of ADHD and anxiety disorders during different courses of the treatment (p<0.001). No significant changes were observed in systolic and diastolic blood pressure and pulse and weight of the patients during the study. The most common complications were headache and anorexia. The short-term treatment with reboxetine was effective in improving ADHD with comorbid anxiety disorders. Therefore, reboxetine could be used as a treatment option for ADHD in those children who experience comorbid anxiety disorders or in those who are non-responsive or intolerant to methylphenidate.
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ABSTRACT: The present study evaluated an alternative method of neuropsychological test interpretation for the classification of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Specifically, an intra-individual discrepancy analysis was implemented in which differences between intellectual functioning and performance on a battery of six frontal/executive tests were examined within a homogeneous group of ADHD adults and matched normal controls. Significant group differences were identified between the ADHD adults and control sample on each of the dependent measures, with moderate diagnostic efficiency rates for the individual measures and a Discrepancy Impairment Index (DII). The discrepancy analysis approach generated significantly greater sensitivity in detecting the presence of ADHD as compared to a level of performance interpretive approach. Overall, these results provide support for the consideration of discrepancies between intellectual ability and frontal/executive functioning for the assessment of adult ADHD.Archives of Clinical Neuropsychology 01/2002; 17(4):351-369. DOI:10.1016/S0887-6177(01)00120-2 · 1.92 Impact Factor