Results suggest a positive effect of smoking history on divided attention in schizophrenic patients. This study provides first evidence that the complex attention domain of divided attention is improved by smoking, which further substantiates the self-medication hypothesis of smoking in schizophrenia, although this has been shown mainly for sustained and selective attention. Gender-specific effects on cognition need to be further investigated.

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Background: It is a key concern in psychiatric research to investigate objective measures to support and ultimately improve diagnostic processes. Current gold standard diagnostic procedures for attention deficit hyperactivity disorder (ADHD) are mainly subjective and prone to bias. Objective measures such as neuropsychological measures and EEG markers show limited specificity. Recent studies point to alterations of voice and speech production to reflect psychiatric symptoms also related to ADHD. However, studies investigating voice in large clinical samples allowing for individual-level prediction of ADHD are lacking. The aim of this study was to explore a role of prosodic voice measures as objective marker of ADHD. Methods: 1005 recordings were analyzed from 387 ADHD patients, 204 healthy controls, and 100 clinical (psychiatric) controls. All participants (age range 18-59 years, mean age 34.4) underwent an extensive diagnostic examination according to gold standard methods and provided speech samples (3 min in total) including free and given speech. Paralinguistic features were calculated, and random forest based classifications were performed using a 10-fold cross-validation with 100 repetitions controlling for age, sex, and education. Association of voice features and ADHD-symptom severity assessed in the clinical interview were analyzed using random forest regressions. Results and Conclusion: ADHD was predicted with AUC = 0.76. The analysis of a non-comorbid sample of ADHD resulted in similar classification performance. Paralinguistic features were associated with ADHD-symptom severity as indicated by random forest regression. In female participants, particularly with age < 32 years, paralinguistic features showed the highest classification performance (AUC = 0.86). Paralinguistic features based on derivatives of loudness and fundamental frequency seem to be promising candidates for further research into vocal acoustic biomarkers of ADHD. Given the relatively good performance in female participants independent of comorbidity, vocal measures may evolve as a clinically supportive option in the complex diagnostic process in this patient group.

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Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder, characterized by core symptoms of inattention, hyperactivity and impulsivity. Comorbid depression is commonly observed in ADHD-patients. Psychostimulants are recommended as first-line treatment for ADHD. Aberrant long-range temporal correlations (LRTCs) of neuronal activities in resting-state are known to be associated with disorganized thinking and concentrating difficulties (typical in ADHD) and with maladaptive thinking (typical in depression). It has yet to be examined whether (1) LRTC occur in ADHD-patients, and if so, (2) whether LRTC might be a competent biomarker in ADHD comorbid with current depression and (3) how depression affects psychostimulant therapy of ADHD symptoms. The present study registered and compared LRTCs in different EEG frequency bands in 85 adults with ADHD between groups with (n = 28) and without (n = 57) additional depressive symptoms at baseline. Treatment-related changes in ADHD, depressive symptoms and LRTC were investigated in the whole population and within each group. Our results revealed significant LRTCs existed in all investigated frequency bands. There were, however, no significant LRTC-differences between ADHD-patients with and without depressive symptoms at baseline and no LRTC-changes following treatment. However, depressed ADHD patients did seem to benefit more from the therapy with psychostimulant based on self-report.

ZusammenfassungDie Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter ist mit verhaltensbezogenen und psychopharmakologischen Maßnahmen symptomatisch behandelbar. Die Ätiologie der Störung ist noch nicht zur Gänze geklärt, wobei genetische Faktoren einen großen Stellenwert einnehmen. Neurobiologisch wird ein Defizit dopaminerger und noradrenerger Funktionen modellhaft angenommen. Zur pharmakologischen Behandlung stehen mehrere Substanzen zur Verfügung. Zugelassen sind aktuell in Deutschland zur Neueinstellung im Erwachsenenalter retardierte Methylphenidate (Medikinet® adult, Ritalin® adult) und Atomoxetin (Strattera®). Eine Behandlung mit Methylphenidat retard gilt als erste Wahl. Methylphenidat wird dabei die Wirkung im Sinne eines starken Dopamin- und Noradrenalin-Wiederaufnahmehemmers als ursächlich für den therapeutischen Effekt zugeschrieben. Unerwünschte Wirkungen in der Behandlung mit Methylphenidat ergeben sich vordringlich aus den sympathomimetischen peripheren Effekten. An ein Missbrauchspotenzial und mögliche depressiogene Effekte sollte gedacht werden. Daten aus Langzeitstudien lassen bei guter Verträglichkeit auf eine zuverlässige positive Wirkung auf die Kernsymptomatik, den Komorbiditätsstatus sowie auf assoziierte Probleme bei ADHS schließen. Es besteht weiterhin großer Forschungsbedarf was die Ursachen der Störung sowie die genaue Wirkungsweise der Substanzen angeht.