Adult ADHD

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Seasonal and interannual variability of the surface circulation in the eastern Gulf of Cadiz (SW Iberia)

11 páginas, 6 figuras, 1 tabla.An 11-year (1996–2007) time series of current meter observations representative of the open sea circulation; a 4-year (2001–2005) time series of current meter records over the continental shelf and in situ data during different seasons have been compared in order to study the seasonal and interannual variability of the surface circulation in the eastern Gulf of Cadiz. The open sea velocity observations indicate southeastward flow along the northern continental slope of the Gulf of Cadiz, compatible with anticyclonic circulation, during most of the year and more intense during summer months. Flow reversals (northwestward circulation) at seasonal time scales in late autumn and early winter (preferably December and January) are a rather recurrent feature with variable intensity depending on the year. Anticyclonic circulation is associated with westerlies, whereas flow reversals usually take place under easterly episodes, suggesting wind-driven circulation. Negative North Atlantic Oscillation indices (indicative of southward displacement of the Azores high) are also linked to the reversals. Changes in this mainly wind-driven large-scale surface circulation are echoed by the shelf circulation: the coastal countercurrent that closes the mesoscale cyclonic cell over the eastern shelf in spring-summer (upwelling season) is replaced by and eastward current in autumn and winter.We acknowledge CANIGO (MAS3-PL95-0443) European-funded project and, particularly, Guillermo Díaz Del Río for CTD data and the UIB-IMEDEA (Special Action CICYT, REN2000-2599-E) for the software used for the optimal interpolation. Partial support from CTM2006–02326 (Ministry of Science and Technology) and P07-RNM-02938 (Junta de Andalucía) Spanish-funded projects and the Consejeria de Agricultura y Pesca of the Junta de Andalucia are also acknowledged.Peer reviewe

Activity-Based Prospective Memory in ADHD during Motor Sleep Inertia

Prospective memory (PM) is essential in everyday life because it concerns the ability to remember to perform an intended action in the future. Individuals diagnosed with attention deficit hyperactivity disorder (ADHD) often show poor performance in PM. Because age can be confounding, we decided to test PM in ADHD patients (children and adults) and healthy controls (children and adults). We examined 22 children (four females; mean age = 8.77 ± 1.77) and 35 adults (14 females; mean age = 37.29 ± 12.23) with ADHD, in addition to 92 children (57 females; mean age = 10.13 ± 0.42) and 95 adults (57 females; mean age = 27.93 ± 14.35) as healthy controls. Each participant originally wore an actigraph around the non-dominant wrist and was requested to push the event-marker at get-up time. To assess the efficiency of PM performance, we calculated the time elapsing between the end of sleep in the morning and the pushing of the event-marker button. The results showed lower PM performance in ADHD participants, regardless of age. However, the differences between ADHD and control groups were more evident in the children group. Our data seem to confirm that PM efficiency is compromised in individuals diagnosed with ADHD regardless of age, and agree with the idea of considering the PM deficit as a neuropsychological marker of ADHD

Antidepressant efficacy is correlated with plasma levels: mega-analysis and further evidence

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Suicide methods in Europe: a gender-specific analysis of countries participating in the "European Alliance Against Depression"

Objective: To identify the most frequent gener-specific suicide methods in Europe. Design: Proportions of seven predominant suicide methods utilised in 16 countries participating in the European Alliance Against Depression (EAAD)were reported in total and cross-nationally. Relative risk (RR)relating to suicide methods and gender was calculated. To group countries by pattern of suicide methods, hierarchical clustering was applied. Setting and participants: Data on suicide methods for 119 122 male and 41 338 female cases in 2000-4/5 from 16 EAAD countries, covering 52% of European population were obtained. Results: Hanging was the most prevalent suicide method among both males (54.3%) and females (35.6%). For males, hanging was followed by firearms (9.7%) and poisoning by drugs (8.6%); for females, by poisoning by drugs (24.7%)and jumping from a high place (14.5%). Only in Switzerland did hanging rank as second for males after firearms. Hanging ranked first among females in eight countries, poisoning by drugs in five and jumping from a high place in three. In all countries, males had a higher risk than females of using firearms and hanging and a lower risk of poisoning by drugs, drowning and jumping. Grouping showed that countries might be divided into five main groups among males; for females, grouping did not yield clear results. Conclusions: Research on suicide methods could lead to the development of gender-specific intervention strategies. Nevertheless, other approaches, such as better identification and treatment of mental disorders and the improvement of toxicological aid should be put in place

