Search

Introduction: 5% of infants and teenagers worldwide are diagnosed with attention deficit disorder (ADD) (APA, 2013). We present ADD Escape, an immersive serious game for cognitive intervention in ADD patients. We support abilities such as omission of irrelevant stimuli, following instructions, sustained attention, cognitive flexibility, inhibition, interference control, and task persistence. Objectives: To study the effect of virtual reality for the intervention of ADD. Methods: Subjects. The final sample will be teenagers (n:150) between 13 and 16 years old, with ADD. We will do a randomized controlled trial (RCT) where subjects will be divided into three conditions: G1: Pen and paper. G2: ADD Escape. G3. Waiting list Subjects will receive 9 weeks of intervention. Pre and post interventions will include neuropsychological evaluations of selective, sustained, and divided attention, as well as a motivation measurement. A follow up after three months will be performed. Data Analysis. An ANOVA analysis and its size effect will allow a comparison between conditions. Tools and Functionality. ADD Escape is an escape room puzzle that presents RCTs such as the following: voice and text commands, shape matching, organization of objects, and inhibiting activities. ADD Escape is designed for the Oculus Quest platform, with 64GB of memory, a resolution of 1440 x 1600 pixels per eye, and a refresh rate of 72Hz. Results: We hypothetize that ADD Escape will motivate more than pen and paper and will create more adherence to treatment. Conclusions: We show with ADD Escape some of the benefits of VR for the intervention of disorders such as ADD. [ABSTRACT FROM AUTHOR]

Essential minerals are cofactors for synthesis of neurotransmitters supporting cognition and mood. An 8-week fully-blind randomised controlled trial of multinutrients for attention-deficit/hyperactivity disorder (ADHD) demonstrated three times as many children (age 6–12) had significantly improved behaviour ('treatment responders') on multinutrients (54 %) compared with placebo (18 %). The aim of this secondary study was to evaluate changes in fasted plasma and urinary mineral concentrations following the intervention and their role as mediators and moderators of treatment response. Fourteen essential or trace minerals were measured in plasma and/or urine at baseline and week eight from eighty-six participants (forty-nine multinutrients, thirty-seven placebos). Two-sample t tests/Mann–Whitney U tests compared 8-week change between treatment and placebo groups, which were also evaluated as potential mediators. Baseline levels were evaluated as potential moderators, using logistic regression models with clinical treatment response as the outcome. After 8 weeks, plasma boron, Cr (in females only), Li, Mo, Se and vanadium and urinary iodine, Li and Se increased more with multinutrients than placebo, while plasma phosphorus decreased. These changes did not mediate treatment response. However, baseline urinary Li trended towards moderation: participants with lower baseline urinary Li were more likely to respond to multinutrients (P = 0·058). Additionally, participants with higher baseline Fe were more likely to be treatment responders regardless of the treatment group (P = 0·036.) These results show that multinutrient treatment response among children with ADHD is independent of their baseline plasma mineral levels, while baseline urinary Li levels show potential as a non-invasive biomarker of treatment response requiring further study. [ABSTRACT FROM AUTHOR]

The UK's services for adult attention-deficit hyperactivity disorder (ADHD) are in crisis, with demand outstripping capacity and waiting times reaching unprecedented lengths. Recognition of and treatments for ADHD have expanded over the past two decades, increasing clinical demand. This issue has been exacerbated by the COVID-19 pandemic. Despite an increase in specialist services, resource allocation has not kept pace, leading to extended waiting times. Underfunding has encouraged growth in independent providers, leading to fragmentation of service provision. Treatment delays carry a human and financial cost, imposing a burden on health, social care and the criminal justice system. A rethink of service procurement and delivery is needed, with multiple solutions on the table, including increasing funding, improving system efficiency, altering the service provision model and clinical prioritisation. However, the success of these solutions hinges on fiscal capacity and workforce issues. [ABSTRACT FROM AUTHOR]

Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, including depression, anxiety, post-traumatic stress disorder, substance use disorder and attention-deficit hyperactivity disorder. Despite literature on such associations, psychiatric intervention in the treatment of patients following traumatic injury is limited. The authors share their experience of challenges in addressing mental health problems in a tertiary care trauma centre located in North India. Steps in overcoming those challenges included: developing a semi-structured form to be completed for referrals and consultations, a psychiatrist attending weekly rounds with the surgeons, and initiating a psychiatry out-patient clinic for patients discharged from the trauma centre. It may be worthwhile in the future to set up a trauma psychiatry unit at the centre, involving a clinical psychologist, a psychiatric social worker and an occupational therapist for the comprehensive care of patients. [ABSTRACT FROM AUTHOR]

