June 30, 2021

ADHDIs A Risk Factor For Type Two Diabetes And High Blood Pressure, As Well As Other Psychiatric Disorders

All Swedish residents have their health records tracked through unique personal identity numbers. That makes it possible to identify psychiatric and medical disorders with great accuracy across an entire population, in this case encompassing more than five and a half million adults aged 18 to 64. A subgroup of more than 1.6 million persons between the ages of 50 and 64 enabled a separate examination of disorders in older adults.
Slightly over one percent of the entire population (about 61,000) was diagnosed with ADHD at some point as an adult. Individuals with ADHD were nine times as likely to suffer from depression as were adults not diagnosed with ADHD. They were also more than nine times as likely to suffer from anxiety or a substance use disorder, and twenty times as likely to be diagnosed with bipolar disorder.  These findings are very consistent with reports from clinical samples in the USA and Europe.
Adults with ADHD also had elevated levels of metabolic disorders, being almost twice as likely to have high blood pressure, and more than twice as likely to have type 2 diabetes. Persons with ADHD but without psychiatric comorbidities were also almost twice as likely to have high blood pressure, and more than twice as likely to have type2 diabetes.
Similar patterns were found in men and women with ADHD, although comorbid depression, bipolar disorder, and anxiety were moderately more prevalent in females than in males, whereas substance use disorder, type 2 diabetes, and hypertension were more prevalent in males than in females.
ADHD was less than a third as prevalent in the over-50 population as in the general adult population. Nevertheless, individuals in this older group with ADHD were twelve times as likely to suffer from depression, anxiety, or substance use disorders, and more than 23 times as likely to be diagnosed with bipolar disorder as their non-ADHD peers. They were also 63% more likely to have high blood pressure, and 72% more likely to have type 2 diabetes.
The authors noted, "Although the mechanisms underlying these associations are not well understood, we know from both epidemiologic and molecular genetic studies that a shared genetic predisposition might account for the coexistence of two or more psychiatric conditions. In addition, individuals with ADHD may experience increased difficulties as the demands of life increase, which may contribute to the development of depression and anxiety." As for associations with hypertension and type 2 diabetes, these "might reflect health risk behaviors among adult patients with comorbid ADHD in addition to a shared biological substrate. As others have noted, inattention, disinhibition, and disorganization associated with ADHD could make it difficult for patients to adhere to treatment regimens for metabolic disorders." They concluded that "Clinicians should remain vigilant for a wide range of psychiatric and metabolic problems in ADHD affected adults of all ages and both sexes."

Qi Chen, Catharina A. Hartman, Jan Haavik, Jaanus Harro, Kari Klungsøyr, Tor­Arne Hegvik, Rob Wanders, Cæcilie Ottosen, Søren Dalsgaard, Stephen V. Faraone, Henrik Larsson, “Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: A population-based cross-sectional study,” PLoSONE (2018), 13(9): e0204516. https://doi.org/10.1371/journal.pone.0204516.

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Patterns of Child and Adolescent Psychiatric Admissions During COVID-19: Key Insights from Clinical Data

A recent study from Istanbul sheds light on how psychiatric admissions and diagnoses changed during the first few months of the pandemic compared to previous periods, offering critical insights for parents, clinicians, and policymakers. 

This study, conducted by a team of researchers led by Ozalp Ekinci, examined psychiatric admissions among children and adolescents during 2019 and 2020. 

By looking at diagnosis rates for various psychiatric conditions, the researchers aimed to pinpoint shifts in the mental health landscape as a direct response to the pandemic.

