Ego-dystonic" delusions in psychotic patients

2017

Objective: To assess the prevalence of psychotic symptoms among youths (age 14-25 years) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type. Method: The participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed. Results: Data were available from 509 MTA participants (88% of the original MTA sample) and 276 LNCG subjects (96% of the original sample), with a mean age of 25.1 and 24.6 years, respectively, at Year 16. Twenty-six MTA subjects (5%, 95% CI: 3, 7) and 11 LNCG (4%, 95% CI: 2, 6) screened positive for at least one psych...

Journal of the American Academy of Child & Adolescent Psychiatry, 2017

Objective-To assess the prevalence of psychotic symptoms among youths (age 14-25 years) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type. Method-The participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed. Results-Data were available from 509 MTA participants (88% of the original MTA sample) and 276 LNCG participants (96% of the original sample), with a mean age of 25.1 and 24.6 years, respectively, at year 16. Twenty-six MTA participants (5%, 95% CI: 3, 7) and 11 LNCG (4%, 95% CI: 2, 6) screened positive for at least one psychotic symptom (p=.60). Most psychotic symptoms were transient. The prevalence of clinician-confirmed psychotic symptoms was 1.

ADHD Attention Deficit and Hyperactivity Disorders

Adult attention-deficit/hyperactivity disorder (aADHD) has recently been better recognized and treated in many European countries. In spite of this development, aADHD still features as a "hidden" comorbidity, often not diagnosed even in patients under psychiatric treatment for other psychiatric disorders. The aim of this study was to establish the prevalence rates of unrecognized aADHD in academic centers providing regular psychiatric services in the Czech Republic and Hungary. In a population of psychiatric in-and outpatients, Adult ADHD Self-Report Scale was administered. All positively and about half of the negatively screened subjects were clinically interviewed and the DSM diagnosis of ADHD was determined based on the symptom list and Conners' Adult ADHD Rating Scale. The estimated point prevalence rate of unrecognized comorbid aADHD among psychiatric in-and out patients was 6.99% (95% lower CI: 5.11, 95% upper CI 8.86) according to the DSM-IV-TR criteria and 9.27% (95% lower CI: 7.13, 95% upper CI 11.40) according to the DSM-5 criteria. Current suicide risk was significantly associated with the presence of undiagnosed aADHD; however, life time suicide attempts, depression, dysthymia, alcohol and substance dependence, anxiety and stress related disorders were not. Further educational efforts are needed to improve the recognition and treatment of aADHD in adults

Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2014

The prevalence of symptoms and diagnosis of attention-deficit-hyperactivity disorder among adult female patients with mild / moderate major depressive disorder who were referred to the psychiatric outpatient department of a training hospital: a preliminary study Objective: Attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD) are frequently comorbid among adults. Also, people diagnosed with ADHD in adulthood frequently apply to psychiatry departments with complaints of anxiety and depression, especially irritability. In this study, it was aimed to determine the prevalence of ADHD symptoms and diagnosis among adult female patients, who were referred to the outpatient psychiatry clinic and diagnosed with MDD as well as to evaluate the relationship between symptoms of ADHD and MDD. Method: Sixty-one female patients with MDD, who were evaluated for the first time in a training and research hospital between June 2008 and July 2009 were enrolled in the study. MDD severity was mild-moderate according to Clinical Global Impression Scale (CGI-S) and none of the patients had Axis I comorbidity. Hamilton Depression Rating Scale (HAM-D), Wender Utah Rating Scale (WURS) and Adult ADHD Rating Scales (A-ADHRS) were applied to the participants. Non-parametric methods were used for analyses and p value was set at 0.05. Results: In the study, 31.1% of patients were found to have WURS scores 36 and above. Four patients (6.5% of the whole sample and 11.1% of those scoring at least 36 with WURS) had adult type ADHD, when they were evaluated with A-ADHRS and interviewed according to DSM-IV criteria. There were no significant differences between patients with WURS ≥36 and others in terms of their educational levels, HAM-D scores, number of depressive episodes, and duration for the remission of index episode. Similarly, there were no significant differences between patients with WURS ≥36 and patients diagnosed with adult ADHD according to A-ADHRS and DSM-IV criteria in terms of their age, educational levels, HAM-D scores, number of depressive episodes, and duration for the remission of index episode. Conclusion: The prevalence of adult ADHD was higher than those reported for general community in our country. The lack of relationship between the evaluated variables of MDD and symptoms as well as diagnosis of ADHD in our sample may be due to our inclusion of female outpatients with mild/moderate MDD. Further studies evaluating those relationships may yield different data related to comorbidity of ADHD-MDD.