Introduction: Dopamine depletion in prefrontal cortex (PFC) plays a key pathofysiological role in severity of ADHD. Depression is an frequent cormobide condition of ADHD. To date, effect of SSRI's on dopamine level in PFC is limited to animal studies. Authors of current paper provide our experience with fluoxetine in relation to ADHD treatment. Objectives: To provide pharmacological insights in treatment of depression and ADHD. Methods: A case rapport of a patient treated with fluoxetine, followed by deterioration of ADHD symptoms. Results: A 28 y.o. and otherwise healthy male, was receiving 20mg and 40mg. of fluoxetine for minor depression for a total period of two months. During the course of treatment he started to complain about increasing attention deficit and developing of chaotic, obviously deviant, sexual thoughts and disorganised behaviour. The burden of disease caused him to abandon his occupation. Patient contacted psychiatric emergency service. Fluoxetine was gradually reduced and stopped within two weeks, while symptomatologic treatment with small doses of olanzapine was started. Shortly thereafter the DIVA test was accomplished and the patient was found to score heavily positive for ADHD symptoms. Subsequently, treatment with venlafaxine and methylphenidate was initiated. Shortly hereafter, patient reported a significant relief of the symptoms and he was able to resume his job. Conclusions: Fluoxetine might worsen the symptoms of ADHD through the diminished postsynaptic D2 receptor binding capacity in PFC. Given the long wash out period of the drug, we recommend to consider an SNRI or NDRI as drug of choice because of a favorable effect on ADHD symptomatology. [ABSTRACT FROM AUTHOR]

Background. Attention-deficit hyperactivity disorder (ADHD) is highly heritable, though environmental factors also play a role. Prenatal maternal stress is suggested to be one such factor, including exposure to highly distressing events that could lead to post-traumatic stress disorder (PTSD). The aim of this study is to investigate whether prenatal maternal PTSD is associated with offspring ADHD. Method. A register-based retrospective cohort study linking 553 766 children born in Sweden during 2006-2010 with their biological parents. Exposure: Prenatal PTSD. Outcome: Offspring ADHD. Logistic regression determined odds ratios (ORs) with 95% confidence intervals (CIs) for ADHD in the offspring. Adjustments were made for potential covariates, including single parenthood and possible indicators of heredity measured as parental ADHD and maternal mental disorders other than PTSD. Subpopulations, excluding children with indicators of heredity, were investigated separately. Results. In the crude results, including all children, prenatal PTSD was associated with offspring ADHD (OR: 1.79, 95% CI: 1.37-2.34). In children with indicators of heredity, the likelihood was partly explained by it. Among children without indicators of heredity, PTSD was associated with offspring ADHD (OR: 2.32, 95% CI: 1.30-4.14), adjusted for confounders. Conclusions. Prenatal maternal PTSD is associated with offspring ADHDregardless of indicators of heredity, such as parentalADHDormaternalmental disorder other than PTSD. The association is partly explained by heredity and socioeconomic factors. If replicated in other populations, preferably using a sibling design, maternal PTSD could be identified as a risk factor for ADHD. [ABSTRACT FROM AUTHOR]

Adults with attention-deficit hyperactivity disorder (ADHD) often struggle with emotion regulation (ER), impacting their empathic skills and relationships. ADHD medication might not be as effective for ER issues as for ADHD symptoms. Microdosing (MD) psychedelics has shown promise for ADHD treatment and previous studies reported social-emotional benefits. Two online prospective studies investigatedMDeffects on ER and empathy in adults with severe ADHD symptoms across three assessments: baseline, two-, and four-week post-initiation. Study 1 examined adults initiating MD on their own (n = 233, n = 64, and n = 44) and found positive effects on ER (cognitive reappraisal and expressive suppression) and aspects of empathy (perspective-taking and personal distress). Study 2, including a control group and an ADHD symptom scale, compared individuals onlyMD(n = 180, n = 50, and n = 38) to individuals using conventional ADHD medication (n = 37, n = 27, and n = 28). After 4 weeks, ADHD symptoms were lower in the MD group. Only improvements in expressive suppression persisted after adding the control group. This study indicates the positive effects of MD psychedelics onADHD symptoms and ER in adults with severe ADHD symptoms while lacking evidence for effects on empathy. [ABSTRACT FROM AUTHOR]