Findings: A Closer Look at Diagnosis Patterns

The analysis revealed several notable trends in psychiatric diagnoses among children and adolescents:

  1. Autism Spectrum Disorder (ASD): ASD diagnoses were notably higher in the early pandemic phase (6.4% in Group A) compared to the same period in the previous year (3.6%). This increase could reflect heightened stress or changes in routines that may have exacerbated underlying symptoms, leading to more frequent clinical presentations.
  2. Obsessive-Compulsive Disorder (OCD) and Tic Disorders: OCD and tic disorder diagnoses also saw a rise, increasing from 1.7% in 2019 to 2.9% during the pandemic’s onset. It’s possible that pandemic-driven anxieties and hygiene concerns, as well as disruptions to typical routines, may have worsened symptoms in those predisposed to OCD and similar disorders.
  3. Intellectual Disability (ID): Diagnoses for ID rose from 2.1% (Group C) to 3.7% (Group A). This increase highlights the challenges faced by children with developmental and intellectual disabilities, who may have experienced heightened difficulty adapting to the many changes imposed by the pandemic.
  4. Attention-Deficit Hyperactivity Disorder (ADHD): ADHD diagnoses were significantly higher in the pandemic phase (59.8% for Group A vs. 49.7% for Group B). With altered school structures, remote learning, and restricted socialization, ADHD symptoms could have been amplified, making it harder for children to concentrate and adhere to routines.
  5. Depression: Depression diagnoses also saw a rise (4.1% in Group A vs. 2.2% in Group C). Isolation, disruption of daily activities, and reduced social interactions likely contributed to increased depressive symptoms, particularly in adolescents who rely heavily on peer support.
  6. Conduct Disorder (CD): Interestingly, CD diagnoses were lower during the pandemic phase compared to pre-pandemic levels (3.6% in Group A vs. 6.4% in Group B). The reduction in face-to-face interactions and less exposure to traditional school settings may have lessened some of the typical triggers associated with conduct-related issues.
Implications

This study’s findings highlight some key takeaways that can guide mental health support efforts for children and adolescents:

  1. Increased Need for Early Support in Neurodevelopmental Disorders: The rise in ASD and ADHD diagnoses points to the need for specialized support in times of crisis, particularly for children who depend on routine and structure. Families and educators should work to create consistent environments that help manage symptoms.
  2. Addressing Pandemic-Induced Anxiety: With heightened cases of OCD and tic disorders, it’s clear that the pandemic’s emphasis on cleanliness and health may have intensified anxiety-driven behaviors. Future mental health responses should include strategies to manage health-related fears and equip children with coping skills.
  3. Supporting Emotional Resilience in Adolescents: Depression was notably higher among young people during the pandemic onset, suggesting a critical need for access to counseling and peer support, especially in times of isolation. Developing robust virtual mental health resources and promoting mental well-being in schools can help support children and adolescents both in and out of school.
  4. Recognizing the Complexity of Behavioral Changes: The drop in conduct disorder diagnoses during the pandemic suggests a link between behavioral disorders and social settings. Understanding these dynamics could lead to more tailored interventions that account for environmental factors impacting behavior.
Conclusion: 

As we continue to see the effects of the COVID-19 pandemic on mental health, studies like this one serve as important reminders of the unique mental health needs of young people. Supporting children and adolescents through proactive and targeted mental health services—especially during times of crisis—will be crucial to fostering resilience and well-being in future generations.

November 19, 2024

New Global Estimate of Adult ADHD Prevalence: A Comprehensive Review

Adult ADHD has long been a subject of debate in the field of mental health, with previous estimates of its prevalence varying widely. To achieve a more precise understanding, an international team of researchers conducted a new umbrella review and meta-analysis, offering an updated estimate of adult ADHD rates worldwide.

A Comprehensive Approach: Reviewing 57 Studies

This large-scale analysis combined five systematic reviews and meta-analyses, incorporating data from 57 unique primary studies. Altogether, the research synthesized findings from a pooled total of over 21 million participants. This comprehensive approach provided a more accurate estimate of the global prevalence of ADHD in adults.

Key Findings: 3.1% Global Prevalence

The study concluded that the worldwide prevalence of adult ADHD is 3.1%, with a 95% confidence interval ranging from 2.6% to 3.6%. This estimate falls within the range of earlier reports but provides a more targeted understanding of the rate at which ADHD affects adults globally.

