Diagnosis and Treatment of Minimal Brain Dysfunction in Adults

Wood, D.; Reimherr, Frederick W.; Wender, Paul H.; Johnson, Glen E.

doi:10.1001/archpsyc.1976.01770120057005

Cited by 314 publications

(98 citation statements)

References 30 publications

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“…(7)(8)(9)(10) The importance of EL in adult ADHD was established by Wood, Wender and colleagues, who were among the first to describe the syndrome and included affective lability, hot temper, and stress intolerance as core symptoms of the disorder. (11,12) The current diagnostic and statistical manual of mental disorders (DSM-5) describes such emotional symptoms as associated features of ADHD that support the diagnosis. (13) Furthermore, high levels of EL are also observed in ADHD patients who do not present with co-occurring mental health disorders, (7) indicating that the association of EL with ADHD cannot always be accounted for by the presence of comorbid disorders such as bipolar or borderline personality disorders.…”

Section: Introductionmentioning

confidence: 99%

Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis

et al. 2017

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. Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis. European Psychiatry, 44,[198][199][200][201][202][203][204][205][206][207] AbstractBackground: Emotional lability (EL) is an associated feature of attentiondeficit/hyperactivity disorder (ADHD) in adults, contributing to functional impairment. Yet the effect of pharmacological treatments for ADHD on EL symptoms is unknown. We conducted a systematic review and meta-analysis to examine the effects of stimulants and atomoxetine on symptoms of EL and compare these with the effects on core ADHD symptoms. Methods:A systematic search was conducted on the databases Embase, PsychInfo, and Ovid Medline ® and the clinicaltrials.gov website. We included randomised, double-blind, placebo-controlled trials of stimulants and atomoxetine in adults aged 18-60 years, with any mental health diagnosis characterised by emotional or mood instability, with at least one outcome measure of EL. All identified trials were on adults with ADHD. A random-effects meta-analysis with standardised mean difference and 95% confidence intervals was used to investigate the effect size on EL and compare this to the effect on core ADHD symptoms.Results: Of the 3,864 publications identified, nine trials met the inclusion criteria for the meta-analysis. Stimulants and atomoxetine led to large mean weighted effect-sizes for on ADHD symptoms (n=9, SMD= -0.8, 95% CI:-1.07 to -0.53). EL outcomes showed more moderate but definite effects (n=9, SMD= -0.41, 95% CI:-0.57 to -0.25). Conclusions:In this meta-analysis, stimulants and atomoxetine were moderately effective for EL symptoms, while effect size on core ADHD symptoms was twice as large. Methodological issues may partially explain the difference in effect size. Reduced average effect size could also reflect heterogeneity of EL with ADHD pharmacotherapy responsive and non-responsive sub-types. Our findings indicate that EL may be less responsive than ADHD symptoms overall, perhaps indicating the need for adjunctive psychotherapy in some cases. To clarify these questions, our findings need replication in studies selecting subjects for high EL and targeting EL as the primary outcome. Funding: None

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Section: Introductionmentioning

confidence: 99%

Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis

et al. 2017

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“…1 It has long been considered a disorder of childhood that resolve during adolescence with little or no continued percussion in adult life. 2 However numerous studies of children with ADHD suggest that the disease persists during adulthood up to two-thirds of affected children. [3][4][5][6][7][8][9][10][11] Longitudinal follow up studies estimate the prevalence of adult ADHD (aADHD) ranges between 2.5 to 4.9 percent.…”

Section: Introductionmentioning

confidence: 99%

Attention deficit hyperactivity disorder: a short review

Gill

Bhatt

2016

Int J Adv Med

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Attention deficit hyperactivity disorder (ADHD) is a common childhood psychiatric disorder with a prevalence of 4 to 8%. ADHD is characterized by hyperactivity, impulsiveness, and inappropriate inattentiveness. Though long considered a disease of childhood, studies have shown that a majority of cases persist in adulthood causing significant psychosocial impairment. Diagnosis is often based on clinical symptoms, and psychostimulants are mainstay in treatment of ADHD that are often complemented by psychotherapy and behavioural modifications.

