Fractionating Executive Functions of Adults With ADHD

Objective: To evaluate the performance of adults with ADHD considering the fractionation of executive functions into six different domains. Method: Participants were adult ADHD patients who were not under the acute effects of medication (n = 48). Their performance was compared with that of a healthy control group (n = 20) of comparable age, education, and nonverbal intelligence quotient. The cognitive domains assessed were executive shifting, updating, inhibition of prepotent responses, dual-task performance, planning, and access to long-term memory. We also assessed the symptoms of inattention, hyperactivity/impulsivity, anxiety, and depression by validated questionnaires. Results: Compared with controls, patients reported more symptoms related to ADHD, anxiety and depression symptoms and were impaired in the shifting cost measure and phonemic fluency (measure of access to long-term memory). Conclusion: ADHD in adults selectively impaired executive shifting and access to long-term memory, domains that may alter performance in a wide range of daily tasks.FAPESPAssociação Fundo de Incentivo à Pesquisa in BrazilCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Pesquisa (CNPq)Univ Fed São Paulo, Dept Psicobiol, São Paulo, BrazilUniv São Paulo, Fac Med, Hosp Clin, Inst Psiquiat, São Paulo, BrazilUniv Fed São Paulo, Dept Psicobiol, São Paulo, BrazilFAPESP: 2011/08547-3Web of Scienc

Aripiprazole for Patients with Schizophrenia and Schizoaffective Disorder: An Open-Label, Randomized, Study Versus Haloperidol

Introduction: Aripiprazole, a dopamine D(2) receptor partial agonist, has also partial agonist activity at serotonin (5-HT)(1A) receptors and antagonist activity at 5-HT(2A) receptors. Methods: In this 8-week, multicenter, randomized, parallel-group, open-label, flexible-dose study, patients diagnosed with schizophrenia or schizoaffective disorder were randomized to aripiprazole 15-30 mg/day or haloperidol 10-15 mg/day. Results: Patients treated with both aripiprazole and haloperidol improved from baseline in Positive and Negative Syndrome Scale total, positive, and negative scores as well as in Clinical Global Impressions scores (all P<.001). At the end of the study, the percentage of patients classified as responders-according to >= 40% reduction in the Positive and Negative Syndrome Scale negative subscale score-was significantly higher in the aripiprazole group (20%) than in the haloperidol group (0%) (P<.05). Additionally, a higher number of patients receiving haloperidol required more anticholinergic medications (P<.001) than aripiprazole-treated patients, whereas more aripiprazole (45.5%) than haloperidol-treated patients (12.9%) required benzodiazepines (P=.002). At endpoint, rates of preference of medication were higher in the aripiprazole group (63.2%) than in the haloperidol group (21.7%), as expressed by patients and caregivers (P=.001). Conclusion: Aripiprazole and haloperidol had similar efficacy in terms of reduction of overall psychopathology. Although aripiprazole has been demonstrated to be superior concerning negative symptoms and in terms of tolerability (extrapyramidal symptoms) and preferred by patients and caregivers than haloperidol, significantly more aripiprazole-treated patients required benzodiazepines