Background: It is well-known that childhood attention-deficit hyperactivity disorder (ADHD) is associated with later adverse mental health and social outcomes. Patient-based studies suggest that ADHD may be associated with later cardiovascular disease (CVD) but the focus of preventive interventions is unclear. It is unknown whether ADHD leads to established cardiovascular risk factors because so few cohort studies measure ADHD and also follow up to an age where CVD risk is evident. Aims: To examine associations between childhood ADHD problems and directly measured CVD risk factors at ages 44/45 years in a UK population-based cohort study (National Child Development Study) of individuals born in 1958. Method: Childhood ADHD problems were defined by elevated ratings on both the parent Rutter A scale and a teacher-rated questionnaire at age 7 years. Outcomes were known cardiovascular risk factors (blood pressure, lipid measurements, body mass index and smoking) at the age 44/45 biomedical assessment. Results: Of the 8016 individuals assessed both during childhood and at the biomedical assessment 3.0% were categorised as having childhood ADHD problems. ADHD problems were associated with higher body mass index (B = 0.92 kg/m2, s.d. = 0.27–1.56), systolic (3.5 mmHg, s.d. = 1.4–5.6) and diastolic (2.2 mmHg, s.d. = 0.8–3.6) blood pressure, triglyceride levels (0.24 mol/l, s.d. = 0.02–0.46) and being a current smoker (odds ratio OR = 1.6, s.d. = 1.2–2.1) but not with LDL cholesterol. Conclusions: Childhood ADHD problems predicted multiple cardiovascular risk factors by mid-life. These findings, when taken together with previously observed associations with cardiovascular disease in registries, suggest that individuals with ADHD could benefit from cardiovascular risk monitoring, given these risk factors are modifiable with timely intervention. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear. Aims: To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders. Method: Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders. Results: A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02–5.29) or accident (RR = 1.62, 95% CI 1.43–1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40–1.66), bipolar disorder (RR = 1.99, 95% CI 1.83–2.16), MDD (RR = 1.98, 95% CI 1.89–2.08) or ADHD (RR = 1.34, 95% CI 1.24–1.44). Conclusions: Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation. [ABSTRACT FROM AUTHOR]

Introduction: 15q11.2-q13.3 region is prone to genomic rearrangements leading to both deletions and duplications. A wide spectrum of neuropsychiatric conditions, such as developmental delay/intellectual disability (DD/ID), autism, attention-deficit hyperactivity disorder, schizophrenia, epilepsy was reported in association with genomic imbalances of this region. Objectives: In this paper we report on 9 children carrying 15q11.2-q13.3 duplications. Methods: Seven boys and two girls, aged 15 months to 15 years, were included in the study. Genomic investigations were carried out by array-based comparative genomic hybridization (Agilent Technologies). In all patients the psychomotor development, dysmorphic features, neuroimaging and EEG anomalies were assessed. Psychologic and psychiatric evaluation was performed with specific tests. Results: The size of the duplications ranged from 9.65 Mb to 0.38 Mb. All patients presented speech delay. Autistic behavior and muscular hypotonia were detected in 8 out of 9 patients, DD/ID in 6. Two children presented epileptic seizures, in addition 4 other children had EEG anomalies. Facial dysmorphic features were observed in 5 patients. Neuroimaging studies showed anomalies in 4 children. The smallest region of overlap in our patient group harbors CHRNA7 gene, a candidate for the behavioral abnormalities. Conclusions: 15q duplications encompassing CHRNA7 gene were associated with different neuropsychiatric features in our patients. Our results further support the association of 15q duplications with neuropsychiatric phenotypes, with clinical heterogeneity and variable severity, which is yet to be explained. Acknowledgment: The research leading to these results has received funding from the EEA RO NO Grant 2014-2021, the project contract No 6/2019. [ABSTRACT FROM AUTHOR]

Introduction: Multiple studies have demonstrated that adopted children develop behavioral and we think that they have a more risk of develop of attention-deficit hyperactivity disorder (ADHD). Objectives: The objective of this paper is to study if there is a higher frequency of ADHD in adopted than non-adopted children and in that case, which risk factors increase the vulnerability. Methods: A bibliographic search was performed from different database (Pubmed, TripDatabase) about both populations, looking for vulnerability factors for the development of ADHD. Results: We found more ADHDon adopted children than children raised in their biological families. This finding might be because of risk factors related with adopted children, like prenatal alcohol exposure and a maintained state of deprivation (from no social or cognitive stimulation, to maltreatment). In addition, the prevalence and levels of ADHD symptoms are increased in children who have been institutionalized early life, because it can disturb the development of some brain regions, and children who have spent more time in these institutions (more than 6 months). We found that de prevalence of ADHD symptoms between adopted children with low level of deprivation were similar to the general population (5.6%), while individuals with high level of deprivation had over four times than the others (20%). Conclusions: In conclusion, adopted children have more risk to develop ADHD, especially if they have been exposed to a serious deprivation, on a earlier age and six months minimum. We should put more attention in this population to act early and supply an appropriate development. [ABSTRACT FROM AUTHOR]

