Attention Deficit Hyperactivity Disorder Among Youth at Clinical High Risk of Psychosis.

Schizophrenia bulletin open Pub Date : 2024-11-06 eCollection Date: 2024-01-01 DOI:10.1093/schizbullopen/sgae028
Amy Braun, Lu Liu, Carrie E Bearden, Kristin S Cadenhead, Barbara A Cornblatt, Matcheri Keshavan, Daniel H Mathalon, Diana O Perkins, William S Stone, Ming T Tsuang, Elaine F Walker, Scott W Woods, Tyrone D Cannon, Jean Addington
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Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) affects a significant proportion of the population and is associated with numerous adverse outcomes including lower educational attainment, occupational challenges, increased substance use, and various mental health issues including psychosis. This study examined the demographic, clinical, cognitive, social cognitive, and functional differences between youth at clinical high-risk (CHR) for psychosis with and without comorbid ADHD.

Method: Data were drawn from the North American Prodrome Longitudinal Studies (NAPLS2 and NAPLS3), which included 764 and 710 CHR individuals, respectively. After applying exclusion criteria, the sample consisted of 271 CHR participants with ADHD and 1118 without ADHD. All data were examined cross-sectionally.

Results: Compared with the non-ADHD group, the ADHD group was younger, had more difficulties with role functioning, premorbid functioning, and social cognition, were more likely to have a comorbid learning disorder, and reported less depression symptoms. There were no significant differences between the groups on positive or negative psychotic symptoms, transition rates, adverse events, or other comorbid disorders including substance use and depression.

Discussion: Comorbid ADHD is likely not a significant predictor of transition to psychosis among CHR youth; however, those CHR with ADHD may experience symptoms at a younger age than those without and present with a distinct clinical profile.

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精神病临床高危青少年中的注意缺陷多动障碍。
背景:注意力缺陷多动障碍(ADHD)影响着很大一部分人口,并与许多不良后果相关,包括教育程度降低、职业挑战、药物使用增加以及包括精神病在内的各种心理健康问题。本研究调查了患有和未患有多动症的精神病临床高危(CHR)青少年在人口统计学、临床、认知、社会认知和功能方面的差异:数据来自北美前驱期纵向研究(NAPLS2 和 NAPLS3),其中分别包括 764 名和 710 名临床高危精神病患者。在应用排除标准后,样本包括271名患有多动症的CHR参与者和1118名不患有多动症的CHR参与者。所有数据均为横截面数据:与非多动症组相比,多动症组更年轻,在角色功能、病前功能和社会认知方面有更多困难,更有可能合并学习障碍,并且报告的抑郁症状较少。在阳性或阴性精神病症状、转归率、不良事件或其他合并症(包括药物使用和抑郁症)方面,两组之间没有明显差异:讨论:合并多动症可能并不是预测青少年精神病患者向精神病过渡的重要因素;但是,与不合并多动症的青少年精神病患者相比,合并多动症的青少年精神病患者可能会在更小的年龄出现症状,并表现出独特的临床特征。
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