SUICIDE RISK IN ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

Background: ADHD (Attention-deficit/hyperactivity disorder) is a common neurodevelopmental disorder that manifests itself during childhood with various combinations of symptoms, including inattention, hyperactivity and impulsivity. Research has shown that psychiatric comorbidities play an important role in the development of suicidal behavior and, recently, there has been a growing interest in a possible association between ADHD and suicide during both childhood and adulthood. Furthermore, some authors have shown a relationship between pharmacological treatments and suicide in patients affected by ADHD. Aims: We conducted a selective review of current literature to explore the factors which contribute to suicidal behavior and selfharm in those with ADHD. Methods: We performed a PubMed/MEDLINE, Scopus, PsycLit, and PsycINFO search to identify all articles and book chapters on the topic up to 2017. Results: Several studies have showed that ADHD may be correlated with an increased suicide ideation and attempts. Conclusions: Although differences in studies design and samples made the results difficult to compare and interpret, many studies indicate an association between ADHD and suicidal behavior. It remains controversial whether there is a direct relationship or whether the association depends on the increased prevalence of pre-existing comorbid conditions and individual and family dysfunctional factors

Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia

<p>Abstract</p> <p>Background</p> <p>One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study.</p> <p>Methods/Design</p> <p>The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome.</p> <p>Discussion</p> <p>The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole rather than with haloperidol, provides physicians with a solid evidence base to be directly applied in the routine care of patients with schizophrenia.</p> <p>Trial Registration</p> <p><b>Clincaltrials.gov Identifier</b>: NCT00395915</p

The Characteristics of Mood Polarity, Temperament, and Suicide Risk in Adult ADHD

The present study was designed to shed light on a topic rarely explored and to suggest possible ways to detect risk factors for the presence of suicidal ideation and behaviors in a sample of adult patients with Attention-Deficit Hyperactivity Disorder (ADHD). This study also explored the association between ADHD, affective temperaments, the presence of hypomania symptoms, and suicide risk. We hypothesized that (compared to healthy controls) (1) patients with adult ADHD would report more negative affective temperaments and more hypomania symptoms and (2) that they would have a higher suicide risk. The participants included 63 consecutive adult inpatients (18 women, 45 men) with ADHD and 69 healthy controls (42 women, 22 men). All participants were administered the Wender Utah Rating Scale (WURS), the Hypomania Check-List-32 (HCL-32), the Mood Disorder Questionnaire (MDQ), the Temperament Evaluation for Memphis, Pisa, Paris, and San Diego (TEMPS-A), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Forty-six percent of the ADHD patients had an Axis 1 comorbid disorder. ADHD patients (compared to controls) more often reported suicidal ideation (46.0% vs. 5.9%, one-way Fisher exact test p &lt; 0.001; phi = 0.46). ADHD patients and the controls also significantly differed in all the scales administered (with Cohen&rsquo;s d between 0.92&ndash;4.70), except for the TEMPS-A Hyperthymia scale. A regression model indicated that ADHD was independently associated with higher scores of a negative temperaments/hypomania factor (Odd Ratio = 14.60) but not with suicidal ideation. A high incidence of suicidal ideation, comorbid psychiatric disorders, and negative affective temperaments was reported in adult ADHD patients, and clinicians should routinely assess risk factors for suicide among these patients

Circadian pattern of motor activity in adults with attention-deficit/hyperactivity disorder

This study aims to describe the 24-hour activity rhythm in adults with attention-deficit/hyperactivity disorder (ADHD). A total of 18 ADHD patients and 37 healthy controls (HCs) wore an actigraph for 7 days. ADHD patients showed higher motor activity than HCs at 4:00, 6:00, 15:00 and 16:00 hour. Within the theoretical framework of the two-process model of sleep regulation, the observed data may be explained by lower homeostatic sleep pressure in ADHD. This could lead to an increase in motor activity in the second half of the night, when sleep need decreases more rapidly, and in the first half of the afternoon, when patients do not experience the typical post-lunch dip