Aims. Previous observational studies have reported potential associations among attention-deficit/hyperactivity disorder (ADHD), obesity, and diabetes (including type 1 and type 2 diabetes mellitus [T1DM/T2DM]). However, whether the association between ADHD and diabetes is mediated by obesity is unknown. Methods. With two-sample Mendelian randomization, we analysed the causal effect of ADHD on T1DM and T2DM and six obesity-related traits [including body mass index, waist circumference (WC), hip circumference, waist-to-hip ratio (WHR), body fat percentage and basal metabolic rate] and the causal effect of these obesity-related traits on T1DM/T2DM. Finally, with multivariable Mendelian randomization, we explored and quantified the possible mediation effects of obesity-related traits on the causal effect of ADHD on T1DM/T2DM. Results. Our results showed that ADHD increased the risk of T2DM by 14% [odds ratio (OR) = 1.140, 95% confidence interval (CI) = 1.005-1.293] but with no evidence of an effect on T1DM (OR = 0.916, 95% CI = 0.735-1.141, P = 0.433.). In addition, ADHD had a 6.1% increased causal effect on high WC (OR = 1.061, 95% CI = 1.024-1.099, P = 0.001) and an 8.2% increased causal effect on high WHR (OR = 1.082, 95% CI = 1.035-1.131, P = 0.001). In addition, a causal effect of genetically predicted high WC (OR = 1.870, 95% CI = 1.594-2.192, P < 0.001) on a higher risk of T2DM was found. In further analysis, WC mediated approximately 26.75% (95% CI = 24.20%-29.30%) of the causal association between ADHD and T2DM. Conclusions. WC mediates a substantial proportion of the causal effect of ADHD on the risk of T2DM, which indicated that the risk of T2DM induced by ADHD could be indirectly reduced by controlling WC as a main risk factor. [ABSTRACT FROM AUTHOR]

Research on the gut microbiome and mental health among children and adolescents is growing. This umbrella review provides a high-level overview of current evidence syntheses to amalgamate current research and inform future directions. Searches were conducted across seven databases for peer-reviewed pediatric (<18 years) review literature. Studies reporting gut microbiome composition and/or biotic supplementation on depression, bipolar disorder, anxiety, attention deficit hyperactivity disorder, autism spectrum disorder (ASD), or obsessive-compulsive disorder (OCD) were included. Deduplication and screening took place in Covidence. A sensitivity analysis was conducted to assess the degree of primary study overlap. Among the 39 included review studies, 23 (59%) were observational and 16 (41%) were interventional. Most reviews (92%) focused on ASD. Over half (56%) of the observational and interventional reviews scored low or critically low for methodological quality. A higher abundance of Clostridium clusters and a lower abundance of Bifidobacterium were consistently observed in ASD studies. Biotic supplementation was associated with ASD symptom improvement. Gut microbiome-mental health evidence syntheses in child and youth depression, anxiety, bipolar disorder, and OCD are lacking. Preliminary evidence suggests an association between specific microbiota and ASD symptoms, with some evidence supporting a role for probiotic supplementation ASD therapy. [ABSTRACT FROM AUTHOR]

Marine n -3 fatty acids (n -3LCPUFA) have shown neurocognitive benefits in children with attention-deficit/hyperactivity disorder (ADHD), but few trials have examined effects in adults with autism spectrum disorder (ASD). We explored, if n -3LCPUFA affect cognitive functions in adults with ASD, and if effects are modified by comorbid ADHD. In a 2 × 4 week crossover study, twenty-six participants were randomised to sequence of supplementation with fish oil (FO, 5·2 g/d n -3PUFA) and safflower oil (SO). At baseline and after each period, we measured primary outcomes: attention (d2-test) and spatial working memory (Corsi test) and secondary outcomes: flexibility (Stroop word-colour test), ADHD symptoms (Conners scales), executive functions (Behavioural Inventory of Executive Function) and social behaviour (Social Responsiveness Scale). The dropout rate was 15 %. Compliance was 94 % and correlated with whole-blood n -3LCPUFA. Corsi scores improved by ∼0·3 × sd (P = 0·032) after FO v. SO, and the odds for d2 errors were 30 % lower (P = 0·016), which was supported by improved Conners scores of attention (P = 0·023). Improvement in Conners ADHD symptom score was limited to participants with ADHD (–3·5(–6·0; –1·0), n 10 v. −0·2(–2·5;2·2), n 11 without ADHD, P interaction = 0·096), who also improved their behavioural regulation index by 0·3 × sd after FO (P interaction = 0·016). Participants without ADHD gained most in d2 test performance (OR = 0·4(0·2;0·7) v. 0·9(0·6;1·3) in those with ADHD, P interaction = 0·002), but their executive function score was exacerbated after FO (5·9(0·0,11·8), P interaction = 0·039). Our results did not show any effects on ASD symptoms, but suggest that FO may improve attention and working memory in adults with ASD and ameliorate ADHD symptoms in those with comorbid ADHD. [ABSTRACT FROM AUTHOR]

