Attention-Deficit/Hyperactivity Disorder and comorbidity in Brazil

Abstract. Objective: The aim of this study was to compare the pattern of comorbidity in referred samples of Attention-Deficit/Hyperactivity Disorder (ADHD) patients from two different geographic areas in Brazil. Methods: The diagnoses of ADHD and comorbid conditions, according to DSM-IV criteria, were achieved in both clinics through semi-structured interview methodology, complemented by clinical interviews with the children or adolescents and their parents. Results: We assessed 343 ADHD children and adolescents in Porto Alegre (capital of the southernmost state of the country) and 78 ADHD youths in Rio de Janeiro (capital of a southestern state). Although a significant difference in the prevalence of ADHD without comorbidity was detected between the two groups (p = 0.02), no significant difference was detected in the profile of comorbidities between them. Main ADHD comorbidities in both samples were: a) Oppositional Defiant Disorder (Porto Alegre = 39.1%; Rio de Janeiro = 51.3 %); b) Anxiety Disorders (Porto Alegre = 24.2%; Rio de Janeiro = 30.8 %); c) Conduct Disorder (Porto Alegre = 13.7%; Rio de Janeiro = 17.9 %); and d) Major Depression and/or Dysthymia (Porto Alegre = 11.4%; Rio de Janeiro = 10.3 %). Conclusions: Our results from clinical samples in a developing country with a diverse culture suggest the crosscultural validity of the ADHD comorbidity profile.     

A Genetic Investigation of Sex Bias in the Prevalence of Attention-Deficit/Hyperactivity Disorder

Background

Attention-deficit/hyperactivity disorder (ADHD) shows substantial heritability and is two to seven times more common in male individuals than in female individuals. We examined two putative genetic mechanisms underlying this sex bias: sex-specific heterogeneity and higher burden of risk in female cases.

Micronutrients reduce stress and anxiety in adults with Attention-Deficit/Hyperactivity Disorder following a 7.1 earthquake

The role of good nutrition for resilience in the face of stress is a topic of interest, but difficult to study. A 7.1 earthquake took place in the midst of research on a micronutrient treatment for Attention-Deficit/Hyperactivity Disorder (ADHD), providing a unique opportunity to examine whether individuals with ADHD taking micronutrients demonstrated more emotional resilience post-earthquake than individuals with ADHD not taking micronutrients. Thirty-three adults with ADHD were assessed twice following the earthquake using a measure of depression, anxiety and stress also completed at some point pre-earthquake (baseline). Seventeen were not taking micronutrients at the time of the earthquake (control group), 16 were (micronutrient group). While there were no between-group differences one week post-quake (Time 1), at two weeks post-quake (Time 2), the micronutrient group reported significantly less anxiety and stress than the controls (effect size 0.69). These between group differences could not be explained by other variables, such as pre-earthquake measures of emotions, demographics, psychiatric status, and personal loss or damage following the earthquake. The results suggest that micronutrients may increase resilience to ongoing stress and anxiety associated with a highly stressful event in individuals with ADHD and are consistent with controlled studies showing benefit of micronutrients for mental health.     

The written expression abilities of adolescents with Attention-Deficit/Hyperactivity Disorder

Students with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience deficits in academic achievement. Written expression abilities in this population have not been extensively studied but existing prevalence estimates suggest that rates of comorbid writing underachievement may be substantially higher than rates of comorbid reading and mathematics underachievement. The current study examined written expression abilities in a school-based sample of 326 middle school age students with ADHD. The prevalence of written expression impairment, the associations between written expression and academic outcomes, and specific patterns of written expression were investigated. Students with ADHD in this sample experienced written expression impairment (17.2–22.4%) at a similar rate to reading impairment (17.0–24.3%) and at a slightly lower rate than mathematics impairment (24.7–36.3%). Students’ written expression abilities were significantly associated with school grades and parent ratings of academic functioning, above and beyond the influence of intelligence. Analyses of patterns suggest that students with ADHD exhibit greater deficits in written expression tasks requiring organization and attention to detail, especially in the context of a complex task.