Attention-Deficit/Hyperactivity Disorder in Adulthood and Adolescence

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Psychiatry".

Deadline for manuscript submissions: closed (1 January 2024) | Viewed by 6194

Special Issue Editors


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Guest Editor
Azienda USL di Modena, Modena, Italy
Interests: ADHD; psychopharmacology; epidemiology; psychosocial treatment; clinical psychiatry

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Guest Editor
CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Interests: epidemiological methods; environmental and nutritional epidemiology with particular focus on childhood leukemia, neurodegenerative and chronic diseases
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Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze Sede ex Sanità Pubblica, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
Interests: nursing care; nursing education; nursing research; empathic caring approach; caring behaviour

Special Issue Information

Dear Colleagues,

We would like to invite you to contribute to this Special Issue on Attention-Deficit/Hyperactivity Disorder in Adulthood and Adolescence with your manuscripts to deepen the knowledge on this topic.

Attention-deficit/hyperactive disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood with a prevalence ranging between 5 and 7%. This disorder is more frequent in males, with a ratio of 2:1, which tends to balance out in adulthood. Females with ADHD mainly manifest inattentive symptoms and tardive clinical manifestation, even if this disorder can be misdiagnosed in females. Up to  65% of subjects can present a persisting ADHD into adulthood with poor quality of life and socio-economic status, low probability of stable marriage and long-term employment, and a higher probability of hospitalization, forensic issues, marginality, and mortality.

The ADHD etiology is not clearly established, and many conditions may represent potential risk factors: genetic heritability, neuroanatomical abnormalities, altered dopamine and serotonin pathway, neurophysiology dysfunction of fronto-striatal structures.

ADHD impulse control and attention deficits foster the impairment of many social skills resulting in educational issues (school dropouts and/or failures, discipline problems, etc.), antisocial behaviour, substance use, incidents, unemployment, and occupational and relational instability.

In childhood and adolescence, ADHD is often associated with other neurodevelopmental disorders such as autism and specific learning difficulties (dyslexia and dyspraxia) as well as many psychiatric disorders including oppositional defiant disorder or conduct disorder, anxiety and depressive disorders, and substance abuse disorders which can further impair social adjustment and increase the complexity of treatments. Moreover, individuals with ADHD present a higher mortality rate compared to the rest of the population.

Diagnosis of ADHD is generally based on clinical observation, anamnesis from multiple sources (parents, teachers), and  semi-structured interviews and standardized questionnaires. In the case of adult subjects, the history of evolution of symptoms and the level of functioning during adolescence represent important information to detect ADHD manifestations.

ADHD treatments can reduce both immediate and long-term negative clinical and social outcomes. Therefore, most guidelines recommend accurate assessment and treatment; however, up until now, ADHD diagnosis and treatment, especially in adults are often limited by poor awareness or training in this disorder.

This Special Issue can contribute to the provision of insight in the diagnosis and management of ADHD and its comorbid disorders as well as in the neurobiology of ADHD.

Dr. Rosaria Di Lorenzo
Dr. Tommaso Filippini
Dr. Paola Ferri
Guest Editors

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Keywords

  • Adult ADHD diagnosis
  • Adult ADHD diagnosis management
  • ADHD neurobiology
  • ADHD etiology
  • Adult ADHD outcome
  • ADHD comorbidities
  • ADHD treatment response

Published Papers (2 papers)

