Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder.

Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.
American Journal of Psychiatry (Impact Factor: 13.56). 01/1994; 150(12):1792-8.
Source: PubMed

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: Background Attention deficit hyperactivity disorder (ADHD) is a chronic behavioural disorder that affects 5–8% of children. It is characterized by age-inappropriate levels of inattention, hyperactivity and impulsivity that cause functional impairment in multiple settings. The most common treatment of ADHD involves prescription of stimulant medications, which often cause undesirable side effects and pose unknown long-term health risks. Therefore, alternative treatment options for ADHD are becoming increasingly popular and need to be further investigated.Objectives This overview of reviews aims to synthesize evidence from the Cochrane Database of Systematic Reviews (CDSR) on the efficacy and safety of non-pharmacologic treatments to improve symptoms of ADHD in children and adolescents.Methods Issue 12, 2010 of the CDSR was searched using the terms “attention deficit hyperactivity disorder”, “hyperkinetic disorder” and “ADHD” restricted to the title, abstract or keywords, and all systematic reviews examining non-pharmacologic treatments for ADHD in children and adolescents were identified. Data were extracted, complied into tables and synthesized using qualitative and quantitative methods.Main ResultsThree systematic reviews (containing ten trials and 594 participants) were identified for inclusion in this overview. Children assigned to Hatha yoga versus a non-specific physical activity control condition showed significantly less symptoms of inattention when measured using both parent ratings (MD: − 0.73; 95% CI: − 1.25, − 0.21) and child-completed tests (MD: − 4.01; 95% CI: − 6.23, − 1.79). There was no significant benefit of homeopathy compared to homeopathy placebo in decreasing symptoms of ADHD. There was also no significant difference between family therapy and standard treatment for parent and teacher ratings of inattention and hyperactivity/impulsivity; however, when overall symptoms were judged by a blinded third party observer in the classroom setting, standard treatment was significantly more effective (MD: 0.11; 95% CI: 0.05, 0.17). There was no significant difference between meditation therapy compared to both drug therapy and standard treatment without drugs for decreasing symptoms of inattention, hyperactivity, impulsivity, distractibility or overall symptoms.Authors' Conclusions The three Cochrane reviews suffered from a lack of high-quality, adequately powered randomized controlled trials using standardized tools to measure clinically important outcomes over adequate periods of time. Therefore, the trials included in this overview are not sufficient to provide evidence of no positive benefit of treatment, nor are they sufficient to recommend the use Hatha yoga, family therapy, meditation therapy or homeopathy for the treatment of ADHD in children and adolescents. Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
    Evidence-Based Child Health A Cochrane Review Journal 03/2011; 6(2).
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    ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is a condition that begins in childhood but can continue into adulthood, and may be the cause of many disadaptive behaviors, as in the case of homeless people, who often display a high incidence of personality disorders. The goal of this study is to analyze the comorbidity of ADHD with axis II disorders in a Spanish homeless population. The outcomes show high comorbidity between these two kinds of disorders, and that the prevalence of axis II disorders is higher among people with ADHD than among the general population. From these results we can draw the conclusion that in homeless people ADHD in childhood continues into adulthood, when it is very often observed together with personality disorders. Finally, the implications of this study both for clinical practice and for future lines of research are discussed.
    BMC Research Notes 12/2014; 7(1):916.
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    ABSTRACT: Background Attention-Deficit/Hyperactivity Disorder (ADHD) in adults is one of the predictive and treatable risk factors for delinquency, including intimate partner violence (IPV). Effective treatment of IPV needs to address personal dynamic risk factors, offender typology, and dynamics of the domestic violence. It is unknown whether treatment of ADHD symptoms contributes to a decrease in IPV. The ITAP study aims to investigate the relationship between treatment of ADHD symptoms and IPV in patients in forensic mental health care. Moreover, this study examines the role of comorbid psychopathology, subtype of the offender, and dynamics of the domestic violence.Methods/designThe ITAP study is a longitudinal observational study. Participants are followed one year through various assessments: one before starting treatment (t0), and four during treatment (8, 16, 24 and 52 weeks after start of the treatment). All participants receive treatment for IPV, ADHD, and comorbid psychopathology, if present. The primary outcome measure is the change in severity of IPV; the primary predictive variable is the change in severity of ADHD symptoms. The secondary outcome measure is the observation of the therapist about change in the offender¿s general violent behaviour, within and outside the partner relationship. Data are analysed in a multiple regression model with change in severity of IPV as the dependent variable and change in severity of ADHD symptoms as the primary predictor. Other predictive variables taken into account in the analyses are presence of comorbid psychopathology and personality disorder, subtype of the offender, and dynamics of the domestic violence. In addition, compliance with treatment and content of the treatment are documented.DiscussionResearch on the treatment process of IPV offenders and victims is complicated by many factors. This observational design will not allow inferences about causality but may reveal clinically important factors that contribute to more effective treatment of IPV.Trial registrationThe Netherlands National Trial Register (NTR), trial ID NTR3887.
    BMC Psychiatry 11/2014; 14(1):336. · 2.24 Impact Factor