Disease burden and direct medical costs of incident adult ADHD:A retrospective longitudinal analysis based on German statutory health insurance claims data

Background. Adult attention-deficit/hyperactivity disorder (aADHD) is still a largely unrecognized psychiatric condition despite its strong impact on individuals' well-being. Here, we describe the healthcare situation of individuals with incident aADHD over 4 years before and 4 years after initial administrative diagnosis. Methods. A retrospective, longitudinal cohort analysis was conducted using German claims data. The InGef database contained approximately 5 million member-records from over 60 nationwide statutory health insurances (SHI). Individuals were indexed upon initial diagnosis of aADHD. Results. Average age at diagnosis of aADHD was 35 years, and 60% of individuals were male. Comorbidities, resource use, and healthcare costs were substantial before initial diagnosis and decreased within the 4 years thereafter. Only 32% of individuals received initial ADHD medication and adherence was low. The majority received psychotherapy. Individuals with initial ADHD medication showed the highest share in comorbidities, physician visits, medication use for comorbidities, psychotherapy, and costs. Overall, healthcare costs were at over euro4,000 per individual within the year of aADHD diagnosis. Conclusions. We conclude that earlier recognition of aADHD could prevent the development and aggravation of comorbid mental illnesses. At the same time, comorbid conditions may have masked ("over-shadowed") aADHD and delayed diagnosis. The burden of disease in aADHD is high, which was noticeable especially among individuals who received initial ADHD-medication, suggesting that psychopharmacological treatment was mainly considered for the most severely ill. We conclude that measures to facilitate access of aADHD patients to clinical experts are required to improve reality of care in the outpatient setting

Electroluminescent textile for therapeutic applications

Alternating-current (AC) electroluminescent (EL) devices on fabrics with high brightness are presented. The EL-devices were fabricated via knife coating; inorganic luminous pigments are based on zinc sulfide. Effects of parameters influencing the brightness were investigated. These parameters are the AC-voltage, AC-frequency, AC-waveform, layer composition of the luminous capacitor and the fabric. Introducing a flexible reflecting dielectric layer enhances the light yield on fine woven fabrics with green luminous pigment. This can be achieved with small concentrations of reflective white pigments such as titanium dioxide, maintaining the flexibility and bendability of the textile substrate. The produced luminous textiles are investigated as a possible replacement for light boxes used in the therapy of seasonal affective disorder (SAD). A high luminous emittance and a high portion of short and energy rich wavelengths are necessary for the treatment. Contrarily to state-of-the-art light boxes a higher acceptance of light therapy is expected, because a luminous textile can be integrated easily and unremarkably into the living environment

Risk of accidents and unintentional injuries in men and women with ADHD across the adult lifespan

INTRODUCTION: Attention Deficit Hyperactivity Disorder (ADHD) is associated with risk-taking behaviour, leading to accidents and unintentional injuries (summarized here as incidents). MAIN AIM: determine if men and women with and without ADHD differ in the risk of mild (treated outpatient) and severe (treated inpatient) incidents across the adult lifespan (age groups 18-29y; 30-59y, ≥60y.). Secondary aim: investigate the role of comorbid mental disorders and drugs for the treatment of these comorbidities, and ADHD-medication. METHODS: Using anonymized German claims data (N=4,575,027), adults with ADHD diagnosis during 2016-2019 (N=17,041) were compared with a 1:4 age and sex-matched group without ADHD diagnosis. Regression analyses statistically tested group differences. RESULTS: Incidents occur in a U-shaped form across the adult lifespan. Individuals with ADHD show the same pattern but at a substantially increased risk of both mild and severe incidents throughout the lifespan. Women without ADHD are at lower risk in young adulthood than men but at higher risk in older adulthood. Women with ADHD show the same pattern for severe incidents, but for mild incidents they have the highest risk throughout the lifespan. Co-occurring anxiety disorder and the use of psycholeptics and ADHD-medication decreased the incident risk. CONCLUSION: We extend available knowledge which has hitherto focused on young adult males and traffic accidents. ADHD is associated with increased incidents across the adult lifespan, with distinct patterns regarding age, sex and incident severity. An accurate diagnosis of ADHD in adulthood provides the first step towards prevention of accidents and unintentional injuries

Alternative light therapy with luminescent textiles

Current research shows, that light directly influences the course of the inner biological rhythm. Light synchronizes the biological clock by controlling the concentration of various hormones in the human body. A well-known example is the discharge of melatonine due to increased blue spectral parts in daylight. Light affects the quality of sleep, general performance and even the phenomenon Season Affected Disorder (SAD)