SYMPOSIA
SYMPOSIA
SYMPOSIA
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[PS-04]<br />
Symposium Title: Adult attention - deficit hyperactivity disorder (ADHD) and comorbidity<br />
ADHD and mood disorders in children<br />
Rasim Somer Diler<br />
Department of Psychiatry, University of Pittsburgh, PA, US<br />
E-mail: dilerrs@yahoo.com<br />
Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org<br />
Abstracts of the Invited Speakers<br />
Five to 40% of children and adolescents with attention deficit hyperactive disorder (ADHD) also have comorbid major depressive disorders<br />
(MDD). Moreover, youths with ADHD have up to a 4 times higher risk of developing depressive disorders than the general adolescent population.<br />
Comorbidity with MDD has been associated with elevated impairment and higher rates of hospitalization versus ADHD alone. However,<br />
depression in youths with ADHD may be more difficult to diagnose, given that some symptoms overlap between the two disorders. Moreover,<br />
many of the medications used to treat ADHD cause side effects resembling symptoms of MDD. Available studies suggest the particular<br />
importance of anhedonia, social withdrawal, psychomotor retardation, negative views of self and future, and suicidal thoughts as symptoms that<br />
distinguish MDD in youths who have ADHD. Despite ongoing controversy, the view that pediatric bipolar disorder (PBD) is rare or non-existent<br />
has been increasingly challenged not only by case reports but also by systematic research; however, a significant portion of bipolar youth,<br />
especially children, have high comorbidity with ADHD. Significant debate exists on whether early onset bipolar disorder is mistakenly attributed<br />
to attention deficit hyperactivity disorder (ADHD), or whether ADHD is frequently misdiagnosed as mania. Among pediatric-onset cases of<br />
bipolar disorder, comorbid ADHD is frequently seen, and there is strong evidence to suggest that this pattern has a familial and genetic basis.<br />
Differentiating bipolarity in children with ADHD is not an academic discussion but also a great concern because of the associated complication of<br />
the treatment of these disorders. It is suggested that manic symptoms should represent a distinct change from a child’s usual level of functioning<br />
(e.g., change or worsening of distractibility during a mood episode in children with ADHD). There are some symptoms that mainly occur in BD<br />
youth as compared to other disorders (e.g., ADHD) and may help to differentiate between BD and these disorders, such as clinically relevant<br />
euphoria, grandiosity, decreased need for sleep, hypersexuality (without history of sexual abuse or exposure to sex), and hallucinations. We need<br />
larger longitudinal studies to better understand the risks and resilience factors of developing BP in ADHD youth.<br />
Key words: ADHD, depression, bipolar, child<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S57<br />
Academic and occupational problems in ADHD<br />
Mücahit Öztürk<br />
PEDAM Psikiyatri Merkezi, İstanbul, Turkey<br />
E-mail: mozturkpdm@gmail.com<br />
Attention Deficit Hyperactivity Disorder (ADHD) is a syndrome of inattention, hyperactivity, impulsiveness and other deficits of<br />
executive functions. It’s now well known that ADHD often continues into adulthood (1, 2). ADHD is a chronic disorder which leads to a<br />
negative impact on functioning throughout the life cycle (3). Children with ADHD are at significant risk of multiple forms of adolescent<br />
maladjustment. Approximately up to 60% of childhood cases continue symptomatic into adulthood. In the remaining 40 percent<br />
symptoms may remit in early adulthood (4). The manifestation of ADHD changes over the course of life. In some cases the hyperactivity<br />
may disappear but decreased attention span and impulse control problems persist (5).<br />
Approximately 1 in 25 adults have ADHD, 90% of whom may be currently untreated, with a potentially negative impact on the lives of<br />
patients and their families (6). Significant legal, academic, social, and occupational problems have been observed in adults with ADHD (7).<br />
Follow up studies suggest that up to 33% of ADHD teens versus 1% to 9% of controls drop out high school. Children with ADHD are at<br />
risk of negative academic outcomes. ADHD and similar problems entail a risk of underachievement at school. The results indicate that<br />
students with ADHD underachieve in the school situation in relation to their optimal cognitive capacity (3).<br />
Adolescents with ADHD complete less education by 2-3 years and demonstrate lower occupational performance at the age of 25 years. Adults<br />
with ADHD may struggle with frequent job changes, frequent partner changes, higher rates of divorce, increased motor vehicle accidents,<br />
poor money management and higher rates of unwed pregnancy (8). Although their educational performance is lower than people without<br />
ADHD, their early employment histories don’t differ from those people with similar education (5). Adolescents with ADHD were more likely<br />
to smoke cigarettes and use illicit drugs. Their academic attainment was below age norms with more than one fourth repeating grades (9).<br />
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