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16 pages, 644 KiB  
Article
ADHD Follow-Up in Adulthood among Subjects Treated for the Disorder in a Child and Adolescent Mental Health Service from 1995 to 2015
by Rosaria Di Lorenzo, Jessica Balducci, Anna Cutino, Emanuela Latella, Giulia Venturi, Sergio Rovesti, Tommaso Filippini and Paola Ferri
Medicina 2023, 59(2), 338; https://doi.org/10.3390/medicina59020338 - 10 Feb 2023
Cited by 3 | Viewed by 2131
Abstract
Background and Objectives: ADHD is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity and can persist in adulthood. The aim of this study is to deepen knowledge about adult ADHD follow-up. Materials and Methods: This observational study consists of one retrospective part aimed at [...] Read more.
Background and Objectives: ADHD is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity and can persist in adulthood. The aim of this study is to deepen knowledge about adult ADHD follow-up. Materials and Methods: This observational study consists of one retrospective part aimed at collecting records of children and adolescents treated for ADHD in the Children and Adolescent Mental Health Service (CAMHS) from 1995 to 2015 and, successively, at identifying their adult follow-up in Adult Mental Health Service (AMHS); the second part consists of ADHD scale administration, Diagnostic Interview for ADHD in Adults (DIVA 2-0) and Adult Self Rating Scale (ASRSv1.1), for the subjects currently being treated at AMHS who agreed to participate in the study. Results: We observed that among the 55 patients treated at CAMHS between 1995 and 2015 for ADHD and subsequently at the AMHS, none presented a diagnosis of ADHD; instead, they were treated for Intellectual Dysfunction (33%), Borderline Personality Disorder (15%) and Anxiety Disorders (9%), and two individuals were also diagnosed with comorbid substance/alcohol abuse (4%). Of the 55 patients, only 25 (45%) were treated at AMHS during the study period. Though we asked for their informed consent to administer the questionnaires, we were able to test only seven patients. The ASRS-V1.1 score showed that 43% of patients reported symptoms of ADHD persistence in adulthood. For DIVA 2.0, 57% of individuals reported scores indicating the persistence of the ADHD inattention component, and 43% the persistence of both ADHD dimensions. Conclusions: ADHD cannot be considered a disorder confined to childhood/adolescence but instead is a chronic and complex condition that can persist into adulthood. The very small size of our final sample may account for both the high ADHD dropout rate over the long follow-up period and the difficult transition from child to adult health care in ADHD treatment. Our investigation suggests the need for specific training in the diagnosis and treatment of adult ADHD and the implementation of transition protocols between minor and adult services to improve long-term treatments. Full article
(This article belongs to the Special Issue Attention-Deficit/Hyperactivity Disorder in Adulthood and Adolescence)
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12 pages, 470 KiB  
Systematic Review
Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies
by Gianluca Fiore, Federica Veneri, Rosaria Di Lorenzo, Luigi Generali, Marco Vinceti and Tommaso Filippini
Medicina 2023, 59(4), 797; https://doi.org/10.3390/medicina59040797 - 19 Apr 2023
Cited by 4 | Viewed by 3590
Abstract
Background and objectives: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by two dimensions: inattentiveness and hyperactivity/impulsivity. ADHD may be the result of complex interactions between genetic, biological and environmental factors possibly including fluoride exposure. Materials and methods: [...] Read more.
Background and objectives: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by two dimensions: inattentiveness and hyperactivity/impulsivity. ADHD may be the result of complex interactions between genetic, biological and environmental factors possibly including fluoride exposure. Materials and methods: A literature search was performed on 31 March 2023 in the following databases: PubMed, Embase and Web of Science. We defined the following inclusion criteria according to the PECOS statement: a healthy child and adolescent population (P), fluoride exposure of any type (E), comparison with low or null exposure (C), ADHD spectrum disorder (O), and ecological, cross-sectional, case–control and cohort studies (S). Results: We found eight eligible records corresponding to seven different studies investigating the effect of fluoride exposure on children and adolescents. One study had a cohort design and one a case–control one, while five were cross-sectional. Only three studies applied validated questionnaires for the purpose of ADHD diagnosis. As regards exposure assessment, levels of fluoride in urine and tap water were, respectively used in three and two studies, while two used both. Three studies reported a positive association with ADHD risk, all assessing exposure through fluoride levels. By using urinary fluoride, conversely, a positive correlation with inattention, internalizing symptoms, cognitive and psychosomatic problems was found in three studies, but no relation was found in the other one. Conclusions: The present review suggests that early exposure to fluoride may have neurotoxic effects on neurodevelopment affecting behavioral, cognitive and psychosomatic symptoms related to ADHD diagnosis. However, due to the heterogeneity of the studies included, current evidence does not allow to conclusively confirm that fluoride exposure is specifically linked to ADHD development. Full article
(This article belongs to the Special Issue Attention-Deficit/Hyperactivity Disorder in Adulthood and Adolescence)
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