Biomedical subjects

Stephen V Faraone

Publications and source records attributed to Stephen V Faraone.

222 records · Page 13Linked to original sources

PubMedDate not supplied

Attention-deficit hyperactivity disorder.

Attention-deficit hyperactivity disorder (ADHD) is a disorder of inattention, impulsivity, and hyperactivity that affects 8-12% of children worldwide. Although the rate of ADHD falls with age, at least half of children with the disorder will have impairing symptoms in adulthood. Twin, adoption, and molecular genetic studies show ADHD to be highly heritable, and other findings have recorded obstetric complications and psychosocial adversity as predisposing risk factors. Converging evidence from animal and human studies implicates the dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits in the pathophysiology of ADHD, and molecular imaging studies suggest that abnormalities of the dopamine transporter lead to impaired neurotransmission. Studies during the past decade have shown the safety and effectiveness of new non-stimulant drugs and long-acting formulations of methylphenidate and amfetamine. Other investigations have also clarified the appropriate role of targeted psychosocial treatments in the context of ongoing pharmacotherapy.

Attention Deficit Disorder with Hyperactivity↗

PubMedDate not supplied

Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms.

BACKGROUND: The goal of this study was to validate the pilot Adult ADHD Self-Report Scale (pilot ASRS) versus standard clinician ratings on the ADHD Rating Scale (ADHD RS). METHOD: Sixty adult ADHD patients took the self-administered ADHD RS and then raters administered the standard ADHD RS. Internal consistency of symptom scores was assessed by Cronbach's alpha. Agreement of raters was established by intra-class correlation coefficients (ICCs) between scales. RESULTS: Internal consistency was high for both patient and rater-administered versions (Cronbach's alpha 0.88, 0.89, respectively). The ICC between scales for total scores was also high (0.84); ICCs for subset symptom scores were also high (both 0.83). There was acceptable agreement for individual items (% agreement: 43%-72%) and significant kappa coefficients for all items (p < 0.001). CONCLUSIONS: The pilot Adult ADHD Self-Report Scale symptom checklist is a reliable and valid scale for evaluating ADHD for adults and shows a high internal consistency and high concurrent validity with the rater-administered ADHD RS.

Adult↗

PubMedDate not supplied

Influence of parental SUD and ADHD on ADHD in their offspring: preliminary results from a pilot-controlled family study.

As part of a pilot-controlled family-based study of the children of parents with and without substance use disorders (SUD), the influence of parental SUD and ADHD on the risk for ADHD in offspring was evaluated. Using structured psychiatric interviews, 96 families (183 youth; mean age 11.6 years) were assessed. To evaluate the effect of parental ADHD and SUD, the offspring were stratified into four groups based on parental status: children of parents with neither ADHD nor SUD, children of parents with SUD only, children of parents with ADHD only, and children of parents with both ADHD and SUD. Using generalized estimating equation models, parental SUD and ADHD were used to predict ADHD in the offspring. The rate of children with ADHD increased among children of parents with neither disorder (3%), children of parents with SUD (13%), children of parents with ADHD (25%), and children of parents with both ADHD and SUD (50%) (p = .001). Children of parents with ADHD or ADHD plus SUD were more likely to have ADHD in comparison to children of parents with neither diagnosis (p < 0.05). Children of parents with ADHD plus SUD were at greater risk of ADHD in comparison to children of parents with SUD only (p = 0.01). Despite the small sample size, the results of this study seem to suggest that the offspring of SUD or ADHD parents are at elevated risk for ADHD compared to controls. The offspring of parents with both ADHD and SUD appear to be at the highest risk for ADHD, highlighting the need for careful screening of this group of youth for ADHD. Replication studies clarifying the nature and strength of the association are necessary.

Attention Deficit Disorder with Hyperactivity↗

PubMedDate not supplied

Characteristics of adults with attention deficit hyperactivity disorder plus substance use disorder: the role of psychiatric comorbidity.

The objective of the study was to investigate the characteristics of adults with Attention Deficit Hyperactivity Disorder (ADHD) or substance use disorder (SUD), especially in the context of comorbid psychiatric disorders. Subjects were adults (n = 78) participating in a controlled family study of ADHD and SUD. Four groups were identified based on a diagnosis of ADHD or SUD: ADHD, SUD, ADHD + SUD, and neither ADHD nor SUD. All diagnoses were determined by structured clinical interview for DSM IV. Rates of psychiatric comorbidity were lowest in the controls, intermediate in the ADHD and SUD groups, and highest in the ADHD + SUD group. Relative to controls, the ADHD, SUD, and ADHD + SUD groups had higher rates of major depression (z = 1.98, p = 0.05), conduct disorder (z = 2.0, p = 0.04), antisocial personality disorder (z = 2.6, p = 0.009), agoraphobia (z = 2.5, p = 0.01) and social phobia (z = 2.7, p = 0.007). Higher rates of psychiatric comorbidity, especially mood and anxiety disorders, exist in subjects with SUD + ADHD relative to subjects with SUD, ADHD, or controls. Clinicians need to be attentive to other psychiatric disorders that may occur in the large group of adults with ADHD + SUD.

Adult↗

PubMedDate not supplied

Reintroduction of antidepressant therapy across pregnancy in women who previously discontinued treatment. A preliminary retrospective study.

BACKGROUND: Pregnancy has frequently been described as a time of emotional well-being conferring 'protection' against psychiatric disorders. However, data to support this impression are sparse. METHODS: A retrospective review was undertaken in order to examine rates of reintroduction of antidepressants across pregnancy among a cohort of 54 euthymic pregnant women who had discontinued these medications around the time of conception. Reintroduction of antidepressants was used as a marker suggesting relapse of depression. RESULTS: Forty-two percent (n = 23) of these women reintroduced antidepressant therapy during pregnancy, with nearly half of these (n = 11) doing so in the first trimester. A greater time spent in episodes since depressive onset and a prior history of suicide attempts was associated with antidepressant reintroduction. CONCLUSIONS: Nearly half of the women who discontinued antidepressants during pregnancy to avoid fetal exposure appeared to experience symptoms severe enough to prompt reintroduction of treatment with these medications. The implications of these findings are discussed with respect to treatment planning for women who are maintained on antidepressants and who plan to conceive.

Antidepressive Agents↗

PubMedDate not supplied

ADHD and dyscalculia: Evidence for independent familial transmission.

The familial relationship between dyscalculia and attention-deficit/hyperactivity disorder (ADHD) was assessed. We conducted a familial risk analysis using probands with and without ADHD of both genders and their first-degree relatives. Participants were assessed with structured diagnostic interviews and a cognitive test battery. We found elevated rates of ADHD in relatives of both ADHD proband groups, regardless of dyscalculia status, and elevated rates of dyscalculia in relatives of probands with dyscalculia, irrespective of ADHD status. There was no evidence for cosegregation or assortative mating. Our findings support the hypothesis that ADHD and dyscalculia are independently transmitted in families and are etiologically distinct. These results reinforce the current nosological approach to these disorders and underscore the need for separate identification and treatment strategies for children with both conditions.

Adolescent↗