Depression is one of the most common mental health problems in the elderly and is associated with a significant burden of illness affecting patients, their families and communities. Selecting, adjusting, and changing antidepressants in the elderly in a sequential way has shown response and remission rates similar to those of younger adults. However, antidepressants may be less effective in older patients because they have a greater burden of somatic disorders (including white matter lesions) and because their physicians have a tendency to prescribe suboptimal doses. Physicians are also increasingly prescribing antidepressants in elderly patients for nondepressive indications (including off-label) such as anxiety disorders, insomnia, pain, panic disorders (with or without agoraphobia), fibromyalgia, obsessive-compulsive disorder, social phobia, nicotine dependence, attention deficit hyperactivity disorder, posttraumatic stress disorder, digestive systemdisorders, urinary system disorders, bulimia nervosa, ... This workshop will give an overview of the literature andwill include clinical advise based on current guidelines. [ABSTRACT FROM AUTHOR]

Background: The ICD-10 and DSM-IV diagnostic criteria for hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD) require symptoms or impairment in two or more settings. Thus, information on children's symptoms in school is usually required. This paper presents the Child ADHD Teacher Telephone Interview (CHATTI), an instrument aimed at systematically obtaining this information.Aims: To examine the stability, test-retest reliability and criterion validity of the CHATTI for children referred with a suspected diagnosis of ADHD.Method: Data were obtained from 79 teachers, of whom 36 were interviewed on two occasions.Results: Overall, the CHATTI shows good stability, test-retest reliability and criterion validity for symptom scores. Test-retest reliability for some individual items was low. Reliability for the operationalised criteria of 'pervasiveness' (i.e. symptoms at school and home) and 'school impairment' was excellent (kappa=1).Conclusions: The CHATTI appears to be a promising tool for assessing ADHD symptoms in a school setting and could be useful in clinical as well as research settings. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about the vital role of micronutrients in treating attention-deficit hyperactivity disorder (ADHD).

To investigate the accuracy of the age-at-onset criterion in those who meet other DSM-5 criteria for attention-deficit hyperactivity disorder, using a prospective population cohort we compared four different approaches to asking those aged 25 years (n = 138) when their symptoms started. Receiver operating characteristic curves showed variation between the approaches (χ(3) = 8.99, P = 0.03); all four showed low discrimination against symptoms that had been assessed when they were children (area under the curve: 0.57-0.68). Asking adults to recall specific symptoms may be preferable to recalling at what age symptoms started. However, limitations to retrospective recall add to debate on the validity of ADHD age-at-onset assessment. [ABSTRACT FROM AUTHOR]

Background. Questions remain regarding whether genetic influences on early life psychopathology overlap with cognition and show developmental variation. Methods. Using data from 9,421 individuals aged 8-21 from the Philadelphia Neurodevelopmental Cohort, factors of psychopathology were generated using a bifactor model of item-level data from a psychiatric interview. Five orthogonal factors were generated: anxious-misery (mood and anxiety), externalizing (attention deficit hyperactivity and conduct disorder), fear (phobias), psychosis-spectrum, and a general factor. Genetic analyses were conducted on a subsample of 4,662 individuals of European American ancestry. A genetic relatedness matrix was used to estimate heritability of these factors, and genetic correlations with executive function, episodic memory, complex reasoning, social cognition, motor speed, and general cognitive ability. Gene × Age analyses determined whether genetic influences on these factors show developmental variation. Results. Externalizing was heritable (h² = 0.46, p = 1 × 10-6), but not anxious-misery (h² = 0.09, p = 0.183), fear (h² = 0.04, p = 0.337), psychosis-spectrum (h² = 0.00, p = 0.494), or general psychopathology (h² = 0.21, p = 0.040). Externalizing showed genetic overlap with face memory (ρg =-0.412, p = 0.004), verbal reasoning (ρg =-0.485, p = 0.001), spatial reasoning (ρg =-0.426, p = 0.010), motor speed (ρg = 0.659, p = 1x10-4), verbal knowledge (ρg = -0.314, p = 0.002), and general cognitive ability (g)(ρg = -0.394, p = 0.002). Gene × Age analyses revealed decreasing genetic variance (γg = -0.146, p = 0.004) and increasing environmental variance (ρe = 0.059, p = 0.009) on externalizing. Conclusions. Cognitive impairment may be a useful endophenotype of externalizing psychopathology and, therefore, help elucidate its pathophysiological underpinnings. Decreasing genetic variance suggests that gene discovery efforts may be more fruitful in children than adolescents or young adults. [ABSTRACT FROM AUTHOR]