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“…Prevalence of adult ADHD is reported as 3.7% and 3.1% in USA and Germany, respectively (7). The effects of psychostimulants in a group of adults who have symptoms of childhood ADHD were first demonstrated by Wood et al (8).…”

Section: Introductionmentioning

confidence: 99%

Bir grup üniversite öğrencisinde dikkat eksikliği ve hiperaktivite bozukluğu semptomları ve mizaç ve karakter profili ile ilişkisi

Akbas¹,

Kılıç²,

Zahmacioglu³

et al. 2015

Dusunen Adam

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Attention deficit and hyperactivity symptoms in a group of university students and relations with temperament and character profilesObjective: In a subgroup of adult patients with a childhood diagnosis of attention deficit and hyperactivity disorder (ADHD), the symptoms decrease but persist at sub-threshold levels, although not fulfilling DSM 5 criteria for ADHD. Diagnostic difficulties, chronicity of the situation and psychiatric comorbidities also increase the risk of personality disorders in this group of patients. The aim of this study is to evaluate the relations between this subgroup of ADHD and personality characteristics in a population who did not attend a clinic for psychiatric problems.Method: Hundred and twenty two of students from different faculties of a university are included in the study. Turgay's Adult ADHD Rating Scale is used to evaluate ADHD symptoms and Cloninger's Character and Temperament Inventory (TCI) is used to evaluate personality characteristics.Results: Moderate levels of ADHD symptoms were present in 14.7% of cases. This group also showed statistically lower scores in cooperativeness and self-directedness in TCI with respect to students who showed low levels of ADHD symptomatology. There were also statistically significant correlations between TCI subgroups and ADHD symptoms.Conclusion: ADHD symptoms should be investigated particularly, as they are temperamental traits for the development of personality characteristics.Keywords: Attention deficit/hyperactivity, character, personality disorders, temperament ÖZET Bir grup üniversite öğrencisinde dikkat eksikliği ve hiperaktivite bozukluğu semptomları ve mizaç ve karakter profili ile ilişkisi Amaç: Çocukluk dikkat eksikliği hiperaktivite bozukluğu (DEHB) tanısı olan bir erişkin hasta alt grubunda belirtiler azalır ama DSM 5 DEHB tanı ölçütlerini karşılamasa da eşikaltı seviyelerde devam etmektedir. Bu gruptaki vakaların tanı koymada yaşanan güçlüklerle birlikte hastalığın süreğen seyri ve psikiyatrik eştanı riskinin artmasıyla birlikte yüksek oranda kişilik bozuklukları geliştirme ihtimali de bulunmaktadır. Bu araştırmada, klinik başvurusu olmayan bir toplulukta erişkin DEHB'nin özellikle eşikaltı belirtilerle seyreden tipinin kişilik özellikleriyle ilişkisini değerlendirmeyi amaçladık.Yöntem: Bir üniversitenin farklı fakültelerinden 122 öğrenci çalışmaya dahil edilmiştir. Olgulara DEHB bulgularını değerlendirmek için Turgay'ın Erişkin DEHB Ölçeği, mizaç ve kişilik özelliklerini değerlendirmek için Cloninger'in Silinecek Mizaç ve Karakter Envanteri (TCI) uygulanmıştır.Bulgular: Olguların %14.7'sinde, orta düzey DEHB belirtileri saptanmıştır. TCI ve DEHB belirtileri arasında yapılan karşılaştırmalarda, orta seviyede DEHB belirtileri gösteren öğrencilerin işbirliği yapma ve kendi kendini yönetme puanları, düşük seviyede DEHB belirtileri gösteren gruba göre istatistiksel olarak anlamlı derecede düşük bulunmuştur. TCI alt tipleri ve DEHB kriterleri arasında da istatistiksel olarak anlamlı korelasyonlar tespit edilmiştir.Sonuç: Öz...

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Diagnosis and Treatment of Minimal Brain Dysfunction in Adults

Cited by 314 publications

References 30 publications

Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis

Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis

Attention deficit hyperactivity disorder: a short review

Bir grup üniversite öğrencisinde dikkat eksikliği ve hiperaktivite bozukluğu semptomları ve mizaç ve karakter profili ile ilişkisi

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