SYMPOSIA

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