Background: Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions.Aims: To estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition.Method: Surveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires.Results: Questionnaire response was 79% at baseline and 82% at follow-up. For those aged 17-19, incident rate (range adjusted for non-response) of transition need was 202-511 per 100 000 people aged 17-19 per year, with successful transition of 38-96 per 100 000 people aged 17-19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria.Conclusions: As inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences. [ABSTRACT FROM AUTHOR]

Aims: There has been a lack of prevalence estimates of DSM-5 mental disorders in child populations at the national level worldwide. This study estimated the lifetime and 6-month prevalence of mental disorders according to the DSM-5 diagnostic criteria in Taiwanese children. Methods: Taiwan's National Epidemiological Study of Child Mental Disorders used the stratified cluster sampling to select 69 schools in Taiwan resulting in a nationally representative sample of 4816 children in grades 3 (n = 1352), 5 (n = 1297) and 7 (n = 2167). All the participants underwent face-to-face psychiatric interviews using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiological version, modified for the DSM-5, and they and their parents completed questionnaires. The inverse probability censoring weighting (IPCW)-adjusted prevalence was reported to minimise non-response bias. Results: The IPCW-adjusted prevalence rates of mental disorders decreased by 0.1–0.5% than raw weighted prevalence. The IPCW-adjusted weighted lifetime and 6-month prevalence rates for overall mental disorders were 31.6 and 25.0%, respectively. The most prevalent mental disorders (lifetime, 6-month) were anxiety disorders (15.2, 12.0%) and attention-deficit hyperactivity disorder (10.1, 8.7%), followed by sleep disorders, tic disorders, oppositional defiant disorder and autism spectrum disorder. The prevalence rates of new DSM-5 mental disorders, avoidant/restrictive food intake disorder and disruptive mood dysregulation disorder were low (<1%). Conclusions: Our findings, similar to the DSM-IV prevalence rates reported in Western countries, indicate that DSM-5 mental disorders are common in the Taiwanese child population and suggest the need for public awareness, early detection and prevention. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses within the issue on topics including the psychological therapy for depression, association of attention-deficit hyperactivity disorder (ADHD) to bipolar disorder and schizophrenia and importance of gene-environment interaction.

Background. Adults with attention deficit hyperactivity disorder (ADHD) frequently suffer from sleep problems and report high levels of daytime sleepiness compared to neurotypical controls, which has detrimental effect on quality of life. Methods. We evaluated daytime sleepiness in adults with ADHD compared to neurotypical controls using an observer-rated sleepiness protocol during the Sustained Attention Response Task as well as electroencephalogram (EEG) slowing, a quantitative electroencephalographic measure collected during a short period of wakeful rest. Results. We found that adults withADHDwere significantly sleepier than neurotypical controls during the cognitive task and that this on-task sleepiness contributed to cognitive performance deficits usually attributed to symptoms of ADHD. EEG slowing predicted severity of ADHD symptoms and diagnostic status, and was also related to daytime sleepiness. Frontal EEG slowing as well as increased frontal delta were especially prominent in adults with ADHD. We have validated and adapted an objective observer-rated measure for assessing on-task sleepiness that will contribute to future sleep research in psychology and psychiatry. Conclusions. These findings indicate that the cognitive performance deficits routinely attributed to ADHD and often conceptualized as cognitive endophenotypes of ADHD are largely due to on-task sleepiness and not exclusively due to ADHD symptom severity. Daytime sleepiness plays a major role in cognitive functioning of adults with ADHD. [ABSTRACT FROM AUTHOR]