Putting the Numbers in Context

The researchers described this prevalence rate as “relatively high.” They noted that it is only slightly lower than the estimated prevalence of major mental health conditions like schizophrenia (4%) and major depressive disorder (5%)—disorders that have historically received significant attention and resources worldwide.

Moreover, the prevalence of adult ADHD is higher than that of several other well-known mental health conditions, including bipolar disorder (1%), as well as anxiety disorders such as PTSD (Post-Traumatic Stress Disorder), OCD (Obsessive-Compulsive Disorder), GAD (Generalized Anxiety Disorder), and panic disorders.

Implications for Awareness and Treatment

This updated estimate emphasizes that ADHD is a significant global mental health concern in adults, comparable to or exceeding the prevalence of other disorders that are often more widely recognized. These findings underscore the need for greater awareness, research, and treatment options for adult ADHD, which is still frequently misunderstood or overlooked in the broader discourse of mental health.

Conclusion

By providing a clearer picture of how prevalent ADHD is in adult populations around the world, this study contributes valuable data that could shape future research, policy, and clinical approaches.

November 8, 2024

Updated Analysis of ADHD Prevalence in the United States: 2018-2021

Attention-Deficit/Hyperactivity Disorder (ADHD) remains a prevalent condition among children and adolescents in the United States. A recent analysis based on the National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics at the CDC, provides an updated look at ADHD prevalence from 2018 to 2021. Here’s a closer look at what the data reveals.

How the Survey Works

The NHIS is an annual survey primarily conducted through face-to-face interviews in respondents’ homes. Telephone interviews are used as a substitute in cases where travel is impractical. For each family interviewed, one child aged 3-17 is randomly selected for the survey through a computer program. Over the four years studied (2018-2021), a total of 26,422 households with children or adolescents participated.

Overall ADHD Prevalence and Age-Related Trends

The analysis found that 9.5% of children and adolescents in the United States had been diagnosed with ADHD, based on reports from family members. However, the prevalence varied significantly with age:

  • Ages 3-5: 1.5%
  • Ages 6-11: 9.6%
  • Ages 12-17: 13.4%

The increase in ADHD diagnosis with age underscores the importance of monitoring children’s developmental needs as they progress through school and adolescence.

Gender Differences: Higher Rates Among Males

The survey revealed a notable difference in ADHD prevalence between genders, with 12.4% of males diagnosed compared to 6.6% of females—nearly a two-to-one gap. This aligns with previous research indicating that ADHD is more frequently diagnosed in boys than girls, though awareness of how ADHD presents differently across genders is growing.

Family Income and ADHD Rates

Family income played a significant role in ADHD prevalence, particularly among lower-income groups:

  • Below the poverty line: 12.7%
  • Above the poverty line but less than twice that level: 10.3%
  • Above twice the poverty level: 8.5%

This pattern suggests that socioeconomic factors might influence the diagnosis and management of ADHD, with lower-income families possibly experiencing greater barriers to early diagnosis or consistent treatment.

Regional Differences Across the U.S.

Geographic location also impacted ADHD rates. Prevalence was highest in the South (11.3%), followed by the Midwest (10%), the Northeast (9.1%), and significantly lower in the West (6.9%). These variations could reflect regional differences in healthcare access, diagnostic practices, or cultural attitudes towards ADHD.

Stability Over Time

Despite these variations in demographics, the overall prevalence of ADHD remained relatively stable across the study period from 2018 to 2021, showing no significant changes by year.

What This Means for Families and Healthcare Providers

The findings from this updated analysis provide a clearer picture of ADHD’s prevalence across different demographic groups in the United States. They highlight the need for tailored approaches to diagnosis and care, taking into account factors like age, gender, income, and geographic location. With ADHD being a common condition affecting nearly 1 in 10 children, ongoing research and support for families are crucial to ensure that those with ADHD receive the care and resources they need.

Conclusion: 

This study reinforces the importance of awareness and early intervention, especially for families in underserved regions or those facing economic challenges. As clinicians and educators continue to support children with ADHD, understanding these demographic trends can help in creating more equitable access to diagnosis and treatment.

October 29, 2024