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Psychotic Symptoms in Attention-Deficit/Hyperactivity Disorder: An Analysis of the MTA Database.

ABSTRACT: OBJECTIVE:To assess the prevalence of psychotic symptoms among youths (14-25 years of age) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type. METHOD:Participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed. RESULTS:Data were available from 509 MTA participants (88% of original MTA sample; mean age 25.1 years) and 276 LNCG participants (96% of original sample; mean age 24.6 years) at year 16. Twenty-six MTA participants (5%; 95% CI 3-7) and 11 LNCG participants (4%; 95% CI 2-6) screened positive for at least 1 psychotic symptom (p = .60). Most psychotic symptoms were transient. The prevalence of clinician-confirmed psychotic symptoms was 1.1% (95% CI 0.2-2.1) in the MTA group and 0.7% (0-1.7) in the LNCG (p = .72). Greater cannabis use was reported by those who screened positive (p < .05) and were confirmed positive (p < .01). CONCLUSION:There was no evidence that ADHD increased the risk for psychotic symptoms. In the ADHD and normative comparison groups, more frequent cannabis use was associated with a greater likelihood of experiencing psychotic symptoms, thus supporting the recommendation that youth should not use cannabis.

SUBMITTER: Vitiello B

PROVIDER: S-EPMC5367469 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Psychotic Symptoms in Attention-Deficit/Hyperactivity Disorder: An Analysis of the MTA Database.

Vitiello Benedetto B Perez Algorta Guillermo G Arnold L Eugene LE Howard Andrea L AL Stehli Annamarie A Molina Brooke S G BS

Journal of the American Academy of Child and Adolescent Psychiatry 20170204 4

<h4>Objective</h4>To assess the prevalence of psychotic symptoms among youths (14-25 years of age) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type.<h4>Method</h4>Participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis sc ...[more]

PMID: 28335878

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Project description:Background:For the diagnosis of attention-deficit/hyperactivity disorder (ADHD), the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes that adherence to six symptoms in either group (inattention and hyperactivity/impulsivity) will lead to the diagnosis of one of three presentations of the disorder. Underlying this diagnostic algorithm is the assumption that the 18 symptoms have equal relevance for the diagnosis of ADHD, all are equally severe, and all have the same power to detect the presence of the disorder in all its degrees of severity, without considering the possibility of using marker symptoms. However, several studies have suggested that ADHD symptoms differ in both their power to discriminate the presence of the disorder and the degree of severity they represent. The aim of the present study was to replicate the results of previous research by evaluating the discriminative capacity and relative severity of ADHD symptoms, as well as to extend the investigation of this topic to Spanish-speaking Latin American samples. Methods:The properties of ADHD symptoms rated by the parents of 474 Chilean children were analyzed. Symptom parameters were estimated using the graded response model. Results:The results suggest that symptoms of ADHD differ substantially in both the accuracy with which they reflect the presence of the disorder, and their relative severity. Symptoms "easily distracted by extraneous stimuli" and "have difficulty sustaining attention in tasks" (inattention) and "is on the go, acting as if driven by motor" (hyperactivity/impulsivity) were the most informative, and those with relatively lower severity thresholds. Discussion:The fact that symptoms differ substantially in the probability of being observed conditionally to the trait level suggests the need to refine the diagnostic process by weighting the severity of the symptom, and even to assess the possibility of defining ADHD marker symptoms, as has been done in other disorders.

Dataset Information

Psychotic Symptoms in Attention-Deficit/Hyperactivity Disorder: An Analysis of the MTA Database.

Publications

Psychotic Symptoms in Attention-Deficit/Hyperactivity Disorder: An Analysis of the MTA Database.

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