Background: 22q11.2 deletion syndrome (22q11.2DS) is associated with high rates of neurodevelopmental disorder, however, the links between developmental coordination disorder (DCD), intellectual function and psychiatric disorder remain unexplored. Aims To establish the prevalence of indicative DCD in children with 22q11.2DS and examine associations with IQ, neurocognition and psychopathology.Method: Neurocognitive assessments and psychiatric interviews of 70 children with 22q11.2DS (mean age 11.2, s.d. = 2.2) and 32 control siblings (mean age 11.5, s.d. = 2.1) were carried out in their homes. Nine children with 22q11.2DS and indicative DCD were subsequently assessed in an occupational therapy clinic.Results: Indicative DCD was found in 57 (81.4%) children with 22q11.2DS compared with 2 (6.3%) control siblings (odds ratio (OR) = 36.7, P < 0.001). Eight of nine (89%) children with indicative DCD met DSM-5 criteria for DCD. Poorer coordination was associated with increased numbers of anxiety, (P < 0.001), attention-deficit hyperactivity disorder (ADHD) (P < 0.001) and autism-spectrum disorder (ASD) symptoms (P < 0.001) in children with 22q11.2DS. Furthermore, 100% of children with 22q11.2DS and ADHD had indicative DCD (20 of 20), as did 90% of children with anxiety disorder (17 of 19) and 96% of children who screened positive for ASD (22 of 23). The Developmental Coordination Disorder Questionnaire score was related to sustained attention (P = 0.006), even after history of epileptic fits (P = 0.006) and heart problems (P = 0.009) was taken into account.Conclusions: Clinicians should be aware of the high risk of coordination difficulties in children with 22q11.2DS and its association with risk of mental disorder and specific neurocognitive deficits. Declaration of interest None. [ABSTRACT FROM AUTHOR]

References 1 Wang Z, Chan AYL, Coghill D, Ip P, Lau WCY, Simonoff E, Association between prenatal exposure to antipsychotics and attention-deficit/hyperactivity disorder, autism spectrum disorder, preterm birth, and small for gestational age. There is an association between maternal mental illness and higher rates of children developing ADHD and ASD, but the prescribed antipsychotic medications are not driving it (this is an example of confounding by indication). B There are ongoing concerns about the impact of antipsychotic use during pregnancy, particularly with respect to increased risks of neurodevelopmental complications. b There are few randomised controlled trials in pregnant women, and there is the major confounder that the condition being treated may itself be associated with adverse effects in the infant. [Extracted from the article]

Background The role of nutrition in the treatment of attention-deficit hyperactivity disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient at a time. Aims To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals, without omega fatty acids, in the treatment of ADHD in adults. Method This double-blind randomised controlled trial assigned 80 adults with ADHD in a 1:1 ratio to either micronutrients (n = 42) or placebo (n = 38) for 8 weeks (trial registered with the Australian New Zealand Clinical Trials Registry: ACTRN12609000308291). Results Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales. However, clinicians rated those receiving micronutrients as more improved than those on placebo both globally and on ADHD symptoms. Post hoc analyses showed that for those with moderate/severe depression at baseline, there was a greater change in mood favouring active treatment over placebo. There were no group differences in adverse events. Conclusions This study provides preliminary evidence of efficacy for micronutrients in the treatment of ADHD symptoms in adults, with a reassuring safety profile. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the diagnostic vulnerability of attention-deficit hyperactivity disorder (ADHD), attitudes of the public to mental illness, collaborative care to people with common mental disorders.

A correction to the article "Attention-deficit hyperactivity disorder across the lifespan: author's reply" is presented.

Background: There is recent evidence of some degree of shared genetic susceptibility between adult schizophrenia and childhood attention-deficit hyperactivity disorder (ADHD) for rare chromosomal variants.Aims: To determine whether there is overlap between common alleles conferring risk of schizophrenia in adults with those that do so for ADHD in children.Method: We used recently published Psychiatric Genome-wide Association Study (GWAS) Consortium (PGC) adult schizophrenia data to define alleles over-represented in people with schizophrenia and tested whether those alleles were more common in 727 children with ADHD than in 2067 controls.Results: Schizophrenia risk alleles discriminated ADHD cases from controls (P = 1.04 × 10(-4), R(2) = 0.45%); stronger discrimination was given by alleles that were risk alleles for both adult schizophrenia and adult bipolar disorder (also derived from a PGC data-set) (P = 9.98 × 10(-6), R(2) = 0.59%).Conclusions: This increasing evidence for a small, but significant, shared genetic susceptibility between adult schizophrenia and childhood ADHD highlights the importance of research work across traditional diagnostic boundaries. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editors discuss the theme of biomedical technologies and its philosophical aspects, such as the role of the body in feminist discourse, neuroscience studies on sex difference, and the ethical aspects of attention-deficit/hyperactivity disorder.

Altered neural connectivity in neurodevelopmental disorders is likely subtle, meaning that neuroimaging literature studying development has produced heterogeneous findings. A recent study, published in this issue, illustrates the translational potential of functional connectivity magnetic resonance imaging findings as a biomarker for attention-deficit hyperactivity disorder and autism spectrum disorder. Importantly, it highlights the overlap between disorders, emphasising the need for transdiagnostic and dimensional approaches in neurodevelopment.Declaration of interestNone. [ABSTRACT FROM AUTHOR]

Larsson et al provide epidemiological evidence for a genetic association between attention-deficit hyperactivity disorder (ADHD) and both bipolar disorder and schizophrenia and Hamshere and colleagues confirm the latter association with genome-wide data. Although a genetic link between ADHD and bipolar disorder has been hypothesised for over a decade, the association with schizophrenia fills a notable gap in the literature. This editorial discusses the implications of these findings for clinicians, who must address psychiatric comorbidity in their treatment formulations, and researchers who are learning that the discrete categorical diagnoses of our diagnostic systems may not be up to the task of clarifying the causes and cures of psychopathology. [ABSTRACT FROM AUTHOR]

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder often diagnosed between the ages of 7 and 10. The estimated prevalence of ADHDin adults is usually 2-5%, which means that in up to half of people this diagnosis persists into adulthood. Objectives: The aim of this sub-study was to determine whether there are significant differences in ADHD symptomatology between individuals who have taken or are taking prescription drugs and those who have never taken them. Methods: Data collection was performed by STEM / MARK in January 2019 through the European National Panel. Respondents completed a demographic questionnaire focusing on the history of ADHD and a standardized ADHD Self-Report Scale (ASRS) questionnaire for the symptomatology of ADHD in adulthood. Results: Of the 1,518 respondents, 3% reported being diagnosed with ADHD / hyperkinetic disorder during their lifetime. According to the ASRS assessment, 119 respondents were classified as suspected ADHD. Overall, men scored higher symptoms of ADHD. The results also show that the group that states that taking medication has a statistically significantly higher average score in ASRS than unmedicated individuals. 6 individuals are taking medication to this day. Conclusions: The data collected confirm our main hypothesis that ADHD symptomatology has an impact on the daily functioning of individuals in adulthood. Unlike peers with reduced or no ADHD symptoms, these people are far more likely to have time management issues, need to plan their day carefully, and yet often experience problems such as late arrivals due to a lack of anticipation. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of adult Attention Deficit and Hyperactivity Disorder (ADHD) has been investigated in the general population by multiple studies. However, few studies have focused on identifying its prevalence in the military population, particularly among military parents of children with ADHD. Objectives: The aim of our study was to screen for adult ADHD among military parents of ADHD children followed-up at the child and adolescent psychiatry department in the Military Hospital of Instruction of Tunis, Tunisia. Methods: This prospective study was carried among military parents (one or both parents belonging to the national army) of ADHD children. Children were diagnosed with ADHD based on the 5th Diagnostic and Statistical Manual ADHD criteria and the Conners Comprehensive Behavior Rating Scale. Whereas adult ADHD was screened for using the Adult ADHD Self-Report Scale-V1.1. Results: Fifteen children and twenty-nine parents were included in the study: sixteen of the parents were military members and thirteen were civilian spouses. Eight (50%) of the sixteen military parents, and four (30,7%) of the civilian spouses were screened positive for ADHD. Whereas 73% of these children had at least one parent screened positive for ADHD, and 53% had at least one military parent screened positive for ADHD. These results suggest a high prevalence of adult ADHD among this population. Conclusions: ADHD occurs in childhood and may persist into adulthood. The findings of this study indicate that ADHD symptoms are not limited to the youth and are common in military population. Implications on screening, management, preventive measures and research should be discussed. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses various reports within the issue on topics including attachment theory, attention-deficit hyperactivity disorder (ADHD), and bipolar disorder.

The article offers perspective on the difficulty of diagnosing mental illness. Topics discussed include the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD) in children, the role of inflammatory biomarkers interleukin-6 and C-reactive protein in assessing possible mental illness, and the moral treatment of mental illness. An overview of a study on deaths attributable to gang activities that are dominated by young men is presented.

An introduction is presented in which the editor discusses various reports within the issue on topics including impulsivity in attention-deficit hyperactivity disorder, cognitive stimulation therapy for dementia, and psychiatric comorbidity following a physical illness.

An introduction is presented in which the editor discusses various reports within the issue on topics including attention-deficit hyperactivity disorder (ADHD) in neurophysiological processes, examing the mentalising processes, and psychosis' risk to adolecents.