Medicina Moderna - Modern Medicine, 2018

Background: ADHD and personality disorders show a considerable symptom overlap. Sometimes these disorders are complicated by comorbidities, the most frequent being depression, alcohol and drug abuse or dependence. Their presence impact the functionality of patients. The introduction of DSM 5 brought a new perspective on the approach of these disorders. Material and methods: The study consists of the evaluation of a sample of 140 individuals with personality disorders. From this sample it has been determined the proportion of the ADHD patients by using a specifi c scale (DIVA). First the analysis has been made using the DSM IV criteria. Two groups were formed: A-the ADHD group and B-the personality disorder non ADHD group. The possible comorbidities in the two groups A and B have been determined using the instrument MINI. The impact on functionality was evaluated with the scale WFIRS and the overall severity with the presence of hospitalizations. The same analysis has been made using the DSM 5 criteria. Then a comparison between the two classifi cations has been made. Results: The prevalence of ADHD in the initial sample of the personality disorder patients has been 29.3% after the DSM IV classifi cation and 44.3% after the DSM 5. Moreover, the prevalence of depression, alcohol, drug abuse and dependence and other comorbidities has been determined in the ADHD and non-ADHD group, fi rst using the DSM IV criteria, then using the DSM 5 criteria. A comparison between the two situations has been made, as well as an evaluation of the impact on functionality. Conclusions: The presence of depression, substance use disorders other than alcohol and alcohol use disorders are not signifi cant in the differentiation of ADHD patients from the population of personality disorder nonADHD patients. The overall severity and the impact on functionality as assessed with the presence of hospitalizations and the WFIRS scale show a signifi cant importance in differentiating the intensity of ADHD symptomatology.

Turk psikiyatri dergisi = Turkish journal of psychiatry, 2014

AIM This study aimed to investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in adult psychiatric outpatients. Moreover, comorbid psychiatric diagnoses in adults with ADHD were determined. Patients with and without ADHD were compared regarding DSM Axis I-II comorbidity and sociodemographic characteristics. MATERIALS AND METHODS The study included patients that presented for the first time to a psychiatric outpatient clinic during a 3-month period and were evaluated for adult ADHD. A sociodemographic form, Wender Utah Rating Scale, Turgay's Adult ADD/ADHD Evaluation Scale, Structured Clinical Interview I and II, Symptom Check List-90-R, and Beck Depression Inventory were administered. RESULTS The study included 246 patients. Among the 39 patients diagnosed with ADHD, 25 were female (64.1%) and 14 were male (35.9%), and the mean age was 27.38 ± 8.3 years. The prevalence of ADHD in adult psychiatric patients was 15.9%. Adults with ADHD usually presented due...

2020

SUMMARY Aim: This study aimed to investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in adult psychiatric outpatients. Moreover, comorbid psychiatric diagnoses in adults with ADHD were determined. Patients with and without ADHD were compared regarding DSM Axis I-II comorbidity and sociodemographic characteristics. Materials and Methods: The study included patients that presented for the first time to a psychiatric outpatient clinic during a 3-month period and were evaluated for adult ADHD. A sociodemographic form, Wender Utah Rating Scale, Turgay's Adult ADD/ADHD Evaluation Scale, Structured Clinical Interview I and II, Symptom Check List-90-R, and Beck Depression Inventory were administered. Results: The study included 246 patients. Among the 39 patients diagnosed with ADHD, 25 were female (64.1%) and 14 were male (35.9%), and the mean age was 27.38 ± 8.3 years. The prevalence of ADHD in adult psychiatric patients was 15.9%. Adults with ADHD usually p...

The aim of this article is to analyze the controversies surrounding ADHD and the process whereby this psychiatric unit was formed and constituted as a social and scientific fact. We focus mainly on the arguments around ADHD in the United States -this is dictated by significant differences between the ways to define and treat this disorder between various countries Cohen 2006: 14). The abovementioned controversies make us conscious of the fact that despite what a considerable number of psychiatrists, scientists and other "spokespeople" for the entity that is ADHD claim, the dominating approach to this disorder has not been based on self-evident, irrefutable scientific findings. What is more important, however, is that the quarrelling actors reveal the circumstances and the way in which the definition, as well as the methods of researching and treating ADHD were formed.

Psychiatry Research-neuroimaging, 2015

Despite both having some shared features, evidence linking psychosis and adult Attention Deficit Hyperactivity Disorder (ADHD) is sparse and inconsistent. Hypotheses tested were 1] adult ADHD symptoms are associated with auditory hallucinations, paranoid ideation and psychosis 2] links between ADHD symptoms and psychosis are mediated by prescribed ADHD medications, use of illicit drugs, and dysphoric mood. The Adult Psychiatric Morbidity Survey 2007 (N=7403) provided data for regression and multiple mediation analyses. ADHD symptoms were coded from the ADHD Self-Report Scale (ASRS). Higher ASRS total score was significantly associated with psychosis, paranoid ideation and auditory hallucinations despite controlling for socio-demographic variables, verbal IQ, autism spectrum disorder traits, childhood conduct problems, hypomanic and dysphoric mood. An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis. In conclusion, higher levels of adult ADHD symptoms and psychosis are linked and dysphoric mood may form part of the mechanism. Our analyses contradict the traditional clinical view that the main explanation for people with ADHD symptoms developing psychosis is illicit drugs.