Association of the paternally transmitted copy of common Valine allele of the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene with susceptibility to ADHD

Attention deficit hyperactivity disorder (ADHD) is a common, highly heritable, neurodevelopmental disorder with onset in early childhood. Genes involved in neuronal development and growth are, thus, important etiological candidates and brain-derived neurotrophic factor (BDNF), has been hypothesized to play a role in the pathogenesis of ADHD. BDNF is a member of the neurotrophin family and is involved in the survival and differentiation of dopaminergic neurons in the developing brain (of relevance because drugs that block the dopamine transporter can be effective therapeutically). The common Val66Met functional polymorphism in the human BDNF gene (rs 6265) was genotyped in a collaborative family-based sample of 341 white UK or Irish ADHD probands and their parents. We found evidence for preferential transmission of the valine (G) allele of BDNF (odds ratio, OR = 1.6, P = 0.02) with a strong paternal effect (paternal transmissions: OR = 3.2, P = 0.0005; maternal transmissions: OR = 1.00; P = 1.00). Our findings support the hypothesis that BDNF is involved in the pathogenesis of ADHD. The transmission difference between parents raises the possibility that an epigenetic process may be involved

Adjustment disorders as stress response syndromes: a new diagnostic concept and its exploration in a medical sample

OBJECTIVE: Adjustment disorders (AD) are an ill-defined category in the present diagnostic nomenclature. We propose a new diagnostic model that describes AD as particular forms of stress response syndrome, in which intrusions, avoidance of reminders and failure to adapt are the central processes and symptoms. In line with the existing classification, the description of AD subtypes is included. Backgrounds on existing psychopathological models of stress response disorders are outlined. METHODS: Data from a clinical sample of patients with an automatic implantable cardioverter defibrillator (n = 160, mean age 63 years, 90% males) are investigated. RESULTS: The items tapping the individual symptoms meet psychometric requirements for diagnostic applications. The diagnostic algorithm chosen indicates a 17% prevalence of AD in the sample. The subtype most commonly diagnosed is AD with mixed emotional features (41%). In a subsample, diagnostic sensitivity was 0.58 and specificity 0.81 in relation to traditional AD cases diagnosed by the Structured Clinical Interview for DSM-IV. By applying the most strongly conservative exclusion rule analogous to the Structured Clinical Interview for DSM-IV, the AD prevalence was reduced to 9%. CONCLUSION: The new AD concept is theory driven and shows methodological soundness. Its application